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[Guidance Overview]
New Nondiscrimination Requirements Under ACA Section 1557: Do You Have to Comply?
"A covered entity is an entity that is a 'health program or activity' and that receives federal financial assistance from HHS. Examples of health programs or activities include group health plans, hospitals, health clinics, health insurance issuers, and physicians' practices.... An employer can be impacted by the regulations, even if the employer itself is not a covered entity. For example, if the employer sponsors a self-insured group health plan that accepts federal funds, such as Medicare Part D subsidies for retiree medical coverage, the plan will be subject to these new requirements."
K&L Gates LLP
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One Employer Fights Against Prescription Drug Abuse
"The 55,000-person company requires employees in some plants to attend training sessions on identifying and addressing drug activity and prescription-drug abuse.... After a positive test, the company steers workers to treatment if needed and reassigns them from safety-sensitive jobs.... Nearly one in three opioid prescriptions covered by employer health plans is being abused[.]"
The Wall Street Journal; subscription may be required
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Higher Marketplace Benchmark Plan Premiums Could Reduce Post-Subsidy Premiums for Many
"Monthly premiums for Benchmark Silver plans in the [ACA]'s (ACA) Federally Facilitated Marketplaces (FFM) for individual health plans will increase by an average of 25 percent from 2016 to 2017. The magnitude of these increases has raised concerns about the viability of the marketplaces and the affordability of the ACA ... [T]ax credits could effectively shield the majority of marketplace enrollees from premium increases. What has been overlooked is that the mechanism for updating the tax credits could actually result in reduced post-subsidy premiums for many marketplace enrollees."
Health Affairs
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Election Results 2016: Preliminary Considerations for the Health Insurance Industry
"[I]nsurers should consider establishing relationships with members of Congress and incoming Administration officials at [HHS] and the White House ... Key questions and preliminary considerations for the health insurance industry include these: Can the ACA be fully or partially repealed? ... What specific ACA provisions could the Congress eliminate? ... What would be the timing for full or partial repeal of the ACA? ... What might replace the ACA? ... Will there be changes in congressional health leadership in 2017?"
Sidley Austin LLP
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The Health Care Challenges Trump's White House Will Face
"The uninsured rate is down ... ACA exchange premiums are up ... Out-of-pocket costs continue to climb ... Drug price hikes make the headlines.... [O]verall drug spending continues to rise ... Medicare spending continues to rise (although the spending growth rate has slowed) ... Medicaid spending is also up ... MACRA sets the stage for the future of value-based payment in Medicare."
The Advisory Board Company
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[Opinion]
Seven Steps to Dismantle Obamacare on Day One of the Trump Administration
"[C]onsider issuing an immediate waiver of all fines and penalties associated with the individual mandate.... [E]mbrace [the House v. Burwell] decision ... [and] determine whether there is a legal basis to recover the roughly $14 billion dollars that insurance companies have already received.... [R]everse or modify the enforceability of the abortion-pill mandate, particularly regarding religious institutions.... [A]dhere to the provisions of the ObamaCare law disallowing health insurance companies from being reimbursed before the United States Treasury receives its funds.... [R]eview all exemptions and waivers with an eye toward dismantling the law.... [H]alt all outreach efforts and eliminate enrollment assistance funds for the ObamaCare market places.... [U]se the bully-pulpit of [the] presidency against insurers."
American Center for Law and Justice [ACLJ]
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Benefits in General
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2016 Year-End Compliance Checklist for Retirement and Group Health Plans (PDF)
"With the results of the Presidential election just behind us, it is likely that the landscape of employee benefit plans -- and the regulations that govern them -- will change. For the time being, however, there are still some important compliance deadlines quickly approaching, so [this 3-page chart reminds] plan sponsors of these key compliance actions as 2016 comes to a close[.]"
Fulcrum Partners, LLC
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Press Releases
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BenefitsLink.com, Inc.
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Winter Park, Florida 32789
(407) 644-4146
Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager
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.
Links to web sites other than BenefitsLink.com and EmployeeBenefitsJobs.com are offered as a service to our readers; we were not involved in their production and are not responsible for their content.
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