Health & Welfare Plans Newsletter

March 14, 2017

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[Guidance Overview]

HHS Offers States Flexibility to Increase Market Stability and Affordable Choices
"Section 1332 of the [ACA] permits a state to apply for a State Innovation Waiver to pursue innovative strategies for providing its residents with access to high quality, affordable health insurance. The Departments are [hereby] promoting these waivers to give states the opportunity to develop strategies that best suit their individual needs. Through innovative thinking, tailored to specific state circumstances, states can lower premiums for consumers, improve market stability, and increase consumer choice."
U.S. Department of Health and Human Services [HHS]

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[Guidance Overview]

Employer Discretion Advised: The Latest on San Francisco's Cutting-Edge Parental Leave Ordinance
"While the California Paid Family Leave (PFL) program currently pays employees 55 percent of their wages, up to a certain weekly amount, for a period of six weeks, the [San Francisco Paid Parental Leave Ordinance (PPLO)] requires employers to pay the remaining 45 percent of for six weeks for the purpose of bonding with a new child.... Despite its name, the [PPLO] ... does not provide employees with additional protected leave. Instead, the ordinance is a wage replacement law. Employees must receive state PFL benefits in order to receive PPLO supplemental compensation."
Ogletree Deakins

[Guidance Overview]

Proposed Regulations Issued for New York's Paid Family Leave
"[T]he state proposes a system where employees apply directly to the employer's insurance carrier for [paid family leave (PFL)] benefits. The employer merely completes one section of a claim form before it is submitted to the carrier by the employee.... [E]mployers cannot require employees to use accrued paid time off (such as PTO, sick, or personal time) for the requested PFL time ... [T]he regulations do allow PFL and FMLA leave to run concurrently. However, this will hinge on the employer designating the leave as FMLA leave by providing the notice required under the federal FMLA regulations."
Bond, Schoeneck & King

The Potential Perils of Collecting Biometric Data About Employees
"Adding to the potential hazards of these initiatives is the dearth of legal authority on the issue of how to collect and manage biometric data.... [O]nly two states, Illinois and Texas, have enacted statutes that even define specifically what constitutes biometric data; and only a few additional states, Alaska, California, New York and Washington, have proposed legislation on the issue.... Here are some rules of thumb -- based in part on the key provisions of the Illinois and Texas laws -- that an employer in possession of its employees' biometric data would be well advised to apply."
Foley & Lardner LLP

ACA Information Returns (AIR) Working Group Meeting, March 14, 2017 (PDF)
36 presentation slides. Topics include: [1] Filing season 2017 lessons learned; [2] Filing due dates; [3] Extensions of time to file; and [4] Waiver from filing electronically.
Internal Revenue Service [IRS]

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Health Policy Expert Is Confirmed as Medicare and Medicaid Administrator
"By a vote of 55 to 43, the Senate approved the nomination of [Seema Verma] to be the administrator of [CMS], which spends more than $1 trillion a year on programs providing health care to more than one-third of all Americans."
The New York Times; subscription may be required

Companies Behind Health Savings Accounts Could Bank on Big Profits Under GOP Plan
"Industry officials are eager to reach new markets, including baby boomers in Medicare and enrollees in the military's Tricare system, for whom -- under current law -- HSAs are off-limits. They also want to manage larger accounts that generate more revenue. Republican proposals in Congress could help accomplish both."
Kaiser Health News

The Potential Impact of Additional Carrier Exits on the Individual Market
"With plans in 14 states, an Anthem exit would leave nearly 300 counties and about a quarter of a million marketplace enrollees with no carrier, mostly in Georgia, Missouri, and Kentucky. An additional half million consumers residing in 227 other counties would find themselves with only one carrier. In terms of the number of people affected, a Cigna exit would be the second most consequential. Roughly 400,000 enrollees would be left with one or no carrier were Cigna to exit."
Robert Wood Johnson Foundation

A Closer Look at House GOP Bills on Stop-Loss Coverage, Wellness Programs, and Association Health Plans
"These bills are not part of the American Health Care Act ... They are therefore very unlikely to be enacted into law because they cannot be passed by the Senate without the support of at least 60 senators. There are intimations, however, that the bills may be passed by the House in conjunction with the AHCA, and thus they are worthy of a closer look."
Timothy Jost, in Health Affairs

