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[Guidance Overview]
ACA Reporting by Employers for Self-Insured Plans
"If an individual is covered by multiple plans providing minimum essential coverage offered by the same provider, reporting is only required for one of the plans or programs.... If [an individual covered under multiple plans] drops one type of coverage ... the employer must report coverage under the [remaining plan] for the months after dropping the [first type of] coverage.... Employers also do not need to report self-insured coverage offered to an employee if that coverage would be supplemental to the employee's primary coverage under Medicare, TRICARE, Medicaid or another plan the employer offers."
Liebert Cassidy Whitmore
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[Guidance Overview]
Are Foreign Nationals on H-1B Work Visas Eligible for FMLA Leave?
"Placing an H-1B worker on an unpaid leave without authorization creates substantial risk, as an employer becomes susceptible to a back wage and/or front pay award by the [DOL].... The Immigration and Naturalization Services (INS) and DOL have made it clear that H-1B workers are entitled to FMLA leave on the same terms as U.S. citizens, whether the leave is paid or unpaid under the employer's policies. So, an H-1B worker can request and be approved for an unpaid FMLA leave on the same terms as the employer's U.S. workers. Of course, whether the leave is paid depends on the employer's policies for paid leave."
FMLA Insights
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[Guidance Overview]
Text of IRS PMTA 2016-12: Calculation of Premium Tax Credit for Fiscal Year Taxpayers (PDF)
"In determining whether [Individual 'A', a fiscal year taxpayer whose taxable year ends June 30,] is eligible for affordable employer coverage, A uses the uses the required contribution percentage that applies to plan years beginning in 2015, 9.56 percent, to determine if the coverage is affordable for the months July 1, 2015 through December 31, 2015, and uses the required contribution percentage that applies to plan years beginning in 2016, 9.66 percent, to determine if the coverage is affordable for the months January through June 2016.... In determining [the tax liability of Individual 'B', a fiscal year taxpayer whose taxable year also ends June 30,] for excess advance payments for the taxable year ending June 30, 2016, B uses the repayment limitation in effect for taxable years beginning in 2015[.]" [Program Manager Technical Advice, dated
Mar. 17, 2016; published online Aug. 31, 2016.]
Internal Revenue Service [IRS]
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[Guidance Overview]
Text of IRS PMTA 2016-10: Limitations on Coverdell ESA Rollovers (PDF)
"There is no published guidance interpreting the Section 530(d)(5) limitation on rollovers. However, Publication 970, Tax Benefits for Education, states that only one rollover per Coverdell ESA is allowed during a 12-month period. In light of the similarity of the language of Sections 408(d)(3)(B) and 530(d)(5), we believe that, with respect to rollovers described in Section 530(d)(5), only one rollover per individual per year is permitted." [Program Manager Technical Advice, dated Dec. 14, 2015; published online Aug. 31, 2016.]
Internal Revenue Service [IRS]
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Price Transparency Tool Attracted Users But Did Not Lead to Use of Lower-Priced Services (PDF)
"This issue brief summarizes findings from an evaluation of a large Midwestern health information technology firm that used a sophisticated transparency tool created by a start-up. [The authors] examine the effect on purchasing behavior and found that the tool, while used by many, did not appear to lead to increased use of lower-priced services. The evaluation is of particular interest since the health IT firm's employees are likely to be comfortable with and interested in transparency."
Robert Wood Johnson Foundation
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Telemedicine May Help Promote Eye Exam Access for People with Diabetes
"A nationwide telemedicine diabetic screening program could help prevent diabetic retinopathy, the top cause of new-onset blindness in the United States.... Only 3% of the 97 patients surveyed had heard of telemedicine, but once it was explained, 69% believed telemedicine could be more convenient than traditional exams with a specialist."
American Journal of Managed Care
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The Future of Paid Family Leave in an Aging America
"Currently, requests for leave to care for infirm relatives (caregiving leave) pale in comparison to requests for leave to care for newborn children (bonding leave), but that could change.... [O]ne in five individuals will be 65 or older by 2030, foretelling an upswing in the percentage of workers who may find it necessary to take leave and care for an aging relative."
Seyfarth Shaw LLP
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2017 Exchange Market: Emerging Plan Type Trends
"HMOs are becoming more prominent, especially among competitively priced plans.... While most consumers will have access to an unmanaged plan offering in 2017, less than a third will have access to both managed and unmanaged options that are competitively priced.... All carrier types are increasing their proportion of managed plan offerings in 2017."
McKinsey & Company
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Taxpayers Foot 70 Percent of California's Health Care Tab
"Many people assume that the U.S. health care system is primarily supported by private dollars, such as insurance premiums from employer-based coverage ... But that's no longer the case, at least in California -- mostly because of its massive expansion of Medi-Cal, the state's version of Medicaid ... Nationwide, public funds paid for about 45 percent of the country's $3 trillion in health care expenditures in 2014 through public insurance programs ... according to federal data. But that estimate may be too low -- it's probably closer to 65 percent[.]"
Kaiser Health News
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Executive Compensation and Nonqualified Plans
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Preliminary Planning for the 2017 Proxy Season
"For those who want to start preparing for the 2017 proxy season, [here is a] preliminary list of important considerations ... [1] Directors' and officer's questionnaire ... [2] Say-on-Pay frequency vote ... [3] Non-GAAP financial measures ... [4] Pay ratio disclosures ... [5] Description of shareholder proposals on proxy cards ... [6] Form 10-K summary ... [7] Inline XBRL ... [8] Audit committee report ... [9] Identification of audit partner."
Dodd-Frank.com, a blog by Stinson Leonard Street
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BenefitsLink.com, Inc.
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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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