Health & Welfare Plans Newsletter

November 2, 2016

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[Official Guidance]

Text of IRS Pub. 5258: ACA Information Returns (AIR) Submission Composition and Reference Guide (PDF)
136 pages; Oct. 2016. "The purpose of this document is to provide guidance to all types of external transmitters about composing and successfully transmitting compliant submissions to IRS. The audience of this document is: ... [A] business filing their own ACA Information Returns regardless of whether they are required to file electronically (transmit 250 or more of the same type of information return) or volunteer to file electronically ... A third-party sending the electronic information return data directly to the IRS on behalf of any business required to file.... An organization writing either origination or transmission software according to IRS specifications.... This document covers details on composing and submitting Forms 1094/1095-B and Forms 1094/1095-C by transmitters to IRS."
Internal Revenue Service [IRS]

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[Official Guidance]

HIOS Portal User Manual, October 2016 Update (PDF)
106 pages. "The Health Insurance Oversight System (HIOS) is a federal system of record and provides a centralized, multi-user interface for insurance issuers and state/territory regulators to submit, and CCIIO to store information on individual and small group major medical insurance. Information submitted to HIOS is transferred in accordance with CCIIO regulations to provide data updates to Healthcare.gov. The Healthcare.gov website displays this information to provide assistance to consumers in locating health insurance coverage available in the market.... This manual provides steps and instructions on how new and existing users can get access to HIOS and use its different functionalities."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Empower Your Employees to Be Better Health Care Consumers
"Five common health care communication barriers: [1] The message is too general.... [2] The message is unfamiliar.... [3] The message is contradictory.... [4] The message is unclear.... [5] The message is passive."
The Alliance

High Value Cancer Care: Guidance for Employers (PDF)
28 pages. "[H]ow can benefits professionals provide help when it comes to steering employees toward high-value care? How can they sort through the proliferation of cancer care benefits and programs available to hone in on those with the most value and/or can amplify the value of what they currently provide? And how can they move toward paying for value instead of volume?"
Northeast Business Group on Health [NEBGH]

Lessons Learned from AHIP's Provider Directory Pilot Program
"Preliminary findings demonstrate: [1] Strong partnership and active participation with physician practices is essential. However, physician practices often remain unaware of how important it is to update the information that consumers access online; [2] Managing this data is complex for health plans, and standard formats would make it easy to process what data has been updated; [3] Data from individual providers sometimes don't match the data provided by the group administrator; and [4] A variety of different outreach methods are needed to connect with providers and make sure information is accurate and up to date."
America's Health Insurance Plans [AHIP]

Blue Shield Again Owes Californians Millions In Health Care Rebates
"About 240,000 Californians with job-based health coverage may have been surprised by a recent letter from Blue Shield of California saying the company owes them money, not the other way around. Those people work for 30,000 small employers around the state ... The refund checks sent by the insurer weren't sent to the individuals, but to their employers, who had to calculate how to distribute the money to workers based on their share of 2015 premium payments. For some bosses, it was no easy task."
Kaiser Health News

Why It Pays to Shop Around for That MRI
"A growing number of employers are trying to get employees into the habit of comparison-shopping by giving them a cut of the savings when they choose cheaper care. Employers like the states of Kentucky and New Hampshire and Jackson Health System, a large Florida hospital system, are using new tools that allow workers to compare prices for common procedures like MRIs and blood work, and get rewarded if they opt for lower-cost options."
The Wall Street Journal; subscription may be required

Benefits in General

Retirement Balances Rise, A Sharp Increase in Adoption of Health Savings Accounts
"The average 401(k) balance rose for the second straight quarter, up 2 percent from Q2 and 7 percent year-over-year. The average IRA balance increased 5 percent from Q2 and 6 percent year-over-year.... In the past year, the number of HSAs provided by Fidelity grew 43 percent to 501,000, with an average HSA balance of $3,150.... [W]hile more people are using HSAs, they're not spending as much as they thought they would."
Fidelity

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Lois Baker, J.D., President  loisbaker@benefitslink.com
David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
Holly Horton, Business Manager  hollyhorton@benefitslink.com

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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