Health & Welfare Plans Newsletter

March 27, 2017

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Webcasts and Conferences

Affordable Care Act and Mental Health Parity and Addiction Equity Act
RECORDED
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

Wellness Plans Part 2 – Reaching Those Who Don’t Want to Be Engaged
April 6, 2017 in MD
Worldwide Employee Benefits Network [WEB] - Baltimore Chapter

Pension Bridge Annual 2017
April 18, 2017 in CA
Pension Bridge

Health Benefits Laws Compliance Assistance Seminar
April 19, 2017 in UT
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

Fixing Tax Qualified Plan Failures under EPCRS
May 2, 2017 WEBCAST
Ohio State Bar Association

401(k) / 403(b) Investment Lineup
May 16, 2017 in IL
Pensions & Investments

2017 Fusion Conference
July 31, 2017 in DC
PenServ Plan Services, Inc.

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[Guidance Overview]

City of Los Angeles Updates Paid Sick Leave Rules and FAQs
"The revised FAQs provide that an employer's business size is based on covered employees, i.e., individuals who perform at least two hours of work in a particular week within the City of Los Angeles and are entitled to the state minimum wage. Also, the revised FAQs specify that employers can use different sick leave methods for different employee classes ... Per the revised FAQs, at the end of each year, employers -- at their discretion -- can pay out accrued but unused sick leave that exceeds the 72-hour overall cap. Finally, relevant revised regulations address frontloading by small employers, calculating an employee's regular rate when sick leave is used, and using existing paid time off benefits to comply with the law."
Littler

[Advert.]

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Study Connects the Dots Between Essential Health Care and Paid Sick Leave
"Researchers ... have found that regardless of sociodemographic factors, workers who lack paid sick leave were significantly less likely to have received preventive health care screenings in the last 12 months -- even among those who have been told they have a condition such as diabetes or cardiovascular disease that places them at higher medical risk. Moreover, workers without paid sick leave are 1.6 times less likely to have received a flu shot in the past 12 months[.]"
Wolters Kluwer Law & Business

2017 Annual Report to Congress on Self-Insured Group Health Plans (PDF)
17 pages. "Approximately 51,600 health plans filed a Form 5500 for 2014, an increase of nearly 3 percent from the health plans that filed a Form 5500 for 2013. Of health plans filing a 2014 Form 5500, about 21,200 were self-insured and approximately 3,800 mixed self-insurance with insurance ('mixed-insured'). Self-insured plans that filed a Form 5500 covered approximately 3 3 million participants in 2014 and held assets totaling about $87 billion. In 2014 there were nearly 26 million participants covered by mixed-insured group health plans; these mixed-insured group health plans held almost $137 billion in assets." [Appendices also available: Abstract of 2014 Form 5500 Annual Reports Reflecting Statistical Year Filings, and Self-Insured Health Benefit Plans 2017 Based on Filings through Statistical Year 2014.]
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

House Leaders ‘Came Up Short' In Effort To Kill Obamacare
"The legislation was damaged by a variety of issues raised by competing factions of the party. Many members were nervous about reports by the [CBO] showing that the bill would lead eventually to 24 million people losing insurance, while some moderate Republicans worried that ending the ACA's Medicaid expansion would hurt low-income Americans. At the same time, conservatives, especially the hard-right House Freedom Caucus ... complained that the bill kept too much of the ACA structure in place."
Kaiser Health News

American Health Care Act Fails; What's Next for Employers?
"In the near-term, there will be intense focus on HHS Secretary Price to provide regulatory relief to the maximum extent permitted under the ACA.... One major concern from an employer-side perspective is whether that regulatory effort will be sufficiently focused on issues facing employer-sponsored group health plans.... In the long-term, there are far more comprehensive repeal/replace alternatives that may form the basis of the next attempt at GOP health care reform down the road."
ABD Insurance & Financial Services

[Advert.]

