Health & Welfare Plans Newsletter

March 9, 2017

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Employee Benefits Jobs

Retirement Plan Administrator
Warren Averett, LLC.
in AL, FL

Director - Account Executive
Aspire Financial Services LLC
in FL

Retirement Specialist
Prestige Employee Administrators
in NY

Conversion Consultant
Aspire Financial Services LLC
in FL

Retirement Plan Administrator
Florida Retirement Consultants
in FL

401k Service Administrator
Retirement Direct
in NC

ERISA Specialist
Newport Group
in FL, MN

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Webcasts and Conferences

Social Security: Benefits, Deficits and Beyond
March 16, 2017 in CA
Western Pension & Benefits Council - Orange County Chapter

403(b) Plans in 2017: Significant Issues and Trends
March 23, 2017 in CA
Western Pension & Benefits Council - Orange County Chapter

Emerging Trends in Consumer Driven Health Care
March 30, 2017 WEBCAST
ConnectYourCare and Devenir

Financial Services Conflicts of Interest & Fiduciary Duties 2017: Navigating the Emerging Regulatory Maze
April 26, 2017 WEBCAST
Practising Law Institute

New Trustees Institute--Level I: Core Concepts
June 26, 2017 in CA
International Foundation of Employee Benefit Plans [IFEBP]

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Employee Fired for Threatening Supervisor After Tardiness Write-Up Failed to Revive FMLA Claims
"An employee who was suspended and discharged after threatening a supervisor who gave him a write-up for a tardy that the employee claimed was covered by the FMLA, failed to revive his FMLA interference and retaliation claims. In an unpublished opinion, the Sixth Circuit determined that he failed to show that he was entitled to FMLA leave on the day in question or that the employer's proffered reason for his discharge was pretextual." [Levaine v. Tower Automotive Operations, No. 16-1782 (6th Cir. Feb. 22, 2017; unpub.)]
Wolters Kluwer Law & Business

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FMLA 'Unusual Circumstances' Rule May Excuse Failure to Call in Absence
"Given an employee's unexpected admission to a psychiatric facility and functional impairment, the FMLA's 'unusual circumstances' exception excused her failure to follow the employer's normal call-in procedures for absences, ruled a federal district court in Massachusetts. Also rejecting a manager's argument that she could not be individually liable for FMLA interference, the court found evidence that she had sufficient control over the employee and played a role in the termination by failing to timely disclose what she knew about the employee's absence." [Boadi v. Center for Human Development, Inc., No. 14-30162 (D. Mass. Mar. 6, 2017)]
Wolters Kluwer

Population Characteristics Data Lacking Among Federal, Commercial Health Plans
"Despite a provision within the [ACA] that requires health plans to collect patient information on race, ethnicity and language, that data is still missing among federal and commercial payers.... As of 2015, half of Medicaid plans and nearly three-quarters of Medicare plans had complete or partially complete data on race ... Two-thirds of commercial plans did not have any data tied to race and even fewer collected ethnicity or language data[.]"
FierceHealthcare

Identifying Barriers to Health and Wellness Program Success
"It's important to recognize that participation isn't just a one way street; and that it's not solely impacted only by your employees. True communication centers on a back and forth exchange of ideas between both the employer and the participant."
Corporate Synergies

What Goldilocks Can Teach Us About Employee Health Benefits
"Make sure the health plans you offer are different enough that they offer your employees real choice ... Offer enough -- but not too much -- employee medical plan choice ... [O]ffering three or four health plans is generally the sweet spot."
Fidelity Health Marketplace

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March 10 webinar. Learn the pros and cons of a self-funded insurance plan design and understand the specific level funding option to see if this is the best fit for you.


The Health Insurer of the Future: Consumers' Advocate, Providers' Partner (PDF)
24 pages. "[E]mployers -- the largest line of business for some insurers -- are questioning whether insurers are the only partners to help them manage costs and keep employees healthy, their biggest healthcare concerns.... Successful health insurers of the future ... will become specialists in delivering consumer services, serve as bridges between providers and their patients, become sources of data and analytics to help providers manage populations' health, align with providers to reduce medical costs, and/or enhance efficiency to tamp down administrative costs[.]"
PricewaterhouseCoopers

House Committee on Education and the Workforce Advances Reforms to Expand Affordable Health Care Coverage for Working Families
"The three bills approved by the committee [on March 7] are: [1] The Small Business Health Fairness Act (H.R. 1101), [which] would empower small businesses to band together through association health plans to negotiate for lower health insurance costs on behalf of their employees.... [2] The Self-Insurance Protection Act (H.R. 1304), [which] would reaffirm long-standing policies to ensure employers can continue to offer workers flexible, more affordable health care plans through self-insurance.... [3] The Preserving Employee Wellness Programs Act (H.R. 1313), [which] would provide employers the legal certainty they need to offer employee wellness plans, helping to promote a healthy workforce and lower health care costs."
Committee on Education and the Workforce, U.S. House of Representatives

