Health & Welfare Plans Newsletter

March 23, 2017

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Webcasts and Conferences

Reference Based Reimbursement
March 28, 2017 in TX
Worldwide Employee Benefits Network [WEB] - Dallas Chapter

Fiduciary Rule Limbo: How Advisors can Adapt and Deliver No Matter Where the Fiduciary Bar is Set
April 4, 2017 WEBCAST
InvestmentNews

Recruiting and Retaining Millennials in Retirement Services
April 6, 2017 WEBCAST
ftwilliam.com

EPCRS Part I - Overview and Update
April 11, 2017 WEBCAST
ERISApedia.com

Inside the Beltway Update
April 25, 2017 WEBCAST
Drinker Biddle & Reath LLP

Employment and Employee Benefits Law Update: The Impact of the Trump Administration for Hawaii Employers
May 10, 2017 in HI
Jackson Lewis LLP

Managing Benefit Options for Part-Time, Seasonal and Hourly Employees
May 11, 2017 WEBCAST
Lorman Education Services

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[Official Guidance]

Text of IRS Publication 5165: Guide for Electronically Filing ACA Information Returns for Software Developers and Transmitters (PDF)
62 pages, rev. Mar. 2017. "[This publication] outlines the communication procedures, transmission formats, business rules and validation procedures for information returns transmitted electronically through the AIR System.... The procedures in this publication should be used when the following information returns are transmitted electronically for TY2015 and TY2016 in PY2017: Form 1094-B ... Form 1095-B... Form 1094-C ... Form 1095-C ... This publication does not contain information or procedures for filing Form 1095-A."
Internal Revenue Service [IRS]

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Blue Cross Wins Appeal Over ERISA Standing
"[The Ninth Circuit] offered a narrow view of standing under [ERISA] by holding that medical providers aren't ERISA plan beneficiaries and thus can bring ERISA lawsuits only in a derivative capacity. The providers in this case also lacked derivative standing, the Ninth Circuit said, because the assignment forms they received from ERISA plan beneficiaries weren't legally valid." [DB Healthcare, LLC v. Blue Cross Blue Shield of Ariz., Inc., No. 14-16518 (9th Cir. Mar. 22, 2017)]
Bloomberg BNA

Over 30 Years Later, COBRA Still Has Fangs
"Some plan administrators and fiduciaries may presume that COBRA notices and other documents are compliant because a reputable source provided them or the documents have not caused any issues for years. However, the threat of class action litigation over misleading and inaccurate plan documents and communications serves as a reminder -- it is important to review routine plan documents."
Michael Best & Friedrich LLP

FSA Reimbursement: Nine Qualified Expenses You May Not Know About
"Guide dogs/service animals.... Braille reading material.... Auto adaptation expenses.... Television closed captioning.... Special telephone equipment.... Wigs ... Smoking cessation programs.... Lead-based paint removal.... Transportation."
DataPath

Wellness Program: 70 Percent of Medical Cost Savings Comes from Employees Using Health Coaches
"Research shows that 70 percent of medical and pharmacy cost savings comes from just 30 percent of employees who enroll in coaching. What's more, those who enrolled in coaching saved an average of $586 on medical costs per year, compared with an average savings of $261 among wellness program participants who do not participate in coaching. This translates to approximately 6 percent more cost savings reaped by those who participate in wellness coaching."
HealthFitness

[Advert.]

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House Passes Small Business Health Fairness Act
"The House of Representatives [on March 22] passed the Small Business Health Fairness Act (H.R. 1101) ... [T]he legislation empowers small businesses to band together though association health plans (AHPs) and negotiate for lower health insurance costs on behalf of their employees. The bill passed by a vote of 236 to 175."
Committee on Education and the Workforce, U.S. House of Representatives

The Consequences of Taxing Healthcare Benefits
"[M]ore than 92 percent of those responding to the survey are against any policy that would tax workers, their families and employers on a portion of health plan premiums.... Three quarters of respondents said they would definitely reduce benefits or consider it, to avoid triggering new taxes on health benefits. Nearly 90 percent indicated they would avoid increasing benefits if it meant triggering a tax.... Only 6 percent said they would increase wages to make up for a reduction in benefits."
Lockton

Impact of Cost Sharing Reductions on Deductibles and Out-of-Pocket Limits
"This note briefly describes the cost-sharing reductions in current law and illustrates their impact by looking at how these provisions affect average deductibles and out-of-pocket maximum limits in benchmark silver plans in 2017 in states using the federally facilitated marketplace."
Henry J. Kaiser Family Foundation

