Health & Welfare Plans Newsletter

August 19, 2016

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Employee Benefits Jobs

401(k) Consultant
Creative Retirement Systems
in OH, Telecommute

Distribution Representative
Professional Capital Services
in PA

Sr. Client Services Manager
Arthur J Gallagher
in TX

Defined Benefit Analyst
OneAmerica Financial Partners
in IN, Telecommute

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Webcasts and Conferences

Everything You Always Wanted to Know About Social Security, But Were Afraid to Ask
September 15, 2016 WEBCAST
Worldwide Employee Benefits Network [WEB] - New York Chapter

Affordable Care Act Compliance Workshop
September 16, 2016 WEBCAST
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

Excel 401(k): The Advisorsí Conference
October 2, 2016 in NV
Rekon Event Management

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[Official Guidance]

Text of IRS Rev. Proc. 2016-28: Inflation Adjusted Amounts for Health Savings Accounts (HSAs) (PDF)
"For calendar year 2017, the annual limitation on deductions ... for an individual with self-only coverage under a high deductible health plan is $3,400. For calendar year 2017, the annual limitation on deductions ... for an individual with family coverage under a high deductible health plan is $6,750.... For calendar year 2017, a 'high deductible health plan' is ... a health plan with an annual deductible that is not less than $1,300 for self-only coverage or $2,600 for family coverage, and the annual out-of-pocket expenses ... do not exceed $6,550 for self-only coverage or $13,100 for family coverage."
Internal Revenue Service [IRS]

[Advert.]

Changes to Cafeteria Plans: What You Need to Know to Prepare

Sponsored by Lorman and BenefitsLink

September 21 webinar. Explores design choices available within the regulatory framework established by the IRS, and provides tools to ensure that cafeteria plan design, documentation and administration are in compliance with applicable requirements.


[Official Guidance]

Text of IRS Rev. Proc. 2016-43: National Average Bronze Level Premium for Purposes of Individual Shared Responsibility Payment for 2016 (PDF)
"This revenue procedure provides the [2016] monthly national average premium for qualified health plans that have a bronze level of coverage and are offered through Exchanges for taxpayers to use in determining their maximum individual shared responsibility payment ... [T]he monthly national average premium ... is $223 per individual.... [and] $1,115 for a shared responsibility family with five or more members.... This revenue procedure is effective for taxable years ending after December 31, 2015."
Internal Revenue Service [IRS]

[Official Guidance]

Tax Year 2016 Schemas and Business Rules for ACA Information Returns (AIR)
"The links [on this page] provide information and technical guidance for software developers and transmitters who are interested in developing software for AIR for Tax Year 2016. Included are the XML Schemas, Business Rules and Release Memorandums."
Internal Revenue Service [IRS]

[Guidance Overview]

IRS Issues Draft Instructions for 2016 ACA Reporting Forms
"Highlights from the draft instructions include: [1] Confirmation that certain transition relief, including the transition penalty relief, is no longer available to ALEs.... [2] Clarification that the number of FTEs to be reported in Part III of Form 1094-C must be based on the employer shared responsibility penalty provisions and the regulations thereunder. [3] New 'Offer of Coverage' codes ... [4] Confirmation that the specialized coding for ALEs subject to the multiemployer plan interim rule reporting will remain in effect for 2016."
The Wagner Law Group

Verdict for Fired Employee's FMLA Retaliation Claim Based Only on Temporal Proximity Can't Stand
"[T]he Sixth Circuit ... explained that where a plaintiff's evidence of retaliatory animus ultimately rests solely on temporal proximity, a jury's verdict in favor of the plaintiff cannot stand. The court remanded for an entry of judgment in favor of [the employer]." [Hartman v. Dow Chemical Co., No. 15-2318 (6th Cir. Aug. 16, 2016, unpub.)]
Wolters Kluwer Law & Business

[Advert.]

