Health & Welfare Plans Newsletter

March 22, 2017

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Employee Benefits Jobs

Defined Contribution Account Manager (Combo Plans)
Nova 401(k) Associates
in AZ, TX, Telecommute

Regional Vice President, Group Retirement Plans
Ohio National Financial Services
in MN

Actuary
West Virginia Consolidated Public Retirement Board
in WV

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Webcasts and Conferences

Making the Connection: How to Make Your Benefits Communications Work
April 3, 2017 WEBCAST
International Foundation of Employee Benefit Plans [IFEBP]

Why Employee Loans Are an Important Voluntary Benefit
April 5, 2017 WEBCAST
Employee Loan Solutions, Inc.

401(k) / 403(b) Investment Lineup
May 9, 2017 in CA
Pensions & Investments

Health & Welfare Plans - Plan Types and Administration (B3): Get It Right from the Start
June 8, 2017 in MA
New England Employee Benefits Council

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[Guidance Overview]

Program of Administrative Services Is Neither a Welfare Plan Subject to ERISA Nor a MEWA, Says DOL
"[DOL Advisory Opinion 2017-01A] concluded that the Program is not an employee welfare benefit plan. It said that such a plan does not include a program maintained by an employer (or group or association of employers) which ... has no employee participants and does not provide covered benefits to employees or their dependents. Rather than being established or maintained for the purpose of providing welfare benefits to participants and beneficiaries, the Program operates so as to facilitate the efficient establishment and operation of employee benefit plans by employer-members."
Cary Kane ERISA Lawyer Blog

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District Court Rules That Cross-Plan Offset Constitutes 'Grave Conflict of Interest'
"In an extraordinary decision, [a U.S. district judge] has effectively barred cross-plan offsets. The judge weighed in on two very important questions: ... whether UHC acted 'reasonably' in interpreting its client's plans to permit cross-plan offsetting; and whether the practice complies with the 'fiduciary duties imposed by ERISA'. The court offered an answer to both issues while providing very clear guidance for plans, claims administrators, medical providers and patients." [Peterson v. UnitedHealth Group Inc., No. 14-2101 (D. Minn. Mar. 14, 2017)]
AVYM Healthcare Revenue Consultants

Why COBRA Might Be Making a Comeback
"[W]e're facing a landscape where the complexity of COBRA remains a part of every employer's benefits program while the ACA gets a makeover from the Republican White House.... Most likely, it just means that the majority of employers will continue to outsource COBRA administration. It also could mean eligible employees go back to just having COBRA as their only choice for 'transitional' coverage. But even if the option remains to enroll in Obamacare plans, COBRA could still win as the most attractive option for employees who qualify."
Benefitfocus

Text of House Budget Committee Report on American Health Care Act
"Repealing Obamacare merely begins the process of establishing truly patient-centered health care in America -- and aspects of both are contained in this legislation ... [The AHCA] is just one component of a broader effort to transform the Nation's troubled health care network. It will be supplemented by other elements, described [in this report]."
Committee on the Budget, U.S. House of Representatives

What's in the Manager's Amendment to the American Health Care Act?
"It consists of two sets of amendments, labeled technical changes ([ with an accompanying summary]) and policy changes ([with an accompanying summary]).... The amendments add an additional year to the relief the AHCA offered from the 'Cadillac' plan excise tax ... and accelerate the repeal of all other ACA taxes from 2018 to 2017.... Another provision clarifies that the 30 percent of premium penalty imposed on consumers who seek coverage after a gap in coverage applies only in the individual and not in the small group market.... [M]uch of the $337 billion in deficit reduction that the CBO credited to the AHCA disappears under the manager's amendment."
Health Affairs

[Advert.]

Online Learning Course: COBRA

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Even though the ACA has made health care coverage easier for individuals to obtain, group insurance plans must continue to offer COBRA coverage. This course will explain the technicalities of COBRA, including who is entitled and how it must be administered.


