Health & Welfare Plans Newsletter

December 13, 2016

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Employee Benefits and the New Administration
January 18, 2017 in IL
Michael Best & Friedrich

What the DOL Expects of Auditors and What Can Go Wrong
January 19, 2017 in CA
Western Pension & Benefits Council - Orange County Chapter

9th Annual ABCs of Pension Plans
January 24, 2017 in CA
Western Pension & Benefits Council - Orange County Chapter

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[Guidance Overview]

PCORI Fees: IRS Audits on the Horizon
"The IRS has recently begun PCORI Fee audits. These examinations require the plan sponsor to [1] identify all of its covered group health plans, [2] identify any plans the plan sponsor determined were exempt from the PCORI Fee and provide the applicable legal authority for that conclusion, [3] specify the method of counting the average number of lives for all covered plans, and [4] provide all associated work papers. In addition, for insured plans, these audits request the plan sponsor to have its Forms 1094-B and 1095-C available during the examination.... [P]lan sponsors may want to perform a precautionary PCORI Fee review."
Wilkins Finston Friedman Law Group LLP

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[Guidance Overview]

ACA Information Returns (AIR) Working Group Meeting, December 13, 2016 (PDF)
45 presentation slides. Topics: [1] Preparation for Filing Season 2017; [2] Filing Season 2017/Tax Year 2016 Lessons Learned; [3] Manifest Crosswalk; [4] Form 1095-C Crosswalk; [5] November Questions and Response Appendix.
Internal Revenue Service [IRS]

OIG Finds EBSA Does Not Have the Ability to Protect 79 Million Participants in Self-Insured Health Plans from Claims Denials
"The OIG has recommended that the EBSA [1] use the agency's existing authority to revisit and revise health plan reporting requirements; [2] require aggregate claims data be reported for all reporting ERISA health and welfare benefit plans; [3] use claims data to focus its health plan investigations; [4] establish external review reporting requirements for [independent review organizations (IROs)]; and [5] issue guidance to clarify the fiduciary status of IROs."
Wolters Kluwer Law & Business

Health & Wellness Programs That Fit Smaller Employers
"If your employees hold memberships and visit the gym a set number of times within a month, they can be rewarded with a partial reimbursement to use toward their membership fees.... Small and mid-size businesses can also encourage employees to see their primary care physician each year for a physical or 'well visit.' "
Corporate Synergies

What Health Reform Law Changes Might Be in Store for Employer-Sponsored Group Health Plans Under the Trump Administration?
"The Filibuster: an obstacle to complete ACA repeal and replacement ... ACA provisions that could be repealed with reconciliation ... ACA provisions that likely cannot be repealed with reconciliation ... Health reform law changes advocated by the President-elect and Republican Congress ... Effecting ACA changes through the executive agencies rather than Congress."
Trucker Huss

[Opinion]

Repeal of Obamacare Could Cause the 'Death Spiral' Critics Warned About
"With guaranteed insurance for people with pre-existing conditions but no subsidies or individual mandate, premiums could skyrocket. Or, more likely, insurers simply would exit the market.... The upshot would be canceled coverage with no other options for people buying in the ACA's marketplaces ... as well as those buying directly from insurers, where the same rules apply. Even if the GOP eliminates only the individual mandate -- while leaving other aspects of the ACA in place for a period of time -- this could happen very quickly. But there are ways to avoid this potential chaos."
Henry J. Kaiser Family Foundation

[Opinion]

Mandatory Paid Sick Leave: The Wrong Prescription for New Jersey
"Proponents have portrayed the law as all gain and no pain. But a careful look at the experience of the other jurisdictions that have adopted such requirements -- including San Francisco, Washington, D.C., Connecticut, and Seattle -- shows that paid sick leave mandates come with notable side effects and few benefits."
Employment Policies Institute

Benefits in General

[Official Guidance]

Text of IRS Notice 2016-79: 2017 Standard Mileage Rates (PDF)
"This notice provides the optional 2017 standard mileage rates for taxpayers to use in computing the deductible costs of operating an automobile for business, charitable, medical, or moving expense purposes.... The standard mileage rate for transportation or travel expenses is 53.5 cents per mile for all miles of business use (business standard mileage rate) ... This notice is effective for [1] deductible transportation expenses paid or incurred on or after January 1, 2017, and [2] mileage allowances or reimbursements paid to an employee or to a charitable volunteer (a) on or after January 1, 2017, and (b) for transportation expenses the employee or charitable volunteer pays or incurs on or after January 1, 2017."
Internal Revenue Service [IRS]

Cover Letters: The Key to Simplifying ERISA Plan Document Requests by Participants and Beneficiaries
"[P]lan sponsors are not required to provide any additional material when responding to a request for plan documents. However, it may pay off to include the following, additional information in a cover letter, when responding to participant requests: [1] The date of the response ... [2] The name of the person to whom the documents are provided.... [3] A list of the documents provided.... [4] Information about next steps."
Foley & Lardner LLP

Press Releases

DATAIR Releases 2016 Government Forms (5500s) and Schedules
DATAIR Employee Benefit Systems, Inc.

DOL Sues Coraopolis, Pennsylvania, Company for Abandoning 401(k) Plan after Ceasing Operations
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

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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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