Health & Welfare Plans Newsletter

October 27, 2016 logo logo
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Employee Benefits Jobs

DC Valuations Specialist / Analyst
PenSys, Inc.
in CA

Retirement Administrative Manager
Bechtel Global Corporation
in CA

401(k) Administrator
Hunter Benefits Consulting Group, Inc.
in CO, IL, WA

Employee Benefits Attorney
Wiggin and Dana LLP
in CT

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Webcasts and Conferences

Face Plan Failures Head On!
November 1, 2016 WEBCAST

2016 Continuing Education for Trustees of Missouri Public Retirement Plans
November 10, 2016 in MO
Husch Blackwell

ERISA Current Developments
November 10, 2016 WEBCAST

Limiting Retirement Plan Liability in Light of Recent Litigation
November 16, 2016 WEBCAST
Husch Blackwell

Employee Benefits Briefing
December 7, 2016 in IL
Nixon Peabody LLP

The Opioid Epidemic and Your Benefit Plan
December 8, 2016 WEBCAST
International Foundation of Employee Benefit Plans [IFEBP]

IRA Reporting
December 13, 2016 WEBCAST

Keeping Current 2016: The Year in Review
December 13, 2016 WEBCAST
FIS Relius Education

Health & Benefits Leadership Conference
April 19, 2017 in NV
Human Resource Executive Magazine

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[Official Guidance]

Text of 2016 Instructions for IRS Form 8965: Health Coverage Exemptions (and Instructions for Figuring Your Shared Responsibility Payment) (PDF)
20 pages. "What's New: Changes to coverage exemptions. Some changes have been made to the coverage exemptions available for 2016. See the Types of Coverage Exemptions chart to review the coverage exemptions that are available."
Internal Revenue Service [IRS]


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[Guidance Overview]

Health Care Information Reporting: Seven Things Employers Can Think About Now
"ALEs are required to furnish a statement to each full-time employee that includes the same information provided to the IRS by January 31, 2017.... ALEs must file Form 1095-C, Employer-Provided Health Insurance Offer and Coverage with the IRS annually, no later than February 28, 2017 or March 31, 2017 if filed electronically. Forms 1095-C are filed accompanied by the transmittal form, Form 1094-C.... The ACA Assurance Testing System opens November 7, 2016 for tax year 2016 testing. Software developers -- including employers and issuers who passed AATS for tax year 2015 -- will not have to retest for tax year 2016; the Tax Year Software Packages will be moved into Production status."
Internal Revenue Service [IRS]

[Guidance Overview]

Another Party Enters ACA Enforcement, and HIPAA Privacy and Security Enforcement Expands
"The anti-retaliation whistleblower protection under the ACA was enacted as an amendment to the Fair Labor Standards Act and as such these claims carry with them not the traditional ERISA remedies for a violation, but also the remedies under the FLSA, such as back pay, tax implications related to the remedies, reinstatement, lost benefits, seniority, etc., to put the individual back in the same place they would have been in absent the retaliatory actions and compensatory damages. Employers also need to remember that the OSHA administered anti-retaliation rule does not replace or eliminate the ERISA 510 retaliation claim and that it may be possible for some claimants to pursue claims on the same facts under two different forums."
Winstead PC

[Guidance Overview]

Dear Participant, Here's Your Notice That Your HIPAA Privacy Notice Is Available
"Not only must Covered Entities abide by the Privacy Standards, but they are also required to let covered individuals know about these standards by providing a notice.... Self-insured Health Plans (and fully-insured health plans that get PHI) are responsible for providing this notice to covered individuals at the time of enrollment and within 60 days of a material revision to the notice.... In addition to the Notice of Privacy Practices, a reminder notice must be distributed every three years notifying individuals covered by the health plan that the Notice of Privacy Practices is available and how they can obtain a copy of it."
Compliance Dashboard

[Guidance Overview]

