Health & Welfare Plans Newsletter

April 13, 2017

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Voluntary Fiduciary Correction Program
April 25, 2017 WEBCAST
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

Employment, Benefits and Financial Planning for Transitioning Service Members Important Information for Your Financial Security Now and in the Future
April 26, 2017 WEBCAST
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

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TIGTA Audit Shows IRS Struggling with Technology to Enforce ACA Employer Mandate
"The technological trouble the IRS is experiencing is undoubtedly one of the reasons the IRS has not penalized a single employer under the employer mandate.... The first major issue the ... is the inability of the IRS's systems to timely and accurately transfer the Forms 1094-C and 1095-C that were submitted in paper format to the electronic ACA Information Returns system (AIR system).... [T]he AIR system was unable to accurately generate error codes when an error condition existed [and] generated error codes when no error condition existed.... The audit reviewed an IRS management report from April 12, 2016 that had rejected 6.2 million Forms 1095-C because of a missing code in line 14. However, the auditors' review of the Forms 1095-C in question showed that this error condition only occurred 828 times within the 6.2 million Forms."
Accord Systems, LLC

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Coordinating FMLA with State and Federal Laws
"Many state FMLA laws follow the federal FMLA almost verbatim. However, many others differ in the following various respects, including that they may: [1] Apply to smaller organizations; [2] Require you to allow more time off; [2] Cover different reasons for leave, such as domestic violence or school conferences; [4] Cover different people; or [5] Require paid leave. If both FMLA and state law apply to the same situation, the employer is required to follow the law that gives the employee greater rights."
HRDailyAdvisor

Health Savings Accounts: Can They Work for Everyone? (PDF)
"More than half (53%) of all large employers offer an HSA-eligible plan, but under a fourth (24%) of covered employees are enrolled in one.... Despite the cost savings, for the most part large employers still offer these plans as a choice, rather than as the only medical plan. Just 6% of all large employers offer an HSA-eligible plan as a 'full replacement' of their traditional medical plan."
Mercer

What is a Limited Purpose FSA, and How Can Account Holders Use It?
"A limited purpose FSA (LPFSA) is a healthcare spending account that can only be used for eligible vision and dental expenses. Unlike a healthcare FSA, however, an LPFSA can be held at the same time as [an HSA]. When coordinated with an HSA, the LPFSA can further reduce your taxes while allowing you to allocate HSA funds to other purposes -- including retirement."
DataPath

More Choice in Employer Health Plan Offerings Raises Risk of Adverse Selection
"[Despite] incentives, older workers were less likely to switch health plans than younger workers, and the higher use of office visits for both primary care physicians and specialists, higher use of emergency departments, and a higher number of outpatient providers were all correlated with less plan switching."
Wolters Kluwer Law & Business

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Repeal, Replace ... Revise: Your Guide to Market Stabilization
"The Trump administration's proposed rule aimed at stabilizing the health law's insurance marketplace could have rapid, dramatic effects on people who do not get insurance through work and buy it on the [ACA]'s exchanges.... The controversial proposal by [HHS] drew letters from nearly 4,000 organizations and individuals during an unusually short, 20-day public comment period that ended in early March. Consumer groups hate it, saying it would wreak havoc by making it harder to get coverage. But [some] experts ... say it's helpful for insurers, though more adjustments are necessary."
Kaiser Health News

Trump Threatens to Withhold Payments to Insurers to Press Democrats on Health Bill
"Mr. Trump said he was still considering what to do about the payments approved by his Democratic predecessor, President Barack Obama, which some Republicans contend are unconstitutional. Their abrupt disappearance could trigger an insurance meltdown that causes the collapse of the 2010 health law, forcing lawmakers to return to a bruising debate over its future."
The Wall Street Journal; subscription may be required

[Opinion]

What Does 'Across State Lines' Really Mean?
"[A] suggestion: modify federal law to require that the coverage in any policy approved in any state, be available for purchase in every state. This would require the states abandon their monopolistic mandate regulations. It would bring the possibility of some premium relief to consumers in states that have the most mandates.... It would still allow the option of higher-coverage policies everywhere. But it would not require everyone have identical basic coverage -- as Obamacare does. It would not require any insurance company to build a new network anywhere so its policyholders could be in the service area."
InsureBlog

[Opinion]

ERIC Letter to Nevada State Senators on Proposed Paid Sick Leave Legislation
"Nevada Senate Bill 196, which provides for paid sick leave to employees of private employers, works against large employers in several ways, including: [1] a lack of guidance on eligible employee; [2] requiring the carryover of accrued sick leave, even when sick leave is front-loaded; [3] mandating the tracking of employees' accrued sick leave; and [4] providing no clear definition of who a family member is for purposes of care."
The ERISA Industry Committee [ERIC]

Benefits in General

ERISA Preempts Common-Law Fraud Claims Against Employer for Enrollment Dispute
"Plaintiff's wife died in 2014, and the insurer denied benefits, asserting that no evidence of insurability questionnaire had been submitted for her.... Plaintiff sued Sears, alleging constructive fraud, negligent misrepresentation, and intentional infliction of emotional distress.... The court noted that plaintiff was entitled to life insurance benefits 'only if the ERISA plan provided them.' Because plaintiff's entitlement to coverage would exist only because of the plan, and because Sears had no independent duty to him, ERISA preempted his claims." [Prince v. Sears Holdings Corp., No. 16-1075 (4th Cir. Jan. 27, 2017)]
Robinson & Cole LLP

Avoiding Beneficiary Befuddlement
"The 11th Circuit decision should be helpful to plan administrators ... [who] may wish to consider some of the following practices and additions to plan language in anticipation of these situations: [1] Giving frequent written reminders to participants about their beneficiary designations; [2] Resoliciting updated beneficiary designations from participants on a periodic basis; [3] Adopting a rule providing for the revocation of spousal designations upon divorce; [4] Adopting a rule specifying a presumption of survival in the event of the simultaneous death of a participant and beneficiary; [5] Adopting a rule that voids a beneficiary designation naming a person who is convicted of the murder of the participant." [Ruiz v. Publix Super Markets, Inc., No. 16-735 (M.D. Fla. Mar. 30, 2017)]
Benefits Bryan Cave

A Few Considerations During Form 5500 Season (PDF)
"Both the IRS and DOL comment that improperly completed Form 5500s will increase the probability that they may take a closer look at plan matters. [This article includes] a short list of considerations and questions aimed at helping plan sponsor employers avoid government investigation otherwise prompted by a 'wrong' answer on the Form 5500."
The ERISA Law Group

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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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