Health & Welfare Plans Newsletter

December 8, 2016

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[Official Guidance]

Text of IRS Proposed Regs: Electronic Filing of Report of Health Insurance Provider Information
10 pages. "This document proposes to amend the Health Insurance Providers Fee regulations to require certain covered entities engaged in the business of providing health insurance for United States health risks to electronically file Form 8963, 'Report of Health Insurance Provider Information.' These proposed regulations affect those entities."
Internal Revenue Service [IRS]

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[Official Guidance]

Text of IRS Proposed Regs: Health Insurance Providers Fee
12 pages. "This document contains proposed regulations that would modify the current definition of 'net premiums written' for purposes of the fee imposed by section 9010 of the [ACA]. The proposed regulations will affect persons engaged in the business of providing health insurance for United States health risks."
Internal Revenue Service [IRS]

[Guidance Overview]

Small Employer Healthcare Relief Act Soon a Reality (PDF)
"Starting January 1, 2017, small employers that do not offer group health insurance to their employees will have a tool to provide a tax-favored reimbursement to their employees. And more good news: there's transition relief retroactive for all plan years beginning on or before December 31, 2016 that the onerous penalties announced by the IRS in Notice 2015-17 are no longer in effect."
Kushner & Company

Congress Passes Legislation Allowing Premium-Reimbursement HRAs Under the ACA
"[T]he bill will allow certain small businesses to use health reimbursement arrangements (HRAs) without incurring penalties under the [ACA].... Under the act, a qualified small employer HRA must be funded solely by an eligible employer, and there can be no salary reduction contributions under the arrangement.... [T]he amount of payments and reimbursements under the plan for any year cannot exceed $4,950 ($10,000 in the case of an arrangement that also provides for payments or reimbursements for family members of the employee)."
Journal of Accountancy

Reference-Based Pricing: The New Frontier of Cost Control?
"The largest entity using [reference-based pricing (RBP)] is Medicare, which uses bottom-up pricing based on providers' costs of doing business ... Medicare determines a base rate for each service and then makes adjustments based on patient complications, geographic cost differences, and other factors. Employers who use RBP often pay providers the Medicare rate plus 20-50%. In contrast, PPOs provide a top-down discount off of billed charges for their in-network providers. With RBP, employers are shifting from discount-based to cost-based payments to providers."
Marsh Consulting Group

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Important Things to Know About HSAs
"[1] HSA portability and ownership ... [2] Tax benefits, 3 times ... [3] Flexible contributions ... [4] Rollover funds ... [5] Option to invest ... [6] Pay for prior medical expenses ... [7] Use it as a retirement income ... [8] Make catch-up contributions ... [9] Cover COBRA and Medicare premiums ... [10] Change of healthcare plans? No problem."
DataPath

Trends in Marketplace Plans: An Early Look at 2017 Coverage
"There are fewer plans across the board, and an increasing concentration in Silver, especially among Medicaid Managed Care plans. The trend toward closed networks continues.... [T]he number of plans declined considerably, nearly 16 percent overall."
Robert Wood Johnson Foundation

Has Obamacare Been Trumped? the Potential Impact of the New Administration on the ACA
"Due to the challenges with a full repeal, Congress is likely to only repeal certain parts of the law.... [T]he following will be high priority issues: [1] Implications of HHS and CMS Leadership on ACA and MACRA Reforms ... [2] Can we keep the ACA's 'good parts' and ditch its 'bad parts'? ... [3] Insurance exchanges and subsidies ... [4] Medicaid reforms ... [5] Provider fraud and abuse and program integrity."
Gray Plant Mooty

[Opinion]

Five Reasons Why the ACA Won't Be Repealed
"[1] ACA repeal has never meant repealing the entire law.... [2] There's a reason the ACA is as complicated as it is. It had to be that way to work.... [3] Ten states led by Republican governors, including Ohio, Michigan, and Indiana, have expanded Medicaid under the ACA.... [4] There is no replacement plan ... [5] Discussions are burgeoning now about how the health care community -- consumers, providers, companies, states, and more -- will come together to oppose ACA repeal without a contemporaneous replacement plan that works."
Health Affairs

[Opinion]

American Academy of Actuaries Letter to Congress: Consequences of Repealing ACA Provisions or Ending Cost-Sharing Reduction Reimbursements (PDF)
"Repealing major provisions of the ACA would raise immediate concerns that individual market enrollment would decline, causing the risk pools to deteriorate and premiums to become less affordable. Even if the effective date of a repeal is delayed, the threat of a deterioration of the risk pool could lead additional insurers to reconsider their participation in the individual market. Likewise, eliminating the reimbursements to insurers for cost-sharing reduction (CSR) subsidies could result in insurer losses and solvency challenges, leading insurers to further consider withdrawing from the market. In either case, significant market disruption could result, leading to millions of Americans losing their health insurance."
American Academy of Actuaries

[Opinion]

Ikea Is Right: Hourly Workers Need Paid Parental Leave, Too
"Ikea's plan treats salaried and hourly workers equally in granting all employees paid leave, unlike almost all existent paid family/parental leave plans.... [Of] the top sixty U.S. employers, just twenty-nine confirmed paid family leave policies, and of those twenty-nine, twenty-two demonstrated unequal leave for fathers, adoptive parents, and as a newer finding, low-wage employees."
The Century Foundation

Executive Compensation and Nonqualified Plans

Sixth Circuit Win for State Street Bank in $200 Million Chrysler 'Top Hat Plan' Class Action
"In a second appeal, the Sixth Circuit Court of Appeals has ruled (again) that plaintiffs have no viable ERISA claims because the plan and trust operated as described in plan documents ... In short, all of the claims have been defeated on pleading and procedural grounds without a trial on what happened during the Chrysler collapse." [Loffredo v. Daimler A.G., No. 15-1443 (6th Cir. Nov. 8, 2016)]
McDermott Will & Emery

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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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