Health & Welfare Plans Newsletter

September 20, 2016

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Pension Plan Administrator
Growing Retirement Plan Administration Firm
in NY

Business Relationship Consultant
Aspire Financial Services LLC
in FL

Account Manager 403(b) - 457 Markets
Aspire Financial Services LLC
in FL

Billing Representative
Fringe Benefit Group
in TX

Retirement Plan Administrator
American Retirement Plan Services, LLC
in MD

Conversion Specialist
BlueStar Retirement Services
in FL

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Webcasts and Conferences

Open Enrollment Preview: Checking the Vitals of the Marketplaces
September 26, 2016 in DC
Alliance for Health Reform

2016 Strategic Employee Benefits Communication: Influencing Behaviors and Attitudes in a Changing Workplace
September 29, 2016 in NY
Conference Board, The

Web 2.0 Employee Benefit Communication: A New Dimension in Engaging Employees in New Ways Using Social Tools and Channels
September 30, 2016 in NY
Conference Board, The

Wellness Strategies
October 20, 2016 WEBCAST
Worldwide Employee Benefits Network [WEB] - Phoenix Chapter

Target Date Funds: What You Need to Know
October 21, 2016 WEBCAST
Lorman Education Services

Pensions on Peachtree
April 24, 2017 in GA
FIS Relius Education

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Text of Federal District Court Opinion: Wellness Program Was Voluntary But Did Not Satisfy EEOC Safe Harbor; EEOC May Apply Rules Retroactively (PDF)
21 pages. "While Orion sought to develop a wellness program ... to benefit economically by mitigating its health insurance costs, it did not perform any underwriting or risk classification for the purpose of calculating insurance premiums ... Only in the broadest sense is Orion's wellness initiative related to insurance. Adopting Flambeau's expansion of the safe harbor provision to employers providing wellness plans goes well beyond the provision's narrow scope.... [E]ven a strong incentive is still no more than an incentive; it is not compulsion. Orion's wellness initiative is voluntary in the sense that it is optional." [EEOC v. Orion Energy Systems, Inc., No. 14-1019 (E.D. Wis. Sept. 19, 2016)]
U.S. District Court for the Eastern District of Wisconsin

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San Francisco Issues 2017 Employer Health Care Spending Rates
"The City of San Francisco has announced the 2017 rates for its employer health care spending law, whereby employers must either contribute a specified amount toward their employees' health care costs on a regular basis or pay into a city health care fund for San Francisco residents. Beginning January 1, 2017, the health care expenditure rate for employers with 100 or more employees will be $2.64 per hour, and the rate for medium-sized businesses with 20-99 employees will be $1.76 per hour."
Wolters Kluwer Law & Business

Government-Mandated Sick-Leave Plans Unlikely to Be Preempted by ERISA
"In the absence of federal action, five states, 27 cities and one county have passed local sick leave laws. The types of employees covered, waiting periods, maximum leave permitted and rate at which leave accrues differs greatly among the various laws. This patchwork of state and local leave laws creates challenges for employers whose employee populations span across these jurisdictions.... While the idea of using ERISA to preempt state and local laws sounds promising, ... relying on ERISA for preemption will not guarantee that result."
Fox Rothschild LLP

Hitch Keeps Many High-Deductible Plans from Covering Chronic Care Up Front
"[H]igh-deductible plans that are set up to link to health savings accounts can only cover preventive services like vaccines and mammograms until patients buy enough services on their own to pay down their deductible. A bipartisan bill was introduced in Congress in July that would allow high-deductible plans that can link to health savings accounts (HSA) to cover care for chronic conditions like diabetes and heart disease before plan members have met their deductibles."
Kaiser Health News

Taking Measure of HIPAA Enforcement
"[It] has been a banner year for OCR in HIPAA enforcement, with more settlements and a bigger haul than ever before. Yet, many of the enforcement actions involve relatively straightforward allegations of noncompliance, such as the lack of adequate risk analyses and risk management plans, failure to enter into business associate agreements, or failure to implement appropriate policies and procedures. Covered entities and business associates should be mindful of these enforcement actions and use them as an opportunity to critically evaluate their own compliance efforts."
Bradley Arant Boult Cummings LLP

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Benchmark Obamacare Plans Often Cost Less Than Job-Based Health Insurance
"The average monthly Obamacare premium for the types of plans examined was $464 per month for an individual, nationally. That compared to $515 per month for an average job-based premium ... In 38 states and the District of Columbia, the average premium for those key Obamacare plans was lower than the average job-based plan premium ... In the case of job-based coverage, that includes what the employer pays toward the premium and the employee's share. For Obamacare plans, that includes what a customer personally pays, plus any subsidy they receive from the government in the form of tax credits."
CNBC

[Opinion]

Just Another Shell Game: Study Falsely Claims Obamacare Premiums Are Lower Than Those of Employer Plans
"[T]axpayers finance a large portion of Exchange-plan premiums through the ACA's 'reinsurance' program. The reinsurance program taxes almost all health plans, including most employer-sponsored plans, and uses the revenue to subsidize Exchange plans.... Exchange-participating carriers have suffered losses, even after accounting for net reinsurance subsidies. So the full premium for Exchange coverage is higher still-and the insurers are paying part of it."
Forbes

[Opinion]

Capping Copays Will Raise Premiums and Drug Prices
"The Manhattan Institute estimates a $250 per month cap on out-of-pocket drug spending would benefit only about 1 percent of all Americans who take any prescription drug in a given year. Furthermore, nearly half of the benefits from a copay cap would accrue to families earning more than four times the federal poverty level. Such a law would also raise premiums for all policyholders and facilitate drug price hikes."
National Center for Policy Analysis [NCPA]

Executive Compensation and Nonqualified Plans

[Guidance Overview]

409A Failures: New Corrections Under Guidance and Case Law (PDF)
"Correcting section 409A mistakes was made easier by the IRS's formal correction program issued under Notice 2010-6 and Notice 2008-113, which allow specific section 409A document failures and operational failures to be corrected with reduced or even zero tax penalties. But not all section 409A failures can be fully corrected under the IRS program."
Ivins, Phillips & Barker Chtd., in Tax Notes

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David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
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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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