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[Guidance Overview]
ERISA Non-Compliance Just Became More Costly (and May Become More Complicated)
"The DOL released interim final rules adjusting the ERISA civil monetary penalties for inflation, and also announced proposed major revisions to the Form 5500 annual return.... [F]ailure to timely file the Form 5500 previously carried a penalty of up to $1,100 per day. The new adjusted penalty amount is up to $2,063 per day.... [A]ll Plan Sponsors would be required to file the Form 5500 -- regardless of plan size. Currently, most health and welfare plans with fewer than 100 covered participants on the first day of the plan year are not required to file a Form 5500.... The other major proposed change is a new Schedule J, which would apply to all group health plans.... The proposed changes are complex and would significantly increase the reporting obligations for health and welfare plan sponsors."
ABD Insurance & Financial Services
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[Guidance Overview]
Proposed Rule Affects Opt-Out Payments to Employees Who Decline Health Coverage
"To avoid having to increase the required contribution by the amount of the opt-out payment, the arrangement must meet specific requirements. Employers with calendar-year plans will need to act quickly to implement necessary changes. Employers also need to review their flex credit programs[.]"
Segal Consulting
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[Guidance Overview]
San Diego Sick Leave Amendments: Cure for -- or Cause of -- Employer Ills?
"San Diego's Earned Sick Leave and Minimum Wage Ordinance has been amended less than two months after its July 11, 2016 effective date. The amendments ... plug gaps the original law created, create an administrative enforcement system for receiving and resolving complaints, and impose additional obligations that require employers to review and potentially revise their notices, policies, and procedures.... [T]he amendments ... will take effect September 2, 2016."
Littler
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2016 Midyear HSA Research Report
"The number of HSA accounts rose to 18.2 million, holding over $34.7 billion in assets, a year over year increase of 22% for HSA assets and 25% for accounts for the period of June 30, 2015 to June 30, 2016.... HSA investment assets reached an estimated $4.7 billion in June, up 23% year over year. The average investment account holder has a $15,092 total balance (deposit and investment account)."
Devenir
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Hidden Plan Exclusions May Leave Gaps In Women's Care
"Buried in the fine print of many marketplace health plan documents is language that allows them to refuse to cover a range of services ... [S]ome women with hereditary breast and ovarian cancer, advocates say, may have gaps in care because of the exclusions."
Kaiser Health News
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Medical Providers Try Uber, Lyft for Patients with Few Transportation Options
"For people without access to private transportation, getting to medical appointments can be a challenge ... Some hospitals and medical providers think that ... ride-hailing services such as Uber and Lyft -- can address this problem by making the trips easier and, in some cases, it is even covered by Medicaid and other insurance plans. Partnerships between ride-hailing companies and hospitals are emerging around the country. While the efforts are still small, some hospitals and medical transportation providers think the potential for growth is large."
Kaiser Health News
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One in Five New York Companies Say They're Hiring Fewer People Because of ACA
"20.9% of manufacturing firms in the state said they were employing fewer workers because of the [ACA] ... while 16.8% of respondents in the service sector said the same.... Firms responding to the New York Fed survey said they anticipated an 8% increase in healthcare costs for 2016 and a 10% increase in 2017.... The most popular adjustments being made by both sectors included raising out-of-pocket costs for employees, increasing deductibles, and increasing total premiums."
Business Insider
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Insurer Exits from ACA Exchanges Turn Few Choices Into None
"Later this year, residents of Pinal County, Arizona, who go shopping for health insurance under Obamacare will face a peculiar dilemma -- they'll have to buy a product that may not exist. The 400,000-population county southeast of Phoenix currently doesn't have a single health insurer offering coverage next year on the [ACA]'s exchanges, where Americans can shop for the insurance they're required to have under the law.... Pinal County is just one place around the country where Americans will be left with few, if any, choices for coverage."
Bloomberg
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Aetna Had Warned It Might Leave ACA Exchanges If Humana Merger Was Blocked
"Aetna warned the Obama administration in July that it would withdraw from some [ACA] exchanges if officials moved to block its proposed merger with rival Humana ... 'Unfortunately, a challenge by the DOJ to that acquisition and/or the DOJ successfully blocking the transaction would have a negative financial impact on Aetna and would impair Aetna's ability to continue its support, leaving Aetna with no choice but to take actions to steward its financial health,' the letter read."
Morning Consult
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[Opinion]
A New Take on Premium Trends Gets Pushback from ACA Critics
"Loren Adler and Paul Ginsberg of the Brookings Institution argue ... that premiums would have risen faster without the ACA -- and that the benefits are much more robust than in the old individual market. And that doesn't even take into account subsidies for premiums and, for many, cost sharing.... [C]ritics of the law ... point out that even if the Brookings numbers are right -- that this insurance is cheaper than such a policy would have cost pre-2014 -- it misses the point that a lot of people don't want this insurance."
Association of Health Care Journalists
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[Opinion]
Another Obamacare Architect Recognizes Its Unintended Consequences
"Dr. Bob Kocher, an Obamacare architect turned venture capitalist, has admitted the law has had a significantly negative unintended consequence ... Back in 2009 and 2010, Dr. Kocher believed that the consolidation of physicians and hospitals into large health systems would lead to higher quality care at lower cost. As Dr. Kocher notes, the systems are consolidating, but they are not hitting cost and quality targets. Instead, smaller, physician-led practices do better at such improvements."
National Center for Policy Analysis Health Policy Blog
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[Opinion]
Aetna to Withdraw from Nearly 70 Percent of Its Obamacare Exchanges
"Aetna's forthcoming withdrawal is the latest blow for the ACA, whose insurers argue that they have been overwhelmed by pools that don't include enough healthy members to balance out heavier users. 'Back when UnitedHealth was the only insurance company bailing out, it was easy to dismiss as just one company trying to boost its bottom line,' wrote Bloomberg's Max Nisen ... 'But when all five big insurers are bleeding money, it's clear you've got bigger problems.' "
The Atlantic
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[Opinion]
The ACA Six Years Later: Success or Failure?
"There are a few aspects of the ACA that make sense, including the electronic delivery of prescriptions and the ability for people with pre-existing conditions to obtain coverage. But there are also unintended consequences. The healthcare cooperatives have largely been a failure and the rapid consolidation of healthcare providers is concerning to both regulators and consumers.... While plans may be available to all, they are rapidly becoming unaffordable to those that most need coverage. Six years later, some 30 million Americans are still uninsured."
BDO Center for Healthcare Excellence and Innovation
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Press Releases
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BenefitsLink.com, Inc.
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Winter Park, Florida 32789
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Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager
BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2016 BenefitsLink.com, Inc. All materials
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