Require Continuous Health Insurance Coverage in 2017, Insurers Say
"The American Health Care Act ... includes a provision under which people would pay a 30 percent surcharge ... for any year they went longer than 63 days in a 12-month period without coverage. But health insurers and the [CBO] say the provision isn't punitive enough to keep people from waiting until they get sick to enroll."
Bloomberg BNA

Providing a Better Way on Health Care for Small Businesses, Working Families
"Because of their size, small businesses lack the same level of bargaining power available to large businesses and labor organizations. And they are unable to band together to increase their bargaining power to help lower health care costs for their workers. The Small Business Health Fairness Act (H.R. 1101) [see Fact Sheet] ... empowers small businesses to band together through association health plans to negotiate for lower health insurance costs on behalf of their employees."
Committee on Education and the Workforce, U.S. House of Representatives

Why Deductibles Would Rise Under the GOP Health Care Plan
"[T]he average deductible for a typical plan in the non-group market under the GOP plan would be about $1,550 higher in 2017 than it would have been under the [ACA] ... Most of the debate has been about what would happen to premiums -- but for consumers, it's total out-of-pocket costs that matter.... The result: premiums may be lower in some cases, but deductibles will go up."
Drew Altman, Kaiser Family Foundation, via Axios

[Opinion]

House Proposal to Promote Association Health Plans Poses Risks for Insurance Markets, Consumers
"The Small Business Health Fairness Act, H.R. 1101 [see Fact Sheet], allows small employers to band together and buy health insurance though federally certified associations. Despite its name, the bill would have a considerable and likely detrimental impact on the private health insurance market and undermine the ability of states to protect small employers and their employees."
The Commonwealth Fund

[Opinion]

The Reality of CBO's American Health Care Act Coverage Projection
"[T]he 24 million figure for coverage loss is a combination of people who do not want coverage and will choose not to have it if allowed, shaky guesses at employer behavior that have not come to pass previously, people whose coverage could be disrupted but for whom the law provides alternatives, people who do not even have coverage today, but who might possibly gain coverage in an alternate future, as well as about 4 million who may lose their current coverage due to changes to the Medicaid program. A far cry from 24 million people being stripped of their health care."
American Action Forum

[Opinion]

How Employer-Provided Healthcare Is Strangling Consumers
"Today, it's hard to imagine health insurance markets without corporate employers as the predominant purchasers. But it is not at all obvious that employers ought to provide health insurance as a benefit, or that such a system would have materialized (particularly on such a scale) were it not for the harmful wage controls of the World War II era."
David D'Amato, in The Hill

[Opinion]

House Obamacare Repeal Bill Limits HSAs for Millions of Americans
"The House Republican American Health Care Act Managers Amendment would not allow Americans to use their tax credits to fund an HSA. Instead of using their tax credit/HSA to pay for doctor visits, prescriptions and OTC drugs, Americans will only be allowed to use their credit for insurance. This is a big mistake -- and a giveaway to insurers."
National Center for Policy Analysis Health Policy Blog

Benefits in General

Implementing Global Benefits Governance (PDF)
"Corporate governance of employee benefits is an increasingly important consideration for companies because the financial costs and risks of benefits have grown significantly and companies need to ensure sufficient value in sponsoring benefits programs. Auditors are also increasingly interested in corporate governance, and that includes benefits governance. Centralization of benefits governance has followed from all of this."
Groom Law Group

IRS Plans to Begin Issuing 'Sub-Regulatory' Guidance Again
"The [IRS] is continuing to have productive conversations with the Treasury Department and the Office of Management and Budget, said IRS Commissioner John Koskinen. And 'as we've been having discussions, we have made clear -- and people have agreed -- that a lot of the sub-regulatory guidance we issue is really for the benefit of the taxpayers,' he said March 21 ... 'I think we will begin to issue some greater guidance in those areas.' "
Bloomberg BNA

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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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