Health & Welfare Plans Newsletter

February 21, 2017

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Hooker & Holcombe, Inc.
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E.H. Thomson & Co., Inc.
in NJ

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Brave New World of HR Technology Are You Maximizing Your Investment?
February 23, 2017 in IL
Worldwide Employee Benefits Network [WEB] - Chicago West Chapter

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[Guidance Overview]

Five Important Things to Remember for the Forms 1094-C and 1095-C Filing Season
"Despite the President, the Executive Order, what your friend said, etc. ALEs still must complete forms ... Deadlines: Employee statements (March 2, 2017) then statements to IRS (March 31, 2017 if filed electronically) ... Each ALE member must file its own Form 1094-C ... All 12 months on line 14 must be completed with a code ... Part III of the Form 1095-C must be completed if an employer sponsors a self-insured plan."
Accord Systems, LLC

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[Guidance Overview]

Individuals Need Not Report Health Coverage Status on 2016 Tax Returns (PDF)
"For those individuals who have already filed returns and who may have paid additional penalties for failure to carry health coverage under the individual mandate, we would imagine that the IRS will either [1] automatically reduce a person's tax liability by any individual mandate penalty paid or [2] provide guidance on amending a tax return to obtain a refund of penalties paid."
Lockton

Facing Pressure, Insurance Plans Loosen Rules For Covering Addiction Treatment
"Aetna will stop requiring doctors seek approval before prescribing particular medications -- such as Suboxone -- that are used to mitigate withdrawal symptoms, and typically given along with steady counseling.... The change comes as addiction to opioids, which include heavy-duty painkillers and heroin, still sweeps the country.... And it puts Aetna in the company of Anthem and Cigna, which both recently dropped the prior authorization requirement for privately insured patients across the country."
Kaiser Health News

ACA's 10 Essential Benefits: A Look At What's At Risk In GOP Overhaul
"Since the 10 required benefits are spelled out in the [ACA], it would require a change in the law to eliminate entire categories or to water them down to such an extent that they're less generous than typical employer coverage.... [P]olicy experts say there's room to 'skinny up' the requirements in some areas by changing the regulations that federal officials wrote to implement the law."
Kaiser Health News

Ex-CEO of Aetna: Here's What Health Care Should Look Like After Reform
"Obamacare has a 'structural imbalance' that resulted in higher costs for healthier, younger people, [former Aetna CEO Ronald Williams] said, but lower costs for those who are 'older and more likely to need care'.... Williams said what is needed is 'much more competition' and lower cost, more flexible plans so that consumers have 'a range of options as opposed to a "one-size-fits-all" approach.' "
CNBC

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When Will Insurers Receive Risk Corridor Payments?
"A number of risk corridor cases are still pending ... While the Lincoln and Health Republic cases were decided on different grounds ... the courts reached contrary conclusions as to whether HHS had an obligation to make annual payments.... The Moda court, however, essentially broke the tie by disagreeing with Lincoln and specifically finding the government liable to Moda.... [In] their recent rate filings, insurers have likely factored in the likelihood of receiving risk corridors payments by raising rates.... [S]ince the risk corridors program expired at the end of 2016, insureds are unlikely to see a significant impact from these cases."
Wolters Kluwer

[Opinion]

Lifetime HSAs: The 'Antisocial' Health Reform that's Good for You!
"Under an individualized lifecycle theory of saving for future health care needs, most young peoples' premium dollars would accrue in their HSAs. Only a small portion of their premiums would go for catastrophic insurance. Over time HSA balances would grow and the ratio of HSA deposits to insurance premiums would decline as one's health risk increases with age."
National Center for Policy Analysis Health Policy Blog

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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 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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