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[Guidance Overview]

CMS Releases Proposed Rule for ACA Market Stabilization
"With a growing number of issuers seriously considering withdrawing from the exchanges in 2018, the Market Stabilization Proposed Rule can be seen as a stopgap attempt to shore up the exchanges and encourage issuers to participate by addressing many long-standing criticisms. The fact that the public comment period is only 20 days instead of the usual 30 days is evidence that CMS hopes to finalize the Market Stabilization Proposed Rule before issuers are required to file their 2018 plans and rates with the states this spring."
Epstein Becker Green


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[Guidance Overview]

Proposed Regulations Issued for New York State Paid Family Leave Law
"[T]he proposed rule fills in many of the blanks regarding how paid family leave (PFL) will interact with leave otherwise covered under [FMLA]. The FMLA provides eligible employees with up to 12 weeks of unpaid, job-protected leave for several covered purposes, three of which ... are also covered under [PFL]. Notably, however, while the federal FMLA requires unpaid leave for an employee's own serious medical condition, [New York's PFL] will not apply to such leave (although leave for an employee's own medical condition may be covered under the New York Short Term Disability law)."
Proskauer's Law and the Workplace

HSA Considerations for Employers
"[S]tudies have shown that HSA owners do spend less on health care. However, some critics suggest that lower spending by HSA owners indicates HSA owners forego necessary health care.... Without having available, and using, adequate resources to make informed decisions about health care needs and options, employees will not benefit from the HSA option."
Jackson Lewis P.C.

ACA-Repeal Proponents Consider Taxing Some Employer-Paid Health Benefits
"The draft for the yet-unnamed bill would eliminate the ACA's subsidies to help those with modest incomes purchase health policies and instead offer refundable tax credits, funded by capping the tax exemption for employer-sponsored health care at the 90th percentile of current premiums. Benefits beyond that level would be subject to payroll and income taxes, like regular compensation."
Society for Human Resource Management [SHRM]

Obamacare's Open Secret: Many Small Business Plans Don't Follow The Rules
"Here, then, is the secret of the Obamacare, one reason why there's no evidence that the law has driven up insurance premiums despite the benefit requirements: a great many people are insured by these so-called 'grandmothered' plans that don't have to meet the requirements. It's also true ... that in the small-group market, these new requirements aren't really a stretch.... At least 32 states are allowing renewals of transitional plans through the end of 2017; 35 states permitted these renewals in 2016."


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9th Annual Health Plan Marketing Summit. Convening marketing, strategy, and innovation professionals from across the health insurance industry to discuss trends in consumerism and market strategy.

Plans Not Complying with Obamacare Extended Through 2018
"The transitional health plans, which don't have to cover people with pre-existing medical conditions or meet other major [ACA] requirements, were initially extended by President Barack Obama in late 2013 after many plans were going to be discontinued. About 1 million policyholders are estimated to be in the plans, which states can choose to allow health insurers to continue."
Bloomberg BNA

Diving Into the Leaked ACA Replacement Bill
"[The bill] does not repeal the ACA. Indeed, it only repeals particular sections of the ACA, such as its taxes, mandates, Medicaid expansion and subsidies. And some of these it only does after 2019. It does not appear to repeal most of the ACA's insurance reforms ... It does not touch the ACA's Medicare reforms or cuts. It is replace, but not repeal."
Health Affairs

State Health Insurance Mandates and Labor Market Outcomes: New Evidence on Old Questions
"[The authors] find no strong evidence that high cost state health insurance mandates discourage employers from offering insurance to employees.... [E]mployers adjust both wages and labor demand to offset mandate costs, suggesting that employees place some value on the mandated benefits.... [T]he effects are persistent, but not permanent. [T]he effects are heterogeneous across worker types."
National Bureau of Economic Research [NBER]


Medicaid Caps: The Threat Below the Surface
"President Trump and Republican leaders are actively considering voucherizing Medicare and converting Medicaid financing into a block grant or per capita cap. This [article] focuses on the efforts to undermine Medicaid and the voucherization of Medicare."
National Health Law Program [NHeLP]

Benefits in General

[Guidance Overview]

DOL Finalizes Regs on Disability Plan Claims Procedures (PDF)
"The vast majority of employers offering disability benefits buy long-term disability insurance, in which case the burden of complying with the new claim processing regulations falls predominantly on the insurer. Additionally, employers typically offer short-term disability benefits through a payroll practice (e.g., salary continuation). Payroll practices are not subject to ERISA, and so the new rules would not apply to those types of arrangements."

'Probate Exception' Barred Federal Jurisdiction in Health Plan's Reimbursement Claim Against Estate
"The U.S. District Court for the Northern District of New York has ruled that the so-called 'probate exception' to federal jurisdiction precludes federal courts from adjudicating cases implicating federal question jurisdiction, including cases arising under ERISA. In so doing, the N.D.N.Y. joins ranks with a small but growing number of federal district and circuit courts that recognize the 'probate exception' as an absolute bar to federal jurisdiction over any in rem action in the custody of a state probate court." [In re Boisseau, No. 16-549 (N.D.N.Y. Jan. 30, 2017)]
Begos Brown & Green LLP

Executive Compensation and Nonqualified Plans

Massachusetts Introduces Highest Paid Employee-Ratio Legislation as Illinois Creates Pay Ratio Fee
"[L]egislators in ... Massachusetts and Illinois introduced new pay ratio measures, with Massachusetts becoming the first state to eschew use of the SEC's pay ratio calculation in favor of a pay ratio which focuses on comparing a company's highest paid employee to median U.S. employee pay.... [This] brings the number of states which have introduced or passed pay ratio legislation to five, not including the cities of San Francisco and Portland, Oregon."
HR Policy Association

10 Ways Stock Compensation Can Make You Happier
"[1] Wealth creation ... [2] A sense of anticipation ... [3] A feeling of being special ... [4] ESPP participation and discount ... [5] Control over when you receive income and pay taxes ... [6] Donations and gifts of company stock ... [7] Being an owner in your company ... [8] New friends ... [9] Feelings of financial security ... [10] Mindfulness and meaningfulness."

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David Rhett Baker, J.D., Editor and Publisher
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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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