Obamacare Replacement Trudges Forward in House
"The Ways and Means Committee approved tax provisions of the Republican replacement plan -- the American Health Care Act -- shortly before 4:30 a.m. in a 23-16 vote.... Democrats on the Energy and Commerce panel were still in the process of trying to tag on more than 100 amendments to the bill. Proposals included language that would get rid of the per-capita caps on Medicaid the bill calls for, remove the portion of the bill that defunds Planned Parenthood for a year, and rename the bill the Republican Pay More for Less Act. Each of these amendments failed to pass."
U.S. News & World Report

GOP Healthcare Reform Proposal: Significant Changes for Employers
"[K]ey provisions in the Proposal that would that affect employers: [1] Elimination of the employer mandate and associated penalties ... [2] Further postponement of the tax on Cadillac Plans ... [3] Repeal of ACA elimination of deduction for expenses allocable to Medicare Part D subsidy ... [4] Government assistance to purchase health coverage ... [5] Enhancements to Health Savings Accounts ... [6] Enhancements to Health Flexible Spending Accounts."
McGuireWoods LLP

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The American Health Care Act: Key Takeaways for Employers and Plan Sponsors
"Individuals enrolled in group health plans would not eligible for the tax credit, unless they are enrolled in COBRA coverage that is not subsidized by the employer. Importantly, in order to receive the credit, the coverage (whether individual market or COBRA) cannot cover services related to abortion (subject to certain exceptions). This arrangement would likely create administrative headaches for plan sponsors and COBRA administrators. The new tax credit scheme appears to require monthly reporting by eligible coverage providers, so COBRA administrators would have to develop procedures to comply with this requirement."
Proskauer's ERISA Practice Center

What a Difference an 'H' Makes: A Retooling and Repurposing of the ACA by the AHCA
"House Republicans revealed, in two parts ... the American Health Care Act (AHCA) that is designed to meet the Republicans' promise to 'repeal and replace' the ACA. In many respects, the AHCA is less 'repeal and replace' and more 'retool and repurpose,' but there are some significant changes that could affect employers, if this bill becomes law as-is."
Benefits Bryan Cave

Five Items Employers Should Know About the AHCA
"The bill repeals the employer mandate as of December 31, 2015 ... The bill repeals the individual mandate as of December 31, 2015 ... A change to the way eligibility is determined for tax credits ... Detailed reporting will still be required by employers ... Employers will need to reassess whether it makes sense to offer certain employees coverage."
Accord Systems, LLC

Sen. Rand Paul on Paul Ryan's 'Obamacare Lite'
"[Sen. Paul] said there are four major reasons that Ryan's bill is wrong; specifically that it creates an entitlement program, that it does not effectively handle Obamacare taxes and even keeps the Cadillac Tax indefinitely, the keeping of Obamacare's individual mandate, and the keeping of Obamacare's risk corridors -- but simply renaming them."
Breitbart

[Opinion]

For Self-Employed Entrepreneurs, Losing the ACA Would Be an Enormous Setback
"Lawmakers who dream of gutting the [ACA] do not seem to care about its importance to small business owners, particularly those who are solo entrepreneurs. What these politicians fail to understand is that the health care law is the first meaningful insurance reform available to entrepreneurs in decades. In fact, for many self-employed business owners, their firms would not exist without it. That's why repealing the law is going to be a sizable setback for entrepreneurship."
Health Affairs

Benefits in General

Does the Fiduciary Exception Apply to Legal Advice Received By Insurers During the Claims Process?
"Adding to the body of conflicting authority on the scope of the attorney-client privilege in ERISA lawsuits, a district court has found that the fiduciary exception to attorney-client privilege applies to an insurance company that acts as a claim administrator, thus requiring disclosure of communications between the insurer and its lawyers regarding a claim for benefits during the claims process." [McFarlane v. First Unum Life Ins. Co., No. 16-7806 (S.D.N.Y. Feb. 6, 2017)]
Seyfarth Shaw LLP

Attract and Retain: How to Become an Employer of Choice with Benefits
"[B]enefits that address an employee's lifestyle are what give an employer the edge. These lifestyle benefits range from flexible work arrangements, telemedicine, parental leave and adoption benefits, or even some that are less commonly known, such as 'paw-ternity leave' for employees that need time to bond with their new fur babies. To be considered an employer of choice, getting the basics right is a must, and connecting your employees to benefits that address their work/life balance is a necessity."
Benefitfocus

Press Releases

PBGC, Sears Reach Agreement to Further Protect Pension Plans
PBGC [Pension Benefit Guaranty Corporation]

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Lois Baker, J.D., President  loisbaker@benefitslink.com
David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
Holly Horton, Business Manager  hollyhorton@benefitslink.com

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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