Health & Welfare Plans Newsletter

November 9, 2016

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[Guidance Overview]

IRS Issues Final Versions of 2016 Forms 1094-C and 1095-C and Instructions
"[K]ey changes to the forms and instructions include ... [1] Conditional offers to spouses.... [2] COBRA reporting.... [3] Penalties.... [4] ALE Aggregated Groups.... [5] Expanded definitions.... [6] Transition relief/interim guidance.... [7] Affordability safe harbor."
Hunton & Williams LLP

[Advert.]

Preconference Workshop Announced!

Sponsored by Health Benefits Conference & Expo [HBCE]

From new strategies in population health management to cost-containment solutions and ACA updates, HBCE will provide the in-depth information you need to keep your benefit plans compliant and your employees engaged. Want to enhance your learning? Register today!


[Guidance Overview]

Proposed IRS Regs Clarify Treatment of 'Opt-Out Payments' to Employees Who Decline Employer Health Coverage
"Under the proposed regulations, the availability of a payment to employees under an 'eligible opt-out arrangement' will not be counted in the affordability calculation for that employer's health coverage. An eligible opt-out arrangement requires the employee who declines employer-provided health coverage to provide evidence that the employee and his or her dependents have other group coverage."
Frost Brown Todd LLC

Reminder to Pay Transitional Reinsurance Program Fee
"If you paid the 2015 Transitional Reinsurance Fee of $44 per member ... in installments, the 2nd installment of $11 per member is due November 15, 2016. The 2016 Reinsurance fee of $27, if paid in one lump sum, is due by January 17, 2017. Groups have to report the total members in their plan by November 15, 2016."
Findley Davies

CDHP Enrollees Experience Lower Overall Health Care Costs
"[In] the first year following migration from a PPO plan to a BlueEdge CDHP plan, members experienced an average 7.1 percent reduction in medical costs. That reduction improved to an average of 9.2 percent in a three-year period."
Wolters Kluwer Law & Business

Onsite Child Care Ebbs as Flexible Benefits Flow
"Traditional brick-and-mortar child care centers are expensive to operate, require a lot of staffers and represent a significant liability risk to the company should something happen to a child at the center. Above all, 'onsite brick-and-mortar child care centers with a finite number of slots and fluctuating demand are not easy to adapt' to changing needs ... Meeting the needs of diverse employees requires offering benefits that can be used as employees see fit to manage their family and work responsibilities."
Society for Human Resource Management [SHRM]

California Voters Reject High-Profile Drug Pricing Measure; Colorado Rejects Statewide Single-Payer
"Early Monday morning, with more than 97 percent of the vote reported, a measure to limit what the state [of California] will pay for prescription drugs appeared headed for defeat. Meanwhile, Colorado rejected an initiative to build a statewide single-payer health care system -- a notable defeat for a policy proposal championed by politicians such as former Democratic presidential candidate and Vermont Sen. Bernie Sanders. It also became the sixth state to allow terminally ill patients to receive medication that would end their lives."
Kaiser Health News

[Opinion]

Will the ACA Get Trumped?
"One of [President-Elect Trump's] campaign promises ... was the repeal of the [ACA] and replacing it with something else.... So is that going to happen? ... Republicans need a plan first ... And then they have to agree on it.... The Democrats could also filibuster.... Nothing of significance is likely to change between now and President Trump's inauguration in January. Even after that, it will take some time (and some political maneuvering) for any huge changes to get implemented."
Benefits Bryan Cave

[Opinion]

Health Reform and the Trump White House: Implications for Key Stakeholders
"[1] Containing health cost will to be the dominant issue. Total healthcare spending will increase 6% annually for the next decade. Utilization is up. Demand is increasing and traditional reimbursement is not keeping pace with underlying costs. That's not sustainable. Something's got to give. [2] The fundamental structure of the health system is shifting.... [3] Alternative payment programs (APMs) are changing incentives for providers.... [4] Competition from non-traditional entrants is increasing.... [5] And the public is divided about the [ACA]...."
Paul Keckley

Benefits in General

DOL Conflict of Interest/Fiduciary Regulatory Package Survives Court Challenge in DC
"Plan sponsors should be watching for packages from their retirement plan services providers regarding how their services, agreements and fees may change under the way the service provider has structured its compliance programs in response to the Conflict Package and should investigate whether what is proposed is the only approach for your plan. It is particularly important to remember that some of the changes can be implemented via a notification and an opportunity to object and if you do not respond to the notification, you will be deemed to have consented to the changes[.]"
Winstead PC

Questions to Ask Before Signing That New Service Agreement (PDF)
"Employers need to carefully review and negotiate proposed service agreement terms (even if their plans are not covered by ERISA) to ensure that they are balanced, fair and reasonable, comply with ERISA where applicable ... and do not create liabilities, duties and obligations that they, in hindsight, never would have 'bargained for.' [This article describes] just a few of the most common areas that should be scrutinized and negotiated with the help of business and legal advisors."
Boutwell Fay LLP

Why Not Let Employees Vote on Benefits?
"You may already survey employees about their benefits to gauge satisfaction, and part of that may be soliciting ideas for changes and/or additions. But have you thought about actually putting specific decisions about your benefits offering to a vote?"
Benefitfocus

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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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