11th Executive Forum on On-Site and Near-Site Employee Health Clinics - Sept. 12-13, 2016 - Orlando, FL

Sponsored by World Congress

Employers & wellness execs exchange ideas & gain the latest insight on building, maintaining, & innovating on-site care. Promo Code BLINK2 takes $200 off your registration (May not combine w any other offer. Not valid twd Govt Rate/Workshop Only/Webcast


CMS Examines Inappropriate Steering of People Eligible for Medicare or Medicaid Into Marketplace Plans
"[CMS is] seeking public comment on concerns that some health care providers and provider-affiliated organizations may be steering people eligible for, or receiving, Medicare and/or Medicaid benefits into [ACA]-compliant individual market plans, including Health Insurance Marketplace plans, for the purpose of obtaining higher reimbursement rates. CMS also sent letters to all Medicare-enrolled dialysis facilities and centers informing them of this announcement."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Medicare Part D Spending Up More Than 17% in 2014
"Drug costs increased more than 17 percent from 2013 to 2014, compared to a 3.3 percent increase in the total cost of claims, according to Medicare Part D data released by [CMS] ... Insulin products Lantus Solostar and Lantus led the way in having the highest increased rates of 47 and 32 percent, respectively. Drugs Abilify (to treat depression, schizophrenia and bipolar disorder), Januvia (Type 2 diabetes) and Revlimid (anemia and myeloma) followed with rates of 20 percent or higher."
Healthcare Finance News

Health Care Provider/Payor Integration: 2016 Is Not the 1990s
"While many of the factors that drove hospitals and health systems to establish [Provider-Sponsored Health Plans (PSHPs)] are again present in today's health care market, the drive to move away from fee-for-service payment systems has heightened the desire of many hospitals and health systems move back into the PSHP business in order to gain control of the full premium dollar."
McDermott Will & Emery, via National Law Review

Where Insurers' Exits Are Hurting Obamacare Exchanges, and Where They Aren't
"Many major metropolitan areas, such as those in California, New York and Texas, will still have several insurers for individual health insurance consumers to choose from. In Texas, all major metro areas ... including Austin, Dallas, Houston and San Antonio -- will have at least three insurers after Aetna and UnitedHealthcare exit. That's true also for most urban exchange customers living in the Northwest, the Midwest and New England. Most hurt will be marketplace consumers in Arizona, North and South Carolina, Georgia and parts of Florida, where only one or two insurers will be left when open enrollment season begins Nov. 1."
National Public Radio

[Opinion]

A Dull EDGE: The Administration Believes Obamacare's Costs Went Down!
"[CMS] has just made the remarkable claim that medical costs paid by health insurers operating in Obamacare's exchanges declined in 2015 from 2014 ... The report compares apples to oranges. When discussing the change in costs in the exchange, it estimates medical claims. When discussing changes in employer-sponsored health insurance, it estimates premiums (which increased 3 percent). The average Obamacare premium increased 5.2 percent in 2015, more than employer-sponsored coverage."
National Center for Policy Analysis Health Policy Blog

Benefits in General

Insights for Optimizing Your Employee Benefits Program (PDF)
12 pages. "Benefits optimization is an approach to designing a portfolio of employee benefits that maximizes desired workforce outcomes against a given benefits budget.... Further enabling employers to refine their approach to benefits optimization is the increased availability of data and analytics, which represents a powerful tool that employers can use to learn more about the employee base, gain a better understanding of the types of benefits employees need at various life stages, and predict financial behaviors. These capabilities can be harnessed to design benefit plans, educational programs, and communications materials to drive desired employee behaviors and outcomes."
Prudential

Press Releases

DOL Sues Blue Bell, Pennsylvania, Employee Benefit Plan Service Provider for Mismanaging Multiple 401(k) Plans
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

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Lois Baker, J.D., President  loisbaker@benefitslink.com
David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
Holly Horton, Business Manager  hollyhorton@benefitslink.com

BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2016 BenefitsLink.com, 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 BenefitsLink.com, 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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