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Six Key Questions Arising from President Trump's ACA Executive Order
"[1] Will 'hardship' undermine the individual mandate? ... [2] Are transitional plans here to stay? ... [3] What impact could the executive order have on selling insurance across state lines? ... [4] Will the executive order fast-track pending 1115 waivers? ... [5] Could the employer market be at the center of the action? ... [6] Will essential health benefits be affected?"
Milliman's Healthcare Town Hall
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Departments Issue FAQs on Special Enrollment, Women's Preventive Care Services
"The departments clarified that someone who loses eligibility for individual coverage, including marketplace coverage, is entitled to a special enrollment period in a group health plan for which that individual is otherwise eligible. They also specified that updated guidelines on women's preventive care apply for plan years beginning on or after January 1, 2017."
Conduent
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Seventh Circuit Punts on Wellness Program Case, Leaving Unanswered Questions for Employers
"[W]hile the 7th Circuit upheld the Western District of Wisconsin's dismissal of Flambeau, the court did not reach the merits of any of the parties' arguments under the ADA. Rather, the dismissal was affirmed on grounds that the case was now moot, and there was no relief that could be granted to the parties.... The Flambeau decision did seem to leave open the possibility that the insurance safe harbor might apply to at least some wellness programs[.]" [EEOC v. Flambeau, No. 16-402 (7th Cir. Jan. 25, 2017)]
Miller & Chevalier
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Is the Patient Freedom Act the First Step Towards Replacing the ACA?
"The key feature of the proposed legislation would allow states to select the form of healthcare regulation to implement for residents.... Under the proposal, the individual mandate, employer mandate and benefit mandates of the ACA would be repealed. However, consumer protections such as the prohibitions on annual and lifetime limits on coverage, pre-existing condition exclusions and discrimination will remain in place."
Polsinelli PC
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[Advert.]
Understanding the Math of Your Health Plan Renewal
Feb. 27 webinar. Understand concepts and terminology in your health insurance renewal to identify inefficiencies and design and build successful strategies that can have both short and long term cost savings.
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ACA Repeal Efforts Would Impact State Laws, Too
"State-level legislation and regulations help ensure that state regulators have full authority to enforce the ACA market reforms.... States with full enforcement authority can, for example, issue regulations or guidance, undertake market conduct exams, or take disciplinary action related to the law's consumer protections, such as its ban on denying coverage based on preexisting conditions or charging women more than men.... These state laws further complicate congressional efforts to repeal and replace the ACA."
The Commonwealth Fund
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Premiums, Cost Sharing, and Provider Choice All Worse in 2017 ACA Exchange Plans
"For plans sold in the exchanges in 2017, not only have the premiums gone up 25 percent for the popular low-cost silver plans, but the average deductibles for silver plans have increased 20 percent, and over two-thirds of plans now have more restrictive networks (with only 31 percent allowing out-of-network coverage with the penalty of higher cost sharing)."
Avalere, via Physicians for a National Health Program [PNHP]
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Benefits in General
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[Official Guidance]
Text of IRS Disaster Relief Announcement ATL-2017-03: For Victims of Severe Storms, Tornadoes and Straight-Line Winds in Georgia
"Victims of the severe storms, tornadoes, and straight-line winds that took place beginning on January 2, 2017 in parts of Georgia, may qualify for tax relief from the [IRS].... Individuals who reside or have a business in Dougherty County may qualify for tax relief.... [C]ertain deadlines falling on or after January 2, 2017, and before May 31, 2017, are granted additional time to file through May 31, 2017.... This relief also includes the filing of Form 5500 series returns (that were required to be filed on or after January 2, 2017, and before May 31, 2017)[.]"
Internal Revenue Service [IRS]
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White House May Favor Cutting Federal Employee Retirement, Health Benefits
" 'Federal employee health and retirement benefits continue to be based on antiquated assumptions and require a level of generosity long since abandoned by most of the private sector,' [White House Press Secretary Sean Spicer] said. 'Those costs are unsustainable for the federal government, just as they are proving to be unsustainable for state and local governments with similar health and retirement packages.' "
Government Executive
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Possible Supreme Court Pick Hardiman Offers Pro-Worker ERISA Streak
"Since his appointment to the U.S. Court of Appeals for the Third Circuit in 2007 by President George W. Bush, Judge Thomas M. Hardiman has signed on to several decisions favoring workers who attempt to enforce their rights under [ERISA]. He's twice joined opinions offering a broad view of ERISA standing in disputes over medical payments, and in 2015 he added his name to a decision placing the burden of demonstrating administrative exhaustion on plan administrators rather than the participants challenging denied benefits."
Bloomberg BNA
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David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager
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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