Health & Welfare Plans Newsletter

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[Official Guidance]

Instructions for the HHS-Developed Risk Adjustment Model Algorithm 'Do It Yourself (DIY)' Software (PDF)
19 pages. "This document provides instructions for the HHS risk adjustment models for the 2016 benefit year, with revisions from the software instructions posted on the CCIIO website on October 19, 2015." [Also available: Technical Details (Excel) and SAS Version of HHS-Developed Risk Adjustment Model Algorithm Software (zip file).]  Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]


ECFC's 29th Annual Administration Symposium Coming This August Sign Up Now!

Sponsored by ECFC [Employers Council on Flexible Compensation]

ECFC's Flexible Benefit Administrators' Symposium is the premier networking and professional development event for the consumer-directed benefits industry: get advice, technical education, and Congressional and regulatory updates from industry leaders.

[Guidance Overview]

IRS Publishes Draft ACA Reporting Forms for 2016
"[T]he instructions for 2016 [are expected] to clarify the definition of a conditional offer to a spouse. The instructions will also include any additional codes in Series 2 for 2016. Reporting systems may be able to streamline the data collection process and formulas used to populate the forms, resulting in fewer errors. Nevertheless, employers should use the remaining months in 2016 to ensure data is accurate and uploaded timely to a vendor's system."  Hill, Chesson & Woody

[Guidance Overview]

New Proposed Rules on ACA Opt-Out Payments
"If [certain specified] requirements are satisfied, the Opt-Out Payment is not required to be added to the employee's premium to determine if the insurance is affordable. It is also not required to be reported as a required employee contribution on Form 1095-C. In the event the alternate coverage of an employee or a member of his tax family terminates before the end of a plan year, the employer may continue to exclude the Opt-Out Payment from the determination of affordability for the remainder of that plan year."  Clifton Budd & DeMaria, LLP

How the DOL Fiduciary Rule May Impact HSA Administration
"Employers whose employees have HSAs were not the main targets of the regulations, and in most cases these rules will not increase potential risk or liability to employers ... However, employers may be impacted by the rule if they provide to their employees information about HSAs that crosses the line from general investment education to investment advice, or if they benefit from the advice being given."  PLANSPONSOR

Health Savings Account Limits to Increase for Some in 2017
"Individuals will be allowed to contribute a maximum $3,400 to an HSA in 2017, a mere $50 more than this year. The maximum contribution for family coverage next year of $6,750 is unchanged from 2016. That's the good news. The bad news affects people who purchase their health insurance through their state or federal health insurance exchanges. New rules will make it virtually impossible for anyone to find an HSA-compatible plan on the government exchanges starting next year."  InvestmentNews


Employers and Providers: Strategic Opportunities and Partnerships Forum - Sept. 12, 2016 - Orlando, FL

Sponsored by World Congress

Explore value-based collaborations and partnerships and innovations in direct-contracting to meet employer needs. Promo Code BLINK2 takes $200 off your registration May not combine w any other offer. Not valid twd Govt Rate/Workshop Only/Webcast.

It Pays to Shop Around for HSAs
"The most attractive option for workers who wish to use their HSAs to pay for medical expenses in retirement may be to find an HSA provider that offers a low-fee fund lineup. However, how steep of a price are workers participating in HSAs with suboptimal or expensive funds paying?"  Morningstar

When Big Insurance Companies Merge, Who Benefits?
"Eliminating competition between Aetna and Humana, and Anthem and Cigna, would reduce choices and lead to higher premiums for thousands of consumers, many of whom could not afford health insurance purchased off the public exchanges, the Justice Department said in its lawsuits ... The Justice Department said it likely would also lead to increases in the amount of financial assistance offered through the public exchanges, harming taxpayers as well. The four insurance companies say the mergers will increase health care innovations while keeping costs more affordable because of reduced operation costs."

Price Transparency Websites Need to Be Simple, Help Patients Interpret the Data
"[A recent] report ... showed 43 states failing when it comes to price transparency. Only three states in the country scored high marks ... Louisiana and Washington have enacted all-payer claims database legislation, but don't have functioning websites yet to publish the data. Once those are in place, and if they are well-designed, you could see very different grades for the states next year."  Healthcare Finance News

Benefits in General

[Guidance Overview]

Agencies Publish Proposed Revisions to Form 5500 and Schedules (PDF)
"The proposed Form and Schedules have been annotated by the Agencies to note 'New' line items. A rough count of 'New' lines ... [1] Form 5500: 30 line items; [2] Schedule A: 6 line items; [3] Schedule C: 12 line items; [4] Schedule H: Well over 150 lines and sublines -- detailed breakouts of assets and investments; [5] Schedule MB: 11 line items; [6] Schedule R: 25 lines or sub lines; [7] Schedule J: all new -- over 100 line and sublines."  United Actuarial Services, Inc.

Group Proposes $333 Billion in Cuts to Feds' Pay and Benefits
"Federal employees are overpaid because the government operates independently of market pressures, according to [The Heritage Foundation], which proposed $333 billion in savings over the next decade aimed at federal personnel costs.... [The] Foundation proposed $26 billion in cuts specifically to federal employees' pay, which researchers argued far outpaces that of the private sector. The rest of the savings came from proposed reforms to retirement benefits, paid leave and health care."  Government Executive

Press Releases

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2016, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of, Inc., or in the case of third party materials, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of the content.

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