Health & Welfare Plans Newsletter

October 25, 2016

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Executive Director
PSCA
Telecommute

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Spectrum Pension Consultants, Inc.
in CA, HI, WA, Telecommute

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USI Consulting Group
in CT

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INTRUST Bank
in KS

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Webcasts and Conferences

IRA Required Minimum Distributions
December 6, 2016 WEBCAST
Ascensus

What the Healthcare Law Means for Your Small Business
December 8, 2016 WEBCAST
Small Business Majority

Floor Offset Plans: Are They Worth the Effort?
December 13, 2016 WEBCAST
ASPPA College of Pension Actuaries [ACOPA]

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[Guidance Overview]

January 1 Is Quickly Approaching: Have You Reviewed Your Health Plan for Section 1557 Compliance?
"[T]he regulations may not directly apply to many employee health plans because neither the sponsoring employer nor the plan receives HHS funding. However, HHS has noted that it may refer discriminatory plans and employers to other government agencies (such as the EEOC), so it is a good idea for all plan sponsors to review their plans to see if any discriminatory provisions need to be amended or removed."
Jackson Lewis P.C.

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2017 Health Savings Accounts Facts

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[Guidance Overview]

Clouds, with a Nearly 100% Chance of a Business Associate Agreement
"[If] your company has an off-site data server that is managed by a third party and ePHI is stored on that server, a business associate agreement with that third party is probably necessary. Even if all you do is use something like Google Docs, OneNote, Evernote, or Dropbox for storage, that could be considered cloud computing subject to these rules.... HHS's position is that it is a HIPAA violation if ePHI is shared with a cloud provider and there's no business associate agreement in place."
Benefits Bryan Cave

Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace (PDF)
40 pages. "This brief presents analysis of Qualified Health Plan (QHP) data in the individual market Marketplace for states that use the HealthCare.gov Marketplace platform and State-Based Marketplaces where data is available. It examines plan affordability in 2017 after taking into account premium tax credits and also examines the plan choice s that new and returning consumers will have for 2017."
Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS]

Average Premiums for Popular ACA Plans Rising 25 Percent
"Insurers are raising the 2017 premiums for a popular and significant group of health plans sold through HealthCare.gov by an average of 25 percent, more than triple the typical increase for this year ... The steep increase in rates serves broadly to confirm what has become evident piecemeal in recent months: Prompted by a burden of unexpectedly sick ACA customers, some insurers are dropping out while many remaining companies are struggling to cover their costs."
The Washington Post; subscription may be required

HIPAA Privacy and Security Audits: OCR Phase 2
"Covered entities and business associates will have approximately 10 days to respond to the audit request. OCR will issue two separate document requests via email: one for policies and procedures (and related documentation), and another for a list of business associates. Auditees must submit requested documentation to OCR's online portal[.]"
Compliance Dashboard

[Advert.]

New York's New Parental Leave Law: What You Need to Know

Sponsored by Lorman and BenefitsLink

October 26 webinar provides an overview of current laws governing parental leave and then turns to an overview of the new New York law, which is effective January 1, 2018.


Ten Eye-Opening Stats About Employees and Their Benefits
"More than half (65%) of employees would only be able to pay less than $1,000 for out-of-pocket expenses associated with an unexpected serious illness or accident.... A third (33%) of employees are only somewhat satisfied with the benefits package offered to them at this time, and 9% are 'not very' or 'not at all' satisfied with their benefits.... More than half (60%) of employees are at least somewhat likely to take a job with slightly lower pay but better benefits.... The vast majority (81%) of employees think the medical costs they're responsible for will increase moving forward."
HR Benefits Alert

Prior Authorization Pilot Reduced Health Plan's Cancer Drug Costs by 20%
"At the end of the 1-year period, Florida saw a 9% change in cost, national costs increased by 10%, and southeast regions increased by 11%. The difference in the changes between the control regions and Florida translated into a $5.3 million savings for Florida during the 1-year period."
American Journal of Managed Care

Feds Find Doctor Listings Often Wrong In Medicare Advantage Directories
"Incorrect information was found for almost half of the 5,832 doctors listed in directories for 54 Medicare Advantage plans checked last fall, [CMS] said. Only online directories were examined."
Kaiser Health News

Government Files Brief in House v. Burwell; ASPE Lays Out 2017 Plans and Premiums
"The government's brief is a full-throated protestation that it is the House's lawsuit -- and not the administration's expenditures for the cost-sharing reduction payments -- that violates the Constitution.... [As] has been widely reported, after two years of moderate premium increases (2 percent for 2015 and 7 percent for 2016 for the second-lowest cost benchmark silver plan), premiums are going up sharply for 2017."
Timothy Jost, in Health Affairs

Central States Not Entitled to Reimbursement From Insurers
"Central States sought to recover $343,000 from the insurers. The parties disputed the coordination-of-benefit clauses, and each side argued that the clauses made the other primarily liable for the beneficiaries' medical expenses." [Central States, Se. & Sw. Areas Health & Welfare Fund v. Am. Int'l Grp., Inc., No. 15-2237 (7th Cir. Oct. 24, 2016)]
Bloomberg BNA

Executive Compensation and Nonqualified Plans

[Guidance Overview]

NASDAQ Updates Equity Compensation Plan FAQs
"[U]pdated FAQs ... provide that an equity plan amendment to permit share withholding up to the maximum statutory withholding amount is not a material amendment requiring shareholder approval. The updated FAQ applies equally to equity plans that permit and prohibit liberal share recycling."
Meridian Compensation Partners, LLC

[Guidance Overview]

Social Security Wage Base Hike In 2017 Affects Year-End Planning For Stock Options
"When you exercise nonqualified stock options or when restricted stock/RSUs vest, you owe Social Security tax up to this yearly income ceiling ... If your yearly income is already over that threshold, you can exercise nonqualified stock options or stock appreciation rights before the end of 2016 without paying Social Security tax, and therefore you can keep an extra 6.2% of the related income.... If you are already over the wage base for 2016 and expect to be eventually over the wage base for 2017, you can therefore save the $539.40 increase in Social Security tax simply by exercising stock options this year rather than in 2017."
myStockOptions.com

SEC Issues Additional Guidance on CEO Pay Ratio Rules
"Companies should ensure that the necessary data to calculate the ratio is available. This may require the creation of a multi-disciplinary project team, including members of the Human Resources, Finance, and Legal departments. Due to the flexibility of the rules in determining the median employee, companies should consider the various approaches ... and model out the results under each to help determine the most appropriate method of calculation."
Steven Hall & Partners

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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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