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The Proposed American Health Care Act and Its Potential Impact on Employers (PDF)
"[This article provides] a summary of the primary provisions of the AHCA as it stands now, obstacles that may lead to changes prior to adoption and what the main provisions mean to employers."
Deloitte

CBO and JCT Cost Estimate for the American Health Care Act (PDF)
37 pages. "CBO and JCT estimate that enacting the legislation would reduce federal deficits by $337 billion over the 2017-2026 period.... CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under the legislation than under current law.... Some of those people would choose not to have insurance because they chose to be covered by insurance under current law only to avoid paying the penalties, and some people would forgo insurance in response to higher premiums.... The legislation would tend to increase average premiums in the nongroup market prior to 2020 and lower average premiums thereafter, relative to projections under current law."
Congressional Budget Office [CBO] and Joint Committee on Taxation [JCT]

Statement of HHS Secretary Tom Price on CBO Report
"For there to be the reductions in coverage they project in just the first year, they assume five million Americans on Medicaid will drop off of health insurance for which they pay very little, and another nine million will stop participating in the individual and employer markets. These types of assumptions do not translate to the real world, and they do not accurately estimate the effects of this bill. "The CBO report also does not incorporate two-thirds of the healthcare reform plan President Trump has called for -- specifically the regulatory relief HHS can provide and the additional legislative reforms Congress is and will be pursuing."
U.S. Department of Health and Human Services [HHS]

[Opinion]

Analyzing the CBO Report on the American Health Care Act
" 'In 2020, CBO and JCT estimate, the average subsidy under the legislation would be about 60 percent of the average subsidy under current law. In addition, the average subsidy would grow more slowly under the legislation than under current law.' ... This is a significant improvement on PPACA in terms of fostering more individual responsibility and keeping deficits under control."
Benefit Revolution

[Opinion]

The American Health Care Act: What You Need to Know and What You Need to Watch
"The calculus underscoring the AHCA is based on three fundamental beliefs held widely by its sponsors: [1] The U.S. healthcare system is best run as a private market in which the physician-patient relationship is central.... The public's interest is best served by policies that promote competition with limited regulation. [2] Reducing health costs is the primary aim for Repeal and Replace.... [3] The [ACA]'s mandate to purchase insurance is an overreach by government and unconstitutional: it should be replaced by incentives for individuals to purchase private insurance and assume greater accountability for the costs and coverage they desire."
Paul Keckley

[Opinion]

Explaining Health Policy to the General Public
"[On] some level every issue discussed in health policy relates to one of the following four fundamental and interrelated questions: How should the health care economy be organized? How should health care be financed? What should govern the availability and pricing of health care services? What should govern the availability and pricing of vehicles used to finance health care (e.g., insurance)?"
The Actuary Magazine

[Opinion]

Obamacare Replacement Debate: Fewer People Will Be Covered and Many Will See Big Cost Increases
"The House Republican plan does a much better job than Obamacare in providing health insurance to the working and middle class. But it does a much worse job in affording access to affordable health insurance to those with low incomes. Obamacare was a massive transfer of wealth from the better off to those with low incomes -- and was very unpopular among the middle class because of that. The House Republican plan is just shifting much of that from the Democratic base back to the Republican base. If it becomes law, we'll just have a different group of people upset."
Bob Laszewski's Health Care Policy and Marketplace Review

Executive Compensation and Nonqualified Plans

Compensation Committee Actions and Disclosure: What to Address in Your February/March Meeting
"To satisfy Code 162(m), within the first 90 days of the performance period, the compensation committee must approve performance goals for the period and certify that the company has achieved the performance goals it had established for prior periods (2016 for short-term incentive plans and 2014-2016 for many long-term plans). Generally, the incentive plan payout for the recently completed year [2016] must be made by March 15, to comply with Code Section 409A."
Winston & Strawn LLP

GOP Health Plan Would Boost Deductibility of Executive Compensation for Health Insurers
"By repealing this $500,000 deduction limit, nonpublic health insurers will be able to fully deduct executive compensation beginning in 2018 and publicly traded health insurers will be treated the same as all other public companies under Section 162(m) of the tax code. That provision generally limits compensation deductions to $1 million for the CEO and the other three highest-paid employees (excluding the CFO) and excludes performance-based pay."
Willis Towers Watson

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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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