Health & Welfare Plans Newsletter

October 4, 2016

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Employee Benefits Jobs


Webcasts and Conferences

2016 Employee Benefit Plan Regulatory Update
October 17, 2016 in MA
Baker Newman Noyes

Election 2016: What's At Stake For Group Health Plans?
October 20, 2016 in NC
Hill, Chesson & Woody

What If the Software You Use to Give Retirement Advice is Wrong?
November 1, 2016 WEBCAST
SourceMedia

Best Practices for Employee Giving Programs
November 14, 2016 WEBCAST
Lorman Education Services

Legislative Updates: Year-End Review of Legal Changes Affecting Benefit Plans
November 17, 2016 in GA
Worldwide Employee Benefits Network [WEB] - Atlanta Chapter

Can We Afford this ESOP?
December 1, 2016 WEBCAST
ESOP Economics

Business Management Conference
January 14, 2017 in AZ
NIPA [National Institute of Pension Administrators]

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HHS Vigorously Defends Against Insurer Claims for Risk Corridor Payments
"On September 30, the DOJ filed motions to dismiss in separate risk corridor cases brought by Blue Cross and Blue Shield of North Carolina and the Moda Health Plan. The memoranda in support of these motions raise the same arguments as to prematurity raised in the Health Republic case. But the memoranda go well beyond the brief filed in that case ... [arguing] that the risk corridor statute only entitled QHP insurers to payments equal to the amounts collected.... Furthermore, the DOJ brief argues, HHS has no contractual obligations, express or implied, to make risk corridor payments[.]"
Health Affairs

[Advert.]

October Certificate in Global Benefits Management -- Last Chance!

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

The Certificate in Global Benefits Management will provide you with a solid foundation in international benefits and an enhanced understanding of the differences in benefit packages offered around the world. Learn more.


Feds Move to Throw Out Lawsuits by Insurers Seeking Risk Corridor Payments
"The two insurers, Moda Healthcare and BlueCross BlueShield of North Carolina, have sued the federal government over a combined $338 million in ObamaCare payments they argue are overdue. The Justice Department filed motions to dismiss both lawsuits on Friday, arguing that the federal government isn't responsible for those payments at all. That argument -- which goes further than the department's move to dismiss a similar case in June -- could have a major ripple effect throughout the marketplace."
The Hill

Employers Move to Pay Providers Based on Greater Value
"[A] growing number of employers plan to ... [1] Establish centers of excellence (COEs) for specialty services with health plans, separate providers or third-party vendors.... [2] Implement high-performance networks.... [3] Contract directly with service providers to secure improved pricing.... [P]lan design features expected to grow in usage include: [1] Reducing point-of-care costs for the use of high-value services.... [2] Increasing point-of-care costs for the use of commonly overused services.... [3] Requiring employees who get certain types of medical procedures to pay a higher cost share if they do not get a second opinion."
Willis Towers Watson

Open Enrollment Riddles: Decoding the Process for Employees
"Remind employees that while there may be reimbursement and coverage available for out-of-network providers, reimbursement is limited based on allowed charges.... Provide employees with step by step information on how to look up providers for their specific networks for their medical plans, and dental & vision plans if applicable.... If you have a Section 125 plan, ... remind your employees that they cannot make changes to their enrollment elections during the plan year unless they experience a qualified life event[.]"
Frenkel Benefits

Important Spending Account Reminders for Open Enrollment
"Employers can reduce the complexity and the confusion for employees during open enrollment by consistently communicating the following information: Plan extensions and deadlines (Carryover or Grace Period).... Contribution limits.... How to track expenses.... What's eligible.... How to eliminate paperwork with an FSA or HSA debit card."
FSA Store

[Advert.]

Be our guest at IHC FORUM West! Nov 9-10 in Las Vegas, NV

Sponsored by Institute for Healthcare Consumerism [IHC]

What compliance and regulatory issues are plaguing open enrollment this year? Will this year's presidential election alter the health & benefits landscape for the next four years? Find out at FORUM West. Claim your free registration now.


Florida Agency for Health Care Administration Releases Invitation to Negotiate for a Vendor to Provide an All-Payor Claims Database to Florida Consumers
"To help develop price information, each insurer and HMO participating in the State Group Insurance plan or Statewide Medicaid Managed Care and their affiliates will be required to contribute all Florida claims data (with certain exceptions) to the vendor selected by AHCA."
Akerman LLP, via Lexology

Maryland's ACA Health CO-OP Will Switch to For-Profit to Save Itself
"Evergreen Health, Maryland's version of the innovative nonprofit insurers created under the [ACA], decided [October 3] to become a for-profit company to avoid the possibility of a shutdown ... If the switch is approved as expected by federal and state officials, Evergreen's unprecedented move will leave standing only five of the 23 co-ops, or Consumer Operated and Oriented Plans, which started nearly three years ago."
The Washington Post; subscription may be required

[Opinion]

Delivering Health Care Value to Consumers
"For the more than 150 million Americans who get their insurance through their employer, last year's premiums rose by 3 percent ... The Congressional Budget Office expects that rate to hold through 2018. And 80 percent of consumers are satisfied with their employer benefits."
America's Health Insurance Plans [AHIP]

Benefits in General

ERISA Advisory Council to Meet November 9-10
"The purpose of the open meeting on November 9 and the morning of November 10 is for the Advisory Council members to finalize the recommendations they will present to the Secretary. At the November 10 afternoon session, the Council members will receive an update from the Assistant Secretary of Labor for [EBSA] and present their recommendations. The Council recommendations will be on the following issues: [1] Participant Plan Transfers and Account Consolidation for the Advancement of Lifetime Plan Participation and [2] Cybersecurity Considerations for Benefit Plans[.]"
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

An Overview of the Pension/OPEB Landscape
"This paper provides a comprehensive accounting of pension and OPEB liabilities for state and local governments and the fiscal burden that they pose. The analysis includes plans serving more than 800 entities: 50 states, 178 counties, 173 major cities, and 415 school districts related to the sample of cities and counties.... The cost analysis calculates, separately, pension and OPEB costs as a percentage of own-source revenue for states, cities, and counties. It then combines pension and OPEB costs to obtain the overall burden of these programs." [Data figures (XLS) also available.]
Center for Retirement Research at Boston College

Executive Compensation and Nonqualified Plans

ISS Policy Updates
"[T]he ISS policy survey reports that both investors and issuers strongly favor using metrics other than total shareholder return (TSR) to measure pay-for-performance alignment.... [T]he survey reports that institutional investors strongly support annual say-on-pay frequency."
Winston & Strawn LLP

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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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