Health & Welfare Plans Newsletter

March 7, 2017

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Employee Benefits Jobs

Senior Conversion Analyst
BlueStar Retirement Services, Inc.
in FL

Retirement Education Specialist
Principal Financial Group
in OR

ERISA Technical Team Manager
Nationwide Financial
in OH

Account Executive/Consultant - Retirements Svcs
Lockton Insurance Brokers - Pacific Series
in CA

Retirement Plan Consultant
Qualified Plan Consultants, LLC
in IA

Senior Pension Administrator
Primark Benefits
in CA

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Webcasts and Conferences

Overview of the Tax Treatment of Popular Employer-Provided Fringe Benefits
March 10, 2017 WEBCAST
Littler Mendelson

Target Date Funds - Ten Years Later
March 22, 2017 WEBCAST
CAPTRUST Financial Advisors

Advanced Topics in Health & Welfare Plans
April 27, 2017 in MA
New England Employee Benefits Council

Certificate in Global Benefits Management
June 12, 2017 in IL
International Foundation of Employee Benefit Plans [IFEBP]

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[Guidance Overview]

New Paid Family Leave Benefits for Employees in New York State: What Employers Need to Know
"If an employer's current practice involves paying employees full salary while they are out on family leave, the employer will be entitled to seek reimbursement from the carrier providing PFL benefits in the same manner as if it were seeking reimbursement for workers' compensation benefits.... [T]he cost of the premium for the addition of paid family leave to an employer's disability benefits policy will be covered in total by the employee's contribution."
Jackson Lewis P.C.

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R&D Costs for Pharmaceutical Companies Do Not Explain Elevated U.S. Drug Prices
"[T]he premiums pharmaceutical companies earn from charging substantially higher prices for their medications in the US compared to other Western countries generates substantially more than the companies spend globally on their research and development. This finding counters the claim that the higher prices paid by US patients and taxpayers are necessary to fund research and development. Rather, there are billions of dollars left over even after worldwide research budgets are covered."
Health Affairs

The Future is Now: Healthcare Delivery Systems
"[T]he next cost mitigation 'silver bullet' for employers who had already adopted high deductible plans [could be] provider-directed initiatives like bundled payments and value-based contracting.... [In one] exchange model ... instead of employees purchasing insurance networks, they are selecting from healthcare delivery systems.... [V]irtually every PBM is now hawking some version of limited retail networks with tougher clinical oversight."
Frenkel Benefits

Direct-to-Consumer Telehealth May Increase Access to Care But Does Not Decrease Spending
"12 percent of direct-to-consumer telehealth visits replaced visits to other providers, and 88 percent represented new utilization. Net annual spending on acute respiratory illness increased $45 per telehealth user."
Health Affairs

Examining the House Republican ACA Repeal-and-Replace Legislation
"[T]he two proposed bills do not repeal the ACA. They leave in place the ACA's titles affecting Medicare, quality of care, program integrity, biosimilars, workforce reform, the Indian Health Service -- indeed virtually all of the ACA except for its insurance affordability provisions, individual and employer mandates, taxes, and Medicaid reforms.... [T]he final bills do not eliminate the essential health benefits provisions (except with respect to Medicaid plans). They do repeal the ACA's actuarial value requirements and replace the ACA's three to one age ratio limit with a five-to-one ratio."
Timothy Jost, in Health Affairs

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House Republicans Unveil Legislation to Replace ACA
"The House Republican bill would roll back the expansion of Medicaid that has provided coverage to more than 10 million people in 31 states, effective in January 2020. The bill would effectively scrap the ... 'individual mandate,' eliminating tax penalties for people who go without health insurance. The requirement for larger employers to offer coverage to their full-time employees would also be eliminated. People who let their insurance coverage lapse, however, would face a significant penalty: Insurers could increase their premiums by 30 percent."
The New York Times; subscription may be required

House GOP Health Care Proposal Relies on Tax Credits and Grants
"[T]he government would no longer penalize Americans for failing to have health insurance but would try to encourage people to maintain coverage by allowing insurers to impose a surcharge of 30 percent for those who have a gap between health plans.... There is no precedent for Congress to reverse a major program of social benefits once it has taken effect and reached millions of Americans."
InsuranceNewsNet.com

Verification of ACA Premium Tax Credit Claims During the 2016 Filing Season (PDF)
51 pages. "TIGTA's analysis of approximately 4.9 million tax returns processed by the IRS as of May 1, 2016, found that the IRS accurately determined the amount of allowable PTC on more than 4.7 million (97 percent) returns. For the remaining 154,744 tax returns, either programming errors resulted in an inaccurate PTC computation or high-risk tax returns were not identified as potentially erroneous because the discrepancy amount was below the dollar tolerance for which the IRS will review a claim."
Treasury Inspector General for Tax Administration [TIGTA]

[Opinion]

The House Republican Obamacare Replacement Plan: Mind Boggling
"Republicans claim their new tax credits would be enough to buy a catastrophic plan even for the poorest -- and in many cases that will likely be true. But, what good will it do a person making $15,000 a year to get a premium credit only large enough to buy a plan with a $3,000 or $5,000 deductible? The House Republicans are also proposing an individual health insurance market scheme that may even be worse than Obamacare itself."
Bob Laszewski's Health Care Policy and Marketplace Review

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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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