SALGBA 2017 National Conference

Sponsored by SALGBA [State and Local Government Benefits Association]

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House Pulls AHCA Minutes After Expected Vote
"There are a few possible 'next steps' ... [1] Retain the ACA.... [2] Nothing would stop Congress from further negotiations to attempt to drum up more votes.... [3] Republicans might attempt to add piecemeal repeal efforts into future legislation, or to address those components on a stand-alone basis.... [4] Even in the absence of a comprehensive repeal or reconciliation effort, the Administration retains great flexibility, through regulatory action, to water down various provisions of the ACA."
Seyfarth Shaw LLP

More Than Obamacare Repeal, Small Businesses Want Congress to Rein in Costs
"As a bloc, small-business owners have been among the health care law's most vocal opponents.... But every business is uniquely affected by the complex law, and simply demolishing it without putting new guardrails in place is not, for most, the ideal outcome. Small-business owners overwhelmingly say they want Republican and Democratic leaders to quit their partisan bickering, acknowledge that the country's health care economics are fundamentally broken, and work together on fixing the problem."
The New York Times; subscription may be required

Health Care Cost Challenges Require Employer Innovation
"For the first time, employers reported specialty pharmacy as a top driver of health costs.... [E]mployers may implement pharmacy management techniques, including utilizing specialty tiers within their pharmacy plan designs.... Engaging employees in all aspects of the health insurance program is paramount to controlling benefit costs.... Helping employees understand and navigate their options and costs through coaching and support tools will increase awareness around benefit offerings and deliver on value as well."
Healthcare Trends Institute

Judge Open to Anthem's Consumer Benefit Claim
"Anthem argued before a panel of three judges in the U.S. Court of Appeals for the District of Columbia Circuit that a district court ruling blocking the merger was wrong because it ignored the $2.4 billion in medical cost savings the company says it can wrestle from doctors and hospitals. U.S. Circuit Judge Brett Kavanaugh appeared most convinced by the insurer's argument that the deal would lead to savings that could be passed on to consumers. He also seemed persuaded that those savings could be good for competition." [U.S.A. v. Anthem Inc., No. 17-05024, (D.C. Cir. filed Feb. 10, 2017)]
Bloomberg BNA

[Opinion]

The Affordable Care Act: Chapter Two
"As we now pivot to Chapter Two for the [ACA], the realities are these: [1] The healthcare system needs improvement. Affordability is the issue one.... [2] The [ACA] has flaws. It successfully increased coverage for 20 million who were uninsured via Medicaid expansion and subsidized coverage for individuals via the marketplaces, but at a hefty price -- $1.1 trillion over 10 years -- and the rules whereby insurers are required to structure and price their plans are problematic.... [3] The strength of our economies--locally and nationally -- is closely tied to the effectiveness of our health system."
Paul Keckley

[Opinion]

What Comes Next for Obamacare? The Case for Medicare for All
"[T]he repeal effort's biggest hurdle may have been loss aversion, one of the most robust findings in behavioral science. As numerous studies have shown, the pain of losing something you already have is much greater than the pleasure of having gained it in the first place.... Part of the appeal of Medicare for all is that single-payer systems reduce financial incentives that generate waste and abuse."
Robert H. Frank in The New York Times; subscription may be required

Executive Compensation and Nonqualified Plans

An Executive's Guide to Defeating the SOX 304 Clawback (PDF)
"Section 304 of the Sarbanes-Oxley Act (SOX) grants the SEC the discretion to claw back the incentive-based compensation and stock sales of chief executive officers (CEO) and chief financial officers (CFO) after a restatement resulting from corporate misdeeds.... [This article examines] possible arguments and responses to an SEC investigation of alleged SOX 304 violations." [A companion article examines the SEC's burden of proof in SOX 304-related litigation and possible defenses.]
Paul Hastings LLP

Proxy Reminders: Don't Forget 162(m) Compliance!
"Section 162(m) generally limits a public company's tax deduction for compensation paid to the chief executive officer and its three other highest-paid officers (other than the chief financial officer) to $1 million per year. This deduction limitation does not apply to certain 'qualified performance-based compensation' if certain requirements under Section 162(m) are satisfied.... Timely establish performance goals and goal adjustments ... Use only performance goals approved by shareholders ... Do not exceed individual limits."
Morgan Lewis

Press Releases

NAGDCA Wins P&I Eddy Award
National Association of Government Defined Contribution Administrators [NAGDCA]

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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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