Health & Welfare Plans Newsletter

October 11, 2016

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[Guidance Overview]

Some 'Elections' Do Work
"[T]here should not be a tax issue -- a constructive receipt problem -- if the employer requires employees to make a choice between accruing PTO or receiving cash in lieu of the PTO in the year before the year when the PTO will be earned.... [PLR 201601012] illustrates how this type of 'safe election' can be used to give employees somewhat greater choice and control over the use of their accumulated sick leave or PTO, without triggering current taxation."
Chang Ruthenberg & Long PC

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[Guidance Overview]

Cook County, Illinois, Enacts Paid Sick Leave Ordinance
"[The] Ordinance mandates that employers in Cook County, Illinois [in which the City of Chicago is situated], allow eligible employees to accrue up to 40 hours of paid sick leave in each 12-month period of their employment.... [It] becomes effective on July 1, 2017.... Individuals are entitled to benefits under the Ordinance if they: [1] perform at least two hours of work for a covered employer while physically present within the geographic boundaries of the County in any particular two-week period; and [2] work at least 80 hours for a covered employer in any 120-day period."
Jackson Lewis P.C.

To Drive Real Health Care Reform, Look to What Employers Are Doing
"Private, non-government employers provide health care coverage to more than 55 percent of Americans, according to the Census Bureau. Many of these companies are already carrying out their own do-it-yourself, market-based health care reform. The formulas they use are both simple and sophisticated. Here's how it works."
STAT

Leadership, Culture and Communication Are Keys to Success of Employee Well-Being Programs (PDF)
44 pages. "More than half of respondents in 2016 (56%) have a formal strategic plan in place, compared to 44% in 2011.... [R]espondents were asked to gauge whether leaders understand the strategic importance of employee health and well-being ... About a fourth responded 'To a great extent,' whereas 20% reported that it isn't seen as connected at all to results. Among employers that have seen a substantial improvement in medical cost, 63% answered 'To a great extent,' compared to just 24% of those that have not seen savings."
HERO and Mercer

A Friendly Competition to Increase ACA Marketplace Stability: Calling All Actuaries
"In an attempt to inform decision making on the critical issue of individual market stability, the RWJF is sponsoring the Actuarial Challenge, a friendly competition in which teams of actuaries will develop and test feasible solutions to improve the performance of the individual health insurance market.... Participants can enter as a team, or individuals will be placed with others to form a team."
Health Affairs

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Medicare: Insolvency Projections (PDF)
15 pages. "Almost from its inception, the [Hospital Insurance (HI)] Trust Fund has faced a projected shortfall. The insolvency date has been postponed a number of times, primarily due to legislative changes that have had the effect of restraining growth in program spending. The 2016 Medicare trustees' report projects that, under intermediate assumptions, the HI Trust Fund will become insolvent in 2028, two years earlier than estimated in the prior year's report." [Report No. RS20946, dated Oct. 5, 2016.]
Congressional Research Service [CRS]

Consumers Continuously Enrolled in CDHPs Experience Lower Overall Health Care Costs
"After switching from a PPO to HCSC's BlueEdge CDHP, members saw a three-year average reduction in: [1] Inpatient care costs -- decreased by 16.1 percent; [2] Outpatient care costs -- decreased by 5.7 percent; [3] Professional services costs -- decreased by 10.4 percent."
Health Care Service Corporation

Rising Health Premiums Rankle Individuals Paying Full Price
"[This] is shaping up to be the most expensive year for the 400,000 or so consumers in Georgia who buy individual policies but don't purchase them on the health law's marketplaces. About 10 million Americans buy individual insurance coverage either on or off the marketplaces and get no federal subsidies to help bring down the cost.... Blue Cross Blue Shield of Georgia, the only insurer offering plans throughout the state, received an increase of more than 21 percent from the state insurance commissioner. Humana was awarded a 67.5 percent hike."
Kaiser Health News

EpiPen Triggers Change In Thinking About Obamacare Requirement
"Three doctors who have led a task force that evaluates preventive medical services say the group's recommendations shouldn't be tied by law to insurance coverage. The former chairmen of the U.S. Preventive Services Task Force [USPSTF] say the link between medical recommendations and insurance coverage leads to financial incentives that can corrupt the process and distort people's health care decisions. Under the [ACA], any preventive service that receives one of the USPSTF's top two ratings must be covered by insurance without any out-of-pocket cost for the patient."
National Public Radio

[Opinion]

Is It Time for the Preventive Task Force to Inform -- But Not Determine -- Health Care Coverage?
"The [ACA] linkage of [U.S. Preventive Services Task Force (USPSTF)] decisions to insurance coverage has brought both benefit and harm. As advocates of preventive services, we are excited that many people who previously had no financial access to preventive services can now benefit from those services for which the balance of benefit and harm has been scientifically established to be favorable. But if such financial access comes at the cost of increased deductibles or copays for equally important services that are not preventive, then we must question whether the link inadvertently discourages other important care."
Annals of Internal Medicine

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