Plan Year 2017 Open Enrollment: A Primer for Agents and Brokers Participating in the Federal Marketplace (PDF)
127 presentation slides. Topics: [1] Agent/Broker Registration Reminders and Tips; [2] Overview of Open Enrollment; [3] Annual Redetermination and Auto-Re-enrollment Updates; [4] Helping Consumers with Data Matching Issues (DMIs); [5] New Call Center Resources for Agents/Brokers; [6] Marketplace Call Center Tips; [7] Working with Navigators and Other Non-Agent/Broker Assisters; [8] Overview of Pathways to Assist Consumers Enrolling in Coverage through the Individual Marketplace; [9] Step-by-step Review of the Individual Marketplace Online Application; [10] Small Business Health Options Program (SHOP) Marketplace Highlights.
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Self-Funded ERISA Plans Subject to California Law Barring Discretionary Clauses
"[M]any states have enacted laws banning discretionary clauses in insurance policies. For insured plans, these laws have generally withstood ERISA preemption attacks. Two federal district courts in California have gone a step further and concluded that the California Insurance Code provision that bars discretionary clauses also applies to self-funded ERISA short-term disability plans."
Proskauer Rose LLP

Employer-Sponsored Insurance Enrollment Stable in 2014
"A new study ... compared the extent to which U.S. employers dropped or added this employee benefit between 2013 and 2014.... 46.38 percent of private-sector employers offered coverage in both years, and 49.08 percent did not offer it in either year. Furthermore, just 3.45 percent of employers dropped coverage in 2014, and 1.10 percent added it[.]"
Health Affairs

More Worker Income Going to Health Care
"For employer-sponsored health plans -- where most individuals receive their health coverage -- the percentage of household income used to pay premiums and deductibles has increased sharply in the last decade -- from 6.6% to 10.1%.... [A]bout 154 million people -- 57% of the U.S. population under 65 -- obtain their insurance through their work ... Their share of insurance costs are consuming an ever larger percentage of their incomes."
Physicians for a National Health Program [PNHP]

Coming in 2017: Key Indicators to Watch on Healthcare Marketplaces
"[T]he key moment for the marketplaces is not the start of this open-enrollment season on Nov. 1 or this round of premium increases but next spring and summer, when state regulators begin to see proposed premiums for next year's open-enrollment season and we learn whether the marketplaces have stabilized."
Henry J. Kaiser Family Foundation

CDHPs Gain Popularity But Offer Less Savings
"26.4 percent of all U.S. employees are now enrolled in CDHP plans, up nearly 70 percent from five years ago. 25.7 percent of plans offered by employers are CDHPs, up from 14.2 percent five years ago. While CDHPs' premiums were still 3.5 percent less costly than the average plan this year, they offered more savings in 2015 when they were 5.6 percent less expensive than the average plan."
Society for Human Resource Management [SHRM]

Drug Prices, Not Obamacare, Top Voters' Health Priorities for 2017
"[M]ajorities of Democratic, Republican and independent voters all support making sure high-cost drugs for chronic conditions are affordable for patients who need them. Majorities of those groups also want to ensure that health plans have enough doctors and hospitals in their networks to serve patients. By contrast, fewer than a third of all voters favored proposals to repeal requirements in the health law for employers to provide health insurance to their workers or pay a fine; reduce the tax subsidies that help people pay their insurance premiums, and eliminate a tax on high-cost health plans."
Kaiser Health News

Executive Compensation and Nonqualified Plans

[Guidance Overview]

SEC Releases Helpful Guidance for Application of New Pay Ratio Rule (PDF)
"The new [Compliance and Disclosure Interpretations (CDIs)] contain additional guidance with regard to [1] the treatment of furloughed employees [2] when compensation can be computed using a method different than that used to compute the compensation reported in the Summary Compensation Table (SCT), [3] permissible time periods over which compensation can be measured, and [4] treatment of independent contractors and leased employees."
FW Cook

Press Releases

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David Rhett Baker, J.D., Editor and Publisher
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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2016, 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, 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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