Health & Welfare Plans Newsletter

November 22, 2016

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Webcasts and Conferences

DOL Audits of Group Health Plans: Prepare and Respond Effectively
December 7, 2016 WEBCAST
Thomson Reuters / EBIA

Executive Compensation Proxy Season Preview
December 8, 2016 WEBCAST
Willis Towers Watson

Voluntary Fiduciary Correction Program Workshop
December 14, 2016 in CA
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

Group Health Plans Year-End Update
December 15, 2016 WEBCAST
Thomson Reuters / EBIA

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[Guidance Overview]

IRS Delays Employer ACA Reporting
"[E]ven if the employer mandate is repealed for 2017, it still appears that at least some form of employer reporting requirement would remain in place.... If an ACA alternative program is effective in 2018, it could eliminate the need for the current ACA reporting needs. However, insurance carriers would almost certainly remain a key component of any ACA replacement plan."
Xerox HR Services

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[Guidance Overview]

IRS Extends Deadlines for Individual Statements Under ACA Information Reporting Rules
"The IRS indicated in Notice 2016-70 that this good-faith extension relief also will apply regarding the ACA information-reporting requirements under Code Sections 6055 and 6056 for 2016.... The transition relief applies to: [1] Missing and inaccurate taxpayer identification numbers and dates of birth; [2] Other information required on a return or statement. However, relief is not available for reporting entities that either: [1] Do not make a good-faith effort to comply with the governing regulations; [2] Fail to file an information return or furnish a statement by the due dates (as extended under Notice 2016-70)."
Practical Law Company

Text of DOL OIG Report: EBSA Did Not Have the Ability to Protect the Estimated 79 Million Plan Participants in Self-Insured Health Plans from Improper Denials of Health Claims (PDF)
30 pages. "In 1975, EBSA exempted health plans having fewer than 100 participants from reporting requirements because the agency did not want to create an undue administrative burden. As a result of this exemption, EBSA has collected no information about denials of health claims from self-insured health plans that cover about 79 million participants. Moreover, Form 5500, EBSA's primary information collection tool, did not capture information on denials of health benefit claims. As a result, even the plans that were required to report to EBSA were not required to provide any information on their denials of health benefit claims. Despite this lack of primary knowledge about denials of health benefit claims in self-insured health plans, EBSA has conducted only limited reviews of these self-insured plans for compliance with external review requirements, and it has yet to issue final guidance for independent review organizations (IRO) that decide appeals of denied claims."
Office of Inspector General [OIG], U.S. Department of Labor [DOL]

Hidden Benefits of Wellness Programs
"[O]ne of the key messages of the university's study is that HR professionals should expand their focus beyond healthcare costs to how wellness programs impact other critical factors such as quality of life or employee engagement and retention. By doing so, they can capture the full value of wellness initiatives and evolve wellness into well-being programs that help shape employee behavior across social, emotional, physical and financial dimensions."
Human Resource Executive Online

HSA Tax Reporting for the Account Holder
"Form 1099-SA does not break down withdrawals for eligible expenses and non-eligible expenses.... You are responsible for tracking eligible and non-eligible expenses. You receive a copy of Form 5498-SA by May 31 each year.... Trustees are not required to issue Form 5498-SA until May 31 because you can continue to make contributions for a calendar year up to the date you file your income tax return or the due-date for federal tax returns (usually April 15), whichever comes first. That means you must rely on other documentation (W-2s, account statements, and web-based transaction searches) to report your HSA contributions on your income tax returns. You complete and submit Form 8889 as part of your federal income tax return."
Xerox HR Insights

Knowledge About Health Insurance and Finance Linked to Higher Rates of Health Coverage
"For a typical person who was uninsured in 2013, the chance of being insured in 2015 was 9.2 percentage points higher if they had high health insurance literacy as compared to someone with low health insurance literacy ... The effects of high health insurance and financial literacy were significantly linked to obtaining coverage even after researchers considered other factors, such as a person's income level, employment and political affiliation."
RAND Corporation

Spotlight on Government Funding and Future of ACA (PDF)
"During 2017, the Republicans will keep the spotlight on writing a playbook to repeal and replace the ACA.... [A]ny replacement law would, in all likelihood, maintain some or all of the ACA insurance market reforms ... The timing and roadmap for any repeal and replacement of the ACA is not yet determined, and employers should not expect such actions to be simultaneous."
Xerox HR

Replacing the ACA: A Reality Infusion
"In theory, congressional Republicans could quickly bring forward the same reconciliation bill that the president vetoed earlier this year. That bill repealed the premium tax credits, individual and employer mandates, Medicaid expansion, medical device tax, the so-called 'Cadillac tax' on high-cost plans, insurer tax, high-income tax and small-business tax credit. It also ... removed the insurance risk-adjusted programs. That Republican package passed Congress with the full knowledge that it would be vetoed by President Obama, so there was no need for its backers to contemplate the real-life implications for patients, the health system or the markets were it to become actual law."
Dentons

[Opinion]

Living in Uncertainty: The New, New Normal
"For six years, the healthcare industry in the U.S. has been adjusting to its new normal based on the regulatory framework of the [ACA]. It became normal to discuss the volume to value transition, accountable care organizations, bundled payments, Medicaid expansion and Healthcare.gov. We adapted. We were certain they'd be around for years to come. Then came the election."
Paul Keckley

Benefits in General

[Guidance Overview]

IRS Changing Employee Plans and Exempt Organization Audit Procedures
"The IRS Tax Exempt and Government Entities Division (TEGE) [has] issued updated internal guidance governing the procedures its agents will use to gather information for employee benefit plan and exempt organization examinations beginning April 1, 2017.... The Guidance also calls for: [1] Taxpayers to be involved in the [information document request (IDR)] process; [2] Examiners to discuss the issue being examined and the information needed with the taxpayer prior to issuing an IDR; [3] Examiners to ensure that the IDR clearly states the issue and the relevant information they are requesting."
Solutions Law Press

Benefits Litigation Update, Fall 2016 (PDF)
Articles include: [1] The Goldilocks Paradox for defined contribution plans: how will plan sponsors determine whether investment alternatives offered are 'just right'? [2] ERISA class action certified challenging behavioral health TPA's administration of mental health benefits; [3] Defining the scope of ERISA preemption; [4] Plan fiduciaries continue to be scrutinized; [5] Employers offering their own proprietary funds under their 401(k) plans at heightened risk for litigation; and [6] EEOC loses another wellness plan voluntariness challenge but prevails on its ADA safe harbor argument.
Epstein Becker Green; The ERISA Industry Committee [ERIC]

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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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