Health Plan Switching: A Case Study -- Implications for Private and Public Health Insurance Exchanges and Increased Health Plan Choice (PDF)
24 pages. "One-third of health plan participants enrolled in both 2014 and 2015 switched health plans between 2014 and 2015. Workers enrolled in the HSA-eligible plan in 2014 were more likely to switch plans than other workers.... While HSA-eligible plan enrollees were more likely to switch plans, those who did switch were most likely to switch to the same plan type with a different carrier.... Very few HSA-eligible plan enrollees who switched plans switched to a different type of health plan."
Employee Benefit Research Institute [EBRI]

As Rivals Stand Silent, One Health Insurer Protests GOP Plan
"[Dr. J. Mario Molina] has become one of the few insurance executives publicly criticizing the [AHCA], which he believes could strip away coverage for millions of their clients and cause considerable turmoil for the insurance industry. The major insurers have mostly stayed silent during the debate, supporting some of the Republicans' provisions that promise near-term stability for the insurance exchanges and a repeal of a tax on health insurance."
The New York Times; subscription may be required

Health Care Priorities from a National Academy of Medicine Initiative (PDF)
31 pages. "Health care today is marked by structural inefficiencies, unprecedented costs, and fragmented care delivery ... Locally and nationally, new models of care delivery and payment are emerging that seek to reduce waste by rewarding value over volume, are more patient-centric, and are driving better care coordination and integration.... This paper synthesizes the range of compelling opportunities ... and presents strategic priorities for the next Administration and the nation's health leaders to undertake now and in the years ahead."
National Academy of Medicine

2015 Commercial Health Insurance: Overview of Financial Results
"This report provides an overview of health insurer financial results in 2015 and evaluates changes in the health insurance industry's expense structure and enrollment relative to prior years. It also explores impacts to the insurance markets from the insurance marketplaces and the [ACA] 3R programs. In addition, the report reviews marketplace enrollment and associated subsidies from 2014 through 2016 in the context of the aggregate individual health insurance market."
Milliman

Benefits in General

Sixth Circuit Joins Six Other Circuits in Ruling Exhaustion of Plan's Administrative Procedures Not Required When Asserting Statutory Violations
"The Sixth Circuit [ruled] that the district court erred by ordering the workers to pursue a 'futile' administrative process before bringing their suit in court.... The court also highlighted that '[i]f such exhaustion were required for those statutory claims, in order for Plaintiffs to receive proper resolution from the plan administrator, the administrator would need to determine whether the retroactive amendment was properly instituted in the first place, i.e., whether the amendment was legal.' The Sixth Circuit held this not to be the administrator's role, but the role of the courts. The decision aligns the Sixth Circuit with the Third, Fourth, Fifth, Ninth, Tenth, and D.C. circuits[.]" [Hitchcock v. Cumberland Univ. 403(b) DC Plan, No. 15-1215 (6th Cir. Mar. 14, 2017)]
Greenberg Traurig

Executive Compensation and Nonqualified Plans

Will ACA Repeal Efforts Impact Executive Pay Practices?
"The American Health Care Act [AHCA] proposes to repeal the $500,000 cap on the deduction health insurers can take for executive pay.... [The AHCA also] proposes to eliminate the additional 3.8 percent tax on net investment income of certain highly compensated individuals.... [The Act] proposes to eliminate the additional 0.9 percent Medicare tax on wages paid to certain highly compensated individuals."
Bloomberg BNA

[Opinion]

CalPERS Joins Other Investors in Continued Support of Pay Ratio Disclosure
"The Investor Statement on Pay Ratio Disclosure letter was signed by more than 100 organizations representing $3 trillion in collective assets under management. Other signatories include the New York City Pension Funds, Legal & General Investment Management, Standard Life Investments, and Washington State Investment Board.... 'As a long-term investor, CalPERS believes the Pay Ratio Rule provides important information for investors regarding CEO and employee compensation,' said Anne Simpson, [of CalPERS] ... 'It shines a light on how well a company is managing its human capital.' "
CalPERS

[Opinion]

Text of Comment Letters to SEC on Reconsideration of Pay Ratio Disclosure Implementation
These letters have been submitted to SEC, in response to the Acting Chairman's request for public input on any unexpected challenges that issuers have experienced as they prepare for compliance with the rule and whether relief is needed. Deadline for submission of comments is March 23, 2017.
Securities and Exchange Commission [SEC]

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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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