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[Official Guidance]
Text of CMS Guidance: Netting of Issuer Payments and Charges Under Various ACA Provisions (PDF)
Unnumbered document dated July 15, 2016. "CMS has a policy of netting ... payments and charges ... under the premium stabilization programs, including risk adjustment.... A State department of insurance may reasonably notify CMS that an issuer will be required to end coverage if advance payments are netted, but that if CMS refrains from netting such payments, continued coverage would -- in the State's view -- be in the best interest of the enrollees or the market. In those cases, CMS will refrain from netting advance payments for the months for which the coverage would otherwise have been terminated."
(Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])
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[Guidance Overview]
Incorrect TINs: A Workable Solution for the Dreaded AIRTN500 Error Message
"The IRS has made it clear to us that ... if an AIRTN500 error message is received for a Form 1095-C (through the UniqueRecordId), each individual on that Form 1095-C will need to have his or her TIN verified. For an employer to fulfill its obligations under section 301.6724-1(f) the cumbersome solicitation procedures would need to be followed. The approach suggested in [this article] may be the best way to minimize an employer's solicitation obligation."
(Health Care Attorneys P.C.)
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[Guidance Overview]
New ACA Regs Will Require Covered Entities Providing Healthcare Programs and Services to Have Accessible Websites
"Effective July 18, 2016, a new 'meaningful access' rule interpreting the [ACA's] Section 1557 Anti-Discrimination requirements will require providers of health care programs and services that receive federal financial assistance to comply with new requirements for effective communication, including accessible electronic information technology.... HHS did not specify a website accessibility standard in the new rule. However, the agency said that compliance with accessibility requirements would be 'difficult' for covered entities that do not comply with 'standards such as the WCAG 2.0 AA standards or the Section 508 standards.' "
(Sheppard Mullin)
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[Guidance Overview]
OCR Releases HIPAA Guidance on Ransomware
"The guidance states that the presence of any malware, including ransomware, on the device of a covered entity or business associate 'is a security incident' under the HIPAA regulations. Business associates who are targeted by ransomware should review the requirements of their business associate agreements with respect to when and how they are required to report security incidents to the covered entities with which they contract. In addition, the OCR [description of] the new guidance states that a ransomware attack 'usually' results in a breach of unsecured PHI."
(Nixon Peabody LLP)
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Health Savings Accounts: How and When a Participant Should Make a Contribution
"Learn before the beginning of the plan year the amount and timing of your employer contribution so that you can plan your personal contributions accordingly. Plan to make pre-tax payroll contributions if your employer offers a Cafeteria Plan. You should begin the discipline of regular HSA deposits. Check to see whether your employer has set up a negative election, Most do not, but some do. Review your contributions before the end of the calendar year to make sure that you have not made an excess contribution (and correct the excess contribution if you have made one)."
(Xerox HR Insights)
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Insurers, Pushing for Higher Rates, Challenge Key Component of Health Law
"Federal officials defer to the insurance commissioners in 46 states deemed to have 'effective rate review' programs. But in Missouri, Oklahoma, Texas and Wyoming, the federal government is in charge of reviewing rates.... In Texas, Blue Cross and Blue Shield is requesting rate increases of nearly 60 percent for 2017. In Oklahoma, Blue Cross and Blue Shield has proposed increases that average 49 percent. And in Missouri, Humana has filed for a 34 percent increase. All three carriers say they have lost money on many policies sold to individuals and families under the [ACA]. Such large requests are not typical and will test the rate review process[.]"
(The New York Times; subscription may be required)
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[Opinion]
Obamacare Panic Prompted Administration's Lawlessness
"Senior Obama administration officials took a series of decisions beginning in late 2013 that ranged from the reckless to the illegal in an effort to keep insurers participating in health insurance exchanges. A report issued last week jointly by the House Ways and Means and Energy and Commerce committees explores how the administration came to unlawfully funnel $7 billion in unappropriated money to insurers through a single ObamaCare program."
(The Hill)
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Benefits in General
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Are Federal Pay and Benefits Too Generous?
"[Personnel reforms proposed by The Heritage Foundation] included: [1] Requiring new federal hires and employees with between five and 25 years of service to pay more for their retirement benefits by decreasing the government contribution.... [2] Requiring federal workers to shoulder more of their health care costs under the Federal Employees Health Benefits Program [FEHBP].... [3] Eliminating the FEHBP government contribution for retiree health benefits for new hires.... Federal employee unions took issue with the proposals."
(Government Executive)
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Executive Compensation and Nonqualified Plans
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[Guidance Overview]
Proposed Changes to Sec. 409A Are Welcome (For the Most Part)
"Some of the proposed changes include: [1] Modification of the short-term deferral exception to permit a delay in payments to avoid violating federal securities laws or other applicable law.... [2] Revision of the rules to allow pre-employment equity grants to be exempt from Section 409A.... [3] Modification of the rules regarding recurring part-year compensation.... [4] Addition of a rule regarding when payment has been made.... [5] Clarification of certain rules permitting payments in connection with the termination and liquidation of a plan not made in connection with a change in control.... [6] Limitation on ability to make corrections of unvested amounts under the proposed income inclusion regulations."
(Jackson Lewis P.C.)
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[Guidance Overview]
Unraveling New Proposed Regs on Non-Qualified Deferred Comp Under Sec. 457
"Because of the retroactive application of the proposed regulations, tax-exempt employers should begin now to take an inventory of all deferred compensation programs that are not clearly designed to comply with the qualified plan rules ... Once these plans have been identified, employers should work with counsel to determine whether any of these plans require modification to comply with 457(f) or to comply with the bona fide severance pay plan requirements to ensure these plans are exempt from or comply with Section 457 and Section 409A."
(Holland & Hart LLP)
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David Rhett Baker, J.D., Editor and Publisher
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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2016 BenefitsLink.com, Inc. All materials
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