Health & Welfare Plans Newsletter

January 17, 2017 logo logo
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Pavilion Advisory Group Inc.
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Webcasts and Conferences

Repeal and Replace? Repeal and Delay? What the Health Reform is Going on Out There?

Helping Your Employees to Think and Act Like Owners
January 18, 2017 WEBCAST
Ohio Employee Ownership Center

Status Update on the DOL's Expanded Fiduciary Rule
February 23, 2017 in IL
Michael Best & Friedrich LLP

Health and Welfare Plans - Strategic Planning & Design (B3A): Discover the Important Issues
March 9, 2017 in MA
New England Employee Benefits Council

LBI & Pension Risk Transfer Market
March 9, 2017 WEBCAST

EBIA Employee Benefits Seminar
June 6, 2017 in TX
Thomson Reuters / EBIA

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[Guidance Overview]

Calendar Year Health Plans Must Complete Online CMS Disclosure by March 1 (PDF)
"The plan sponsor must complete the disclosure within 60 days after the beginning of the plan year. (Sponsors of insured plans may apparently choose to file within 60 days after the beginning of the insurance contract year, but whatever approach they adopt, they should use that approach consistently.) ... A CMS filing is also required within 30 days of termination of a prescription drug plan and for any change in a plan's creditable coverage status. Some plans are exempt from the filing requirement."
Lockton Benefit Group


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[Guidance Overview]

Proposed Amendments to the Cafeteria Plan Provisions of the Puerto Rico Internal Revenue Code
"These proposed amendments are intended to reactivate in Puerto Rico cafeteria plans and make the adoption of these plans more attractive to Puerto Rico employers by expanding the list of 'qualified benefits' that they may be provided to Puerto Rico employees. However, as more fully explained [in this article], unless HR 453 is further amended to correct or eliminate certain deficiencies existing in Section 1032.06 of the 2011 PR Code, it will be very difficult to accomplish its intended goal."
McConnell Valdes

Health Care in 2017: What to Expect
"Trends from 2016: Rising costs as a catalyst for change ... Continued interest in HDHPs ... Decision support & transparency tools ... Alternative care options ... Communication on the rise.... What to expect in 2017: Personalized enrollment software ... Centralized information ... [ACA]."

Large Employer Health Plans Could See Impacts from ACA Overhaul
"If you think that because you get health insurance through your job at a big company, you won't be affected if Republicans overhaul Obamacare, think again. Several of the law's provisions apply to plans offered by large employers too.... No copays for preventive services ... No annual or lifetime limits on coverage ... Annual cap on out-of-pocket payments for covered services ... Adult kids' coverage expanded ... Guaranteed external appeal rights ... No waiting periods to join a plan ... No waiting periods for coverage of pre-existing conditions ... Standardized plan descriptions ... Basic coverage standards for large-group plans."
Kaiser Health News

IRS May Have Big ACA Employer Tax Woes
"[The National Taxpayer Advocate's 2016 Report to Congress said that] the IRS was not equipped to test the accuracy of ACA health coverage information reporting data before the 2016 filing season, for the 2015 coverage year. The IRS expected to receive just 77 million 1095-C forms for 2015, but it has actually received 104 million 1095-C forms and has rejected 5.4 percent of the forms ... [The Taxpayer Advocate Service] helped 10,910 taxpayers with ACA premium tax credit issues in the 12-month period ending Sept. 30, up from 3,318 in the previous 12-month period."
Treasury & Risk; free registration may be required


Now is the time to become a member of ECFC

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ECFC is dedicated to maintaining and expanding employee benefit programs on a tax-advantaged basis. Members include employers, TPAs, health plan providers, brokers, payers, providers, payment networks, processors, and financial institutions.

CBO Report: How Repealing Portions of the ACA Would Affect Health Insurance Coverage and Premiums
"CBO and JCT estimate that enacting [H.R. 3762, the Restoring Americans' Healthcare Freedom Reconciliation Act of 2015] would affect insurance coverage and premiums primarily in these ways: [1] The number of people who are uninsured would increase by 18 million in the first new plan year following enactment of the bill. Later, after the elimination of the ACA's expansion of Medicaid eligibility and of subsidies for insurance purchased through the ACA marketplaces, that number would increase to 27 million, and then to 32 million in 2026. [2] Premiums in the nongroup market ... would increase by 20 percent to 25 percent -- relative to projections under current law -- in the first new plan year following enactment. The increase would reach about 50 percent in the year following the elimination of the Medicaid expansion and the marketplace subsidies, and premiums would about double by 2026." [Unnumbered report dated Jan. 17, 2017]
Congressional Budget Office [CBO]


One Thing Small Businesses Don't Need: ACA Repeal
"The reality is the ACA has been instrumental in helping small employers and their employees who struggled previously to afford health insurance coverage. Prior to the enactment of the health care law, small businesses and their employees comprised a disproportionate share of the working uninsured.... By 2016, however, the insurance landscape for small employers had undergone a dramatic shift.... And thanks to the health care law's cost-containment provisions, premiums are stabilizing for many small firms. We've seen much smaller increases in the small group market compared to pre-ACA, where double-digit increases were often the norm."
John Arensmeyer in Morning Consult


Paid Sick Leave Provides Economic and Health Security to Over a Million Federal Contract Workers
"Evidence from the private sector and the states and cities with paid sick leave laws demonstrates that paid sick days improve employee retention, reduce workplace contagion and injury, and increase productivity. The cost savings associated with paid sick days serve the purpose of the final rule to promote economy and efficiency in federal contracting. Furthermore, as with existing state and local paid sick leave laws that are very similar to the final rule, the proposed rule will benefit workers, their families, and public health."
Economic Policy Institute

Press Releases

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2017, 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, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.

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