Health & Welfare Plans Newsletter

November 8, 2016

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[Guidance Overview]

IRS Announces New PCORI Fee
"[T]he PCORI fee used to calculate the payment amount for plan years that end on or after October 1, 2016, and before October 1, 2017, including 2016 calendar year plans, is $2.26. Plan sponsors must pay the PCORI fee by July 31 of the calendar year immediately following the last day of that plan year. All plan sponsors of self-insured group health plans will pay the PCORI fee in 2017, but the amount of the fee paid will vary depending on when the plan year ends."
Xerox HR Services

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On-the-Job Healthcare Costing More
"We've passed a milestone: workers typically spend more than 10 percent of their incomes for their employer health coverage. A decade ago, they spent 6.5 percent on health costs. One reason for the rising cost burden is the growing prevalence of high-deductible insurance plans, and, within these plans, the deductibles themselves are increasing. Although premium hikes in employer plans have slowed in the past five years, they are also still going up. The nation's aging work force could be another indirect pressure on costs."
SquaredAway Blog, by the Center for Retirement Research at Boston College

Cost Control Over Risk: More Employers Embrace Self-Insurance
"Risk has always been a concern that makes employers wary of self-insurance, but as costs rise, it is a potent cost-control weapon that can't be overlooked. While fully-insured renewals are stuck with rigid insurer methodologies, self-insurance challenges this with flexibility in plan design and significant opportunities for cost savings."
Frenkel Benefits

Benefits Technology Without Benefits Consultation?
"When set up properly, benefits technology can enhance communications and educate employees at the point of enrollment, which is an optimal time to communicate with them because you have their attention anyway. But one-and-done communications that are provided only at enrollment don't fully educate employees or help them make good choices. Messages typically need repeating before they are internalized, and for that, you need a full-blown communications campaign with touch points throughout the year. Repeating information in small segments over a period of time means that employees are more likely to hear and absorb it."
Corporate Synergies

2016 Election 'Infected' with Paid Sick Leave
"While many have been focusing on Tweets, video recordings, and alleged scandals, the paid sick leave epidemic that has spread throughout the nation in recent years has quietly infected this year's election as well. In particular, both Washington and Arizona have proposed statewide paid sick leave bills on their respective ballots. When the Election Day dust settles, the country will not only know its Commander in Chief for the next four years, but also whether the number of statewide paid sick leave laws has increased from five to either six or seven."
Seyfarth Shaw LLP

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Sustainable U.S. Health Spending in the Next Administration: Symposium Summary
"On July 12, 2016 the Altarum Institute Center for Sustainable Health Spending (CSHS) held its annual symposium in Washington, DC. It was the sixth such meeting organized by CSHS, and the fifth year supported by the Robert Wood Johnson Foundation. This blog highlights themes from each of [the] presenters. The full monograph, and complete video of the event are available[.]"
Altarum Institute

How Could a New Administration Tackle ACA Challenges? Look to Medicare
"The ACA marketplaces aren't the only health insurance markets to have faced turmoil.... [T]he Medicare Advantage markets were roiled with health plan exits in the late 1990s and early 2000s.... Key policy solutions included: [1] Throwing money at the problem ... [2] Authorizing a fallback 'public option' plan ... [3] Making risk mitigation programs permanent ... [4] Conducting aggressive enrollment outreach ... These same strategies could be adapted to help stabilize the ACA marketplaces."
Health Affairs

California Hospital System Pushes Employer Groups to Waive Their Right to Sue
"Sutter Health, one of the most powerful hospital systems in the western United States, is apparently making an offer to many employer groups they can't refuse: Drop the right to sue in lieu of network discounts. Many Bay Area employees who self-insure have received notices through their third-party administrators that Sutter wants their enrollees to surrender the right to sue their hospitals in lieu of the discounts ... Any disputes about care would be settled in binding arbitration -- a forum that is believed to be beneficial to companies over plaintiffs."
FierceHealthcare

Benefits in General

The Enforceability of ERISA Forum Selection Clauses: Two Recent 'Against-The-Trend' Cases and an Uncertain Future
"For those interested in the law of ERISA forum selection clauses, 2016 has been a year to remember. The majority of courts to address this issue have ruled in favor of enforcing forum selection clauses. However, going against the trend, two federal district courts recently determined that forum selection clauses are automatically invalid and unenforceable within the ERISA context ... Prior to these summer cases, only two reported district court cases held that forum selection clauses in ERISA plans are inconsistent with the statute and therefore unenforceable."
Trucker Huss

Should Your ERISA Plan Have a Forum Selection Clause?
"This simple provision should promote significant cost savings and enhance uniformity and predictability for administrators defending plan-related claims in federal court. For example, an employer headquartered in New York may have employees in Florida and Alaska that participate in the employer's plan. Without a forum selection clause, ERISA's default venue provision probably permits participants to bring their plan-related lawsuits in Florida or Alaska. Some actions could also be brought in a state court, depending on the claim."
Bradley Arant Boult Cummings LLP

Executive Compensation and Nonqualified Plans

ISS Issues Proposed Policy Updates for 2017
"For the first time in many years, the proposed updates do not modify U.S. policy on compensation matters (e.g., policies relating to Say on Pay and equity plan proposals). However, ISS announced a material change in its U.S. pay for performance assessment that will take effect for the 2017 proxy season."
Meridian Compensation Partners, LLC

When It Comes to Say on Pay, What's the Right Frequency, Shareholders? (PDF)
"While annual vote frequency is currently the majority practice, most companies pushed to hold votes triennially when making their initial frequency recommendations in 2011 ... Ultimately, more than half of the companies (55%) originally recommending vote frequencies other than annual ended up implementing annual votes after evaluating the outcome of their shareholder vote.... Given the expected volume of frequency votes at 2017 annual meetings, the time is right for shareholders to reevaluate factors they might consider when thinking about their preferred say-on-pay frequency."
Willis Towers Watson

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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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