Health & Welfare Plans Newsletter

December 29, 2016

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[Guidance Overview]

From IRS: 11 Facts About Health Care Information Forms for Employers and Coverage Providers
"Under the [ACA], insurance companies, self-insured companies, and large businesses and businesses that provide health insurance to their employees must submit information returns to the IRS and individuals reporting on health coverage.... Here is some information about the types of forms, the purpose of each, and noteworthy dates[.]"
Internal Revenue Service [IRS]

[Advert.]

Online Learning Course: HIPAA Security

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Health plans and business associates must comply with the HIPAA Security Rule. Topics covered include: Administrative Safeguards; Physical Safeguards; Technical Safeguards; and Organizational Requirements.


[Guidance Overview]

CMS Releases Manual for Cost-Sharing Reduction Reconciliations
"The 2016 draft manual is very similar to the 2015 manual, but incorporates guidance that CMS has provided over the first two years of CSR reconciliation, includes updated attestations and guidance on estimating the EHB portion of claims, and additional information on how CMS will handle reporting outliers. The final manual includes revised language on the handling of discrepancies and appeals based on the 2018 payment notice, an additional optional data element for premiums, and an updated process for selecting a methodology."
Timothy Jost, in Health Affairs

[Guidance Overview]

Universal Paid Leave Act Will Create Significant New Costs for District of Columbia Employers
"Covered employers will have to contribute to the UPLA fund the equivalent of 0.62 percent of all wages paid to covered employees. To allow time for the District to establish the bureaucracy that will be necessary to administer the program, the District will not begin collecting the tax from employers until July 1, 2019, and will not begin paying benefits to employees until July 1, 2020."
Ogletree Deakins

CMS Webinar for States and Issuers: Federal Definitions for Health Insurance Products and Plans (PDF)
12 presentation slides; dated Dec. 27, 2016. Topics: [1] What is a Product? [2] Plan Finder -- Product and Plan; [3] Product Level Request for HIOS ID; [4] Is it a Product or a Plan? [5] What is a Plan?
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

CMS Contractor Survey Illustrates Four Health Care Transparency Paradoxes
"Physicians, not websites, are the most trusted source of information about health care ... There is ambivalence about the role of government as a source of quality information ... Quality measures don't report what consumers want to know most ... Many consumers don't feel empowered to act upon ratings."
Health Affairs

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2017 Health Savings Accounts Facts

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State University Is an Arm of the State, Therefore Immune from FMLA Suit
"The employee rejected the offer to be placed in an inferior position, and filed suit under the FMLA's self-care and retaliation provisions.... The district court rejected MSU's motion to dismiss her federal claim based on Eleventh Amendment immunity, finding that the university is not an alter ego of the state and so can be sued in federal court. Applying the fact-intensive, co-equal Fitchik factors -- which differ slightly from the analogous factors considered by its sister circuits -- the Third Circuit reversed in what it deemed a 'close case.' " [Maliandi v. Montclair State Univ., No. 14-3812 (3d Cir. Dec. 27, 2016)]
Wolters Kluwer Law & Business

Lawmakers Interested in Student Loan Repayment as Employee Benefit
"The average debt per borrower has nearly doubled since 2004, increasing from roughly $18,000 to more than $35,000 for a 2015 graduate. As millennials become a larger share of the workforce, the student loan debt dilemma is attracting more attention from employers. Legislative proposals would allow employers to establish a variety of tax-preferred student loan repayment assistance programs."
Willis Towers Watson

The Future of the ACA, Part 4: The Ryan Plan, 'A Better Way'
"Unlike the Trump/Pence plan, which consists of a series of high-level bullet points, the Ryan plan is a fairly detailed policy proposal. Hence, while not in actual legislative form, it provides a good sense of some of the likely features of the ACA's replacement."
Mintz Levin

[Opinion]

How to Boost Workers' Take-Home Pay Without a Raise
"What's needed are ways to avoid the pervasive archaic thought process of the heath insurance industry and to adjust the approach of procurement of benefits to use the same rigor that is used when purchasing other goods and services. This can be achieved by uncovering redundancies, waste and underperformance in benefits plans and vendor arrangements without compromising the quality of services provided to employees."
CFO

[Opinion]

What Can Be Done About Rising Health Care Costs?
"Most of the health care stakeholders do not stand to benefit from transparency and cost-conscious patients.... [W]orkers do not comparison shop. When a decision support tool is available, ... from two-thirds to three-fourths of workers either do not log in ever; log in only once or only twice.... [T]here is plenty that can be done to lower the cost of medical care and get providers to compete on the basis of price, quality and other amenities. The problem is: nobody wants to."
National Center for Policy Analysis Health Policy Blog

Executive Compensation and Nonqualified Plans

More ISS Updates for 2017
"How does ISS view a plan amendment to increase the tax withholding rate applicable upon award settlement? ... What is ISS' policy on say-on-pay frequency?"
Winston & Strawn LLP

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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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