Health & Welfare Plans Newsletter

December 1, 2016

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Beware of Phishing Email Disguised as Official OCR Audit Communication
"[OCR has warned] health plans, health care providers, and their vendors of a mock communication involving the OCR audit program under [HIPAA]. The email falsifies HHS departmental letterhead and the signature of the OCR Director and directs individuals to a non-governmental website marketing the cybersecurity services of a firm that is not associated with HHS or OCR.... OCR has begun contacting business associates as part of its HIPAA audit program. Business associates should be looking out for any emails they receive from OCR and, after first confirming that they are genuine, take prompt measures to meet audit response deadlines."
Ballard Spahr LLP

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Wellness Programs: Regulatory and Litigation Update (PDF)
"Rather than issuing additional formal guidance, the EEOC has opened the lines of communication with stakeholders through their website and responded more actively to questions about the nuances of their final ADA and GINA wellness program regulations -- particularly on how these rules apply when an employer offers multiple health coverage options or a multi-faceted program.... [R]ulings in two pending cases questioning the validity of wellness programs and a new lawsuit brought by the AARP demonstrate that case law in the wellness arena is still very much in flux and ultimately could impact wellness program design and strategy."
Xerox HR Services

2016 Medical Stop-Loss Premium Survey (PDF)
"This year's survey ... reflects the ongoing rise in stop-loss premiums and a continued commitment to employer-sponsored, self-funded health plans. The occurrence of truly catastrophic claimants -- in excess of $1 million -- is further verified with over 18% of respondents reporting such a claimant in the last two policy years. Stop loss remains the primary focus of risk management, with interest in private exchanges nearly disappearing at 1% amongst respondents. Captive arrangements show increased interest, but still slight at 14%."
Aegis Risk, for the International Society of Certified Employee Benefit Specialists [ISCEBS]

House Passes 21st Century Cures Act with HRA Provisions
"This bill contains a provision ... [which] would establish new small employer health reimbursement arrangements [HRAs] so that eligible small employers can offer [an HRA] funded solely by the employer that would reimburse employees for qualified medical expenses including health insurance premiums."
Employers Council on Flexible Compensation [ECFC]

How Tom Price Could Transform Employer Health Coverage
"On many key points, Price's ACA alternative mirrors the provisions in House Speaker Paul Ryan's blueprint for health reform released in June, including an emphasis on expanding the use of HSAs, allowing employers to provide a defined contribution health care benefit and, controversially, capping the deduction for premiums in employer-sponsored group health plans."
Society for Human Resource Management [SHRM]

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Health Plans Brace for ACA Changes
"Health plans are concerned that their investments in technology to comply with ACA demands will be wasted in the wake of the massive changes promised by the incoming administration."
HealthLeaders Media

How Health Plans Harness Artificial Intelligence
"When it comes to artificial intelligence (AI), health plans are poised to use science fiction-like technologies to improve consumers' experiences and streamline their businesses. Some health plans have already ventured into AI.... [H]ealth plan members may not even be aware when AI helps smooth interactions between themselves and their health plan ... What matters most is improved communication -- and better service."
America's Health Insurance Plans [AHIP]

Turbulent Times for Center for Medicare and Medicaid Innovation
"As lawmakers debate and discuss ways to repeal the [ACA], they will weigh the fate of the [Center for Medicare & Medicaid Innovation], funded through the health law with $10 billion for 2011 to 2019, and another $10 billion for each subsequent decade. [CBO] estimates the center would increase federal spending initially, but ultimately result in lower costs and save up to $34 billion over the next 10 years."
National Public Radio

The Enrollees Who Actually Didn't Even Need Obamacare
"[A]bout 70 percent of the decline in the number of uninsured people [can be attributed to] three factors: the subsidies for buying insurance; the law's more generous criteria for Medicaid eligibility; and the 'woodwork effect,' in which people who were previously eligible for Medicaid 'came out of the woodwork' and signed up for the program in 2014.... The largest effect was due to that woodwork effect -- about 44 percent of the effect they can explain, or roughly 30 percent of the overall reduction in the number of uninsured in 2014. Call it 3.3 million people, out of the 11.6 million who gained insurance that year."
Bloomberg

[Opinion]

Making Paid Leave Work for Every Family
"While there are a range of policy areas where improved definitions of family would more appropriately capture the diverse realities and needs of many families, this report focuses specifically on the importance of inclusive definitions in workplace leave policies ... To ensure these benefits are not restricted by one's ZIP code, this report recommends that all levels of government should: [1] Enact paid leave laws and policies that cover extended relatives and chosen family; [2] Pass comprehensive nondiscrimination protections that protect people on the basis of sexual orientation and gender identity; [3] Improve data collection and research on chosen families and LGBTQ communities."
Center for American Progress

Executive Compensation and Nonqualified Plans

Caution on Transferable Equity Award Provisions
"ISS indicates that it will recommend against equity plan proposals if the details of an ongoing [Transferable Stock Option (TSO)] program are not provided to shareholders.... If a company's equity plan provides for the transferability of equity awards to third parties, and the [TSO disclosures] are not made (which ISS will then evaluate on a case-by-case basis), then the company can expect a negative ISS vote recommendation on their equity plan proposal even if they have run the ISS Equity Plan Scorecard model and believe the plan will pass muster."
EdwardHauder.com

ISS Issues Proxy Policy Updates for 2017
"ISS generally recommends a vote against the plan proposal if the combination of the [equity plan scorecard (EPSC)] factors indicates that the plan is not, overall, in shareholders' interests, or if certain egregious factors apply. For 2017, ISS made minor changes to various factor weightings, but only two recognizable changes to the EPSC."
Winston & Strawn LLP

2016 Director Compensation Report (PDF)
"[T]otal compensation increased by 1.3% at the median of the total sample versus last year's study, which reflects an apparent stabilization of director pay among large- and mid-cap companies in particular.... The mid-cap median of $200,000 reflects only a 1.1% increase from last year, while the small-cap median of roughly $145,000 reflects a larger increase of 6.0%. Technology continues to be the highest-paying sector ... and Financial Services the lowest, consistent with recent years."
Fw Cook

2016 Year-End Key Executive Compensation Reminders and Considerations
"Although 2017 may bring significant changes to the executive compensation landscape, [this article provides] a brief summary of the key executive compensation-related reminders and considerations that remain important for public companies to consider as we approach next year's proxy season."
Latham & Watkins

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David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
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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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