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[Guidance Overview]
Integration Rules for Family HRAs Addressed in ACA Guidance
"In their latest FAQs, the Departments address how their prior guidance applies to family HRAs (that is, an HRA that reimburses medical expenses of an employee's spouse and/or dependents) when: An employee is enrolled in self-only coverage. The employee's spouse and dependents are enrolled in a non-HRA group health plan sponsored by the spouse's employer."
Practical Law Company
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District Court Finds Employer Violated FMLA by Failing to Provide Calculation of When Leave Expires
"When Ross informed her employer about her modified return-to-work date, her employer did not provide her with an updated calculation of leave or inform her when her leave would expire. After Ross exhausted her FMLA leave, her employer [failed] to inform her that she exceeded the amount of available time and terminated her [employment]. Ross filed a lawsuit alleging her former employer did not provide her with proper notice after she informed it about a change in her status.... The district court agreed with Ross." [Ross v. Youth Consultation Service, Inc., No. 14-2229 (D.N.J. Dec. 29, 2016)]
Jackson Lewis P.C.
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Supervisor's Comment on Timing of Leave Supports FMLA Claims
"A school district director reassigned shortly after taking medical leave could go to trial on his [FMLA] claims because the superintendent had said that she was 'frustrated' that his leave did not begin immediately ... Additionally, the court found that the timing of the district's discipline of [the employee], which occurred on the very day his FMLA leave was to end, could show that he was reassigned because he used FMLA leave." [Chumbley v. Board of Educ. for Peoria Dist. 150, No. 14-1238 (C.D. Ill. Dec. 9, 2016)]
Society for Human Resource Management [SHRM]
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California Legislators Revisit Parental Leave
"Currently, businesses with 50 or more employees must provide protected baby-bonding leave. The new law would apply to employers with 20-49 workers.... [and] would provide mothers and fathers with 12 weeks of unpaid job-protected baby-bonding leave. Covered employees would be entitled to take the leave within the first year following a child's birth, adoption or foster placement. [A previously] vetoed bill would have provided six weeks of leave."
Society for Human Resource Management [SHRM]
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Blurred Lines: HDHPs and PPOs Looking More Alike
"These two plan types have typically distinguished themselves from each other in the trade-off between the price of premiums and out-of-pocket costs. PPO subscribers pay more up front in premium for the benefit of paying less when they use health care services, while HDHP subscribers experience the inverse. But that dichotomy appears to be fading. According to the 2017 enrollment data, HDHP premiums are starting to look more like those of PPOs, and PPO out-of-pocket costs are starting to look more like those of HDHPs."
Benefitfocus
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An Evaluation of the Individual Health Insurance Market and Implications of Potential Changes (PDF)
48 pages. "[T]his issue paper ... examines experience in the [ACA] individual market. It outlines the conditions necessary for a sustainable individual health insurance market, examines whether these conditions are currently being met, and discusses the implications of potential changes to improve the ACA market rules or replace the ACA with an alternative approach."
American Academy of Actuaries Individual and Small Group Markets Committee
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CBO Updates Projected Effects of a Repeal of ACA
"The CBO projects that the repeal legislation would not have an immediate dramatic effect in 2017 because premium increases would already be established and enrollment set for 2017. In 2018, however, 18 million people would become uninsured, including ... 3 million fewer with employment coverage. These increases would be due to a combination of people dropping coverage because it was no longer mandated and to insurers abandoning the nongroup market and increasing premiums because of adverse selection concerns."
Timothy Jost, in Health Affairs
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Budget Scorekeepers Say GOP Plan Would Raise Number of Uninsured by 32 Million
"The bill considered the most likely prototype for partial repeal of the [ACA] would result in as many as 32 million more people without health insurance and would double premiums in the individual insurance market ... The estimate by the [CBO] and the [JCT] was on the impact of the bill passed by the Republican Congress in 2015 and vetoed by President Barack Obama last January."
Kaiser Health News
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Massachusetts Governor's Health Overhaul Includes Employer Charge, Payment Cap
"If approved by the Legislature, companies with 11 or more employees would be required to pay the state $2,000 annually for each worker who is not covered by an employer health care benefit. The employer mandate was included in the state's 2006 universal health care law but was repealed in 2013 after the federal [ACA] took effect."
Boston.com
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Sen. McConnell Introduces Bill to Fund Coal Miner Health Plans
"Top Senate Republican Mitch McConnell on [January 17] introduced legislation to maintain health benefits for retired union coal miners whose companies have declared bankruptcy in recent years. McConnell was among those who successfully worked last year to provide a four-month extension of health benefits that protected 16,000 miners whose benefits would otherwise have been cut off on Jan. 1."
Associated Press
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Honeywell Retirees Appeal Dismissal of Claim for Lifetime Health Care Benefits
"Retirees of Honeywell International Inc. have appealed an Ohio federal judge's ruling that found the company did not need to pay them lifetime health care benefits.... Through a series of collective bargaining agreements, each of which had a specific term of about three years, Honeywell provided health care benefits to the plaintiffs. Honeywell continued to contribute for several years after the final agreement expired."
LegalNewsLine.com
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[Opinion]
How Can We Repeal the ACA and Still Insure the Uninsured?
"Most of the recommendations that follow are incorporated in bicameral legislation introduced in the House and the Senate by Pete Sessions and Bill Cassidy and in the Patient Freedom Act, sponsored by Senator Cassidy.... [1] Remove the perverse incentives from the individual market ... [2] Offer a uniform tax credit to people who buy their own health insurance ... [3] Offer the same tax credit for group insurance ... [4] Let employers choose between the individual and group markets ... [5] Let employers choose the employee's tax benefit ... [6] Let employers offer their employees personal and portable insurance ... [7] Integrate Medicaid and private insurance ... [8] Create an effective safety net."
Health Affairs
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Benefits in General
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[Guidance Overview]
DOL's Final Rule Modifies ERISA Disability Claim Regulations
"Addressing conflicts of interest, the final rule requires decisions regarding hiring, compensation, termination, or promotion of persons involved in making claim decisions not be based on the likelihood the individual will support denial of benefits.... The final rule expanded the definition of 'adverse benefit determination' to include 'any rescission of disability coverage,' including 'cancellation or discontinuance of coverage that has a retroactive effect.' "
Womble Carlyle
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Executive Compensation and Nonqualified Plans
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Lawsuits and Court Cases of Interest That Involve Stock Compensation
"According to the complaint, Uber recruited software engineers with whom it had employment agreements to grant ISOs with a vesting schedule of 25% after the first 12 months and then monthly vesting thereafter. However, the company changed the provision to allow all of the shares to become exercisable after six months, forcing some ISOs to become NQSOs ... In [a separate case], the Connecticut Supreme Court confirmed that Connecticut can tax income from option exercises by a nonresident if the options were granted as compensation for performing services within the state."
myStockOptions.com
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Press Releases
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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2017 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 those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.
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