Health & Welfare Plans Newsletter

April 10, 2017

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401(k) Plan Administrator
Ascensus
in NC

Program Specialist, Health and Business Performance
National Business Group on Health
in DC

DC Team Assistant Administrator
Shore Tompkins Actuarial Resources
in IL

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Webcasts and Conferences

Assessing and Improving Practices Regarding Investment of Retirement Plan Assets
RECORDED
Verrill Dana LLP

Health Care Reform Update: The AHCA and its Demise
April 27, 2017 in DC
Worldwide Employee Benefits Network [WEB] - Washington Metropolitan Chapter

HIPAA Breaches: Preparation and Response
May 24, 2017 WEBCAST
Thomson Reuters / EBIA

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TIGTA Assessment of Efforts to Implement the Employer Shared Responsibility Provision (PDF)
43 pages. "As of October 28, 2016, the IRS had processed 439,201 Forms 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, and nearly 110 million Forms 1095-C, Employer-Provided Health Insurance Offer and Coverage. However, our review identified that some of the processes did not function as intended, which resulted in the IRS not having accurate and complete data for use in its compliance strategy to identify noncompliant employers potentially subject to the Employer Shared Responsibility Payment. In addition, due to system errors, the IRS was unable to process paper information returns timely and accurately.... Further, the criteria used to identify validation errors in the submissions did not always work as intended.... Finally, the development and implementation of key systems needed to identify noncompliant employers subject to an Employer Shared Responsibility Payment have been delayed, not initiated, or cancelled."
Treasury Inspector General for Tax Administration [TIGTA]

[Advert.]

Health Care Management Conference

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Final Opportunity! At this year's Health Care Management Conference, you'll hear from industry experts working in the field as you review the latest communication strategies, management methods and tactics for lowering health care costs.


Fired While His Premature Baby Was Being Delivered, Employee's FMLA Claim Fails for Lack of Notice
"Granting summary judgment against an FMLA interference claim by an employee who was fired while his partner was in labor for their child's birth, a federal magistrate judge in Ohio explained that childbirth is a foreseeable event and he failed to give the required 30 days' notice of the need for FMLA leave. Even if the induction of labor three weeks early due to preeclampsia was unforeseeable, the employee did not give notice as soon as practicable--he only emailed after his supervisor repeatedly tried to contact him, and in that responsive email the employee made no mention of taking family leave." [Wilson v. Dynasplint Systems, Inc., No. 14-310 (S.D. Ohio Apr. 3, 2017)]
Wolters Kluwer

Cigna Touts Progress in Effort to Curb Opioid Use
"Cigna's effort to tackle the opioid epidemic has resulted in a 12% decline in customers' use of prescribed opioids in the last year ... The insurer said its efforts to combat the opioid epidemic have included analyzing claims data to detect patterns that suggest opioid misuse and notifying those individuals' providers.... Starting in July, Cigna will go further by placing quantity limits on most new short-acting opioid prescriptions."
FierceHealthcare

No 'Death Spiral': Insurers May Soon Profit from Obamacare Plans
"[T]he demise of the individual insurance market seems greatly exaggerated, according to a new financial analysis ... by Standard & Poor's, [which] looked at the performance of many Blue Cross plans in nearly three dozen states ... It shows the insurers significantly reduced their losses last year, are likely to break even this year and that most could profit -- albeit some in the single-digits -- in 2018. The insurers cover more than five million people in the individual market."
The New York Times; subscription may be required

ACA: Potential Legislative and Administrative Actions (PDF)
12 presentation slides; topics include: [1] Repeal Without Replace Scenario; [2] 2017 Proposed Legislative Reforms; and [3] Administrative Actions.
Health Actuarial Task Force, American Academy of Actuaries

[Advert.]

SALGBA 2017 National Conference

Sponsored by SALGBA [State and Local Government Benefits Association]

Join SALGBA, the premier organization for public sector benefits professionals in Anaheim, CA for the 2017 National Conference at the Hyatt Regency Orange County. Visit www.salgba.org for details.


Tweaks to AHCA Potentially Revive ACA Repeal and Replace Efforts
"On April 6, 2017, the House Rules Committee ... voted 9-2 to adopt an amendment that creates a risk-sharing fund.... The Palmer/Schweikert amendment is a bit vague and the structure of it applies only to prospectively-identified eligible individuals, which arguably leaves insurers with tail risk for non-eligible high-costs cases. The risk-sharing program would run as a federal program for the first three years and then states would take over."
Holland & Knight

Court Lacked Jurisdiction to Hear Failed CO-OP's Claim Under ACA's '3Rs' Program
"The U.S. District Court for the Southern District of Iowa did not have jurisdiction over claims against HHS brought by the liquidators of a failed insurance cooperative because their requested damages were purely monetary in nature and could be adequately addressed in the Court of Federal Claims." [Gerhart v. HHS, No. 16-151, (S.D. Iowa Mar. 16, 2017]
Wolters Kluwer

[Opinion]

Trump and the GOP Could Fix Obamacare, Not Repeal It
"Republicans are left to try to paper over their differences by tinkering with 'community rating,' 'high-risk pools' and other things they barely understand but now have suddenly assigned make-or-break political significance.... But what if a newly elected Republican president eager for a political victory were to utter the unutterable -- to declare that he is willing to acknowledge the right of all Americans to buy all the medical care they need for no more than 15 percent of household income? ... What could a self-styled dealmaker demand from Democrats in return?"
Steven Pearlstein. in The Washington Post; subscription may be required

Executive Compensation
and Nonqualified Plans

Exempt Stock Compensation Limits May Increase
"Rule 701 under the Securities Act of 1933 currently provides a mechanism for non-public companies to offer and sell their securities for the purpose of providing compensation to their own employees without the need to register those securities.... [If] the company believes sales under the plan will exceed $5,000,000 in a coming 12-month period, the company must disclose risk factors and certain financial statements to the employee investors. The new legislation would double the $5,000,000 figure to $10,000,000 before a company would have to reveal financial information."
Seyfarth Shaw LLP

Press Releases

Amy Cavanaugh Joins DATAIR as an ERISA Consultant
DATAIR Employee Benefit Systems, Inc.

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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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