Health & Welfare Plans Newsletter

April 14, 2017

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Employee Benefits Attorney
Graydon
in OH

Senior Plan Consultant
Retirement Planning Services, Inc.
in CO, Telecommute

ASC Defined Benefit Software Support Specialist
Actuarial Systems Corporation
in CA, FL, Telecommute

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Webcasts and Conferences

Stop Loss 101
April 25, 2017 WEBCAST
ISCEBS - North California Chapter

Employee Benefits Briefing
May 11, 2017 in NY
Nixon Peabody LLP

Revising the Affordable Care Act without Replacing It: The Trump Administration Regulates and Litigates the ACA
May 17, 2017 WEBCAST
Practising Law Institute

Automatic Retirement Enrollment: The New Norm for Benefits?
June 20, 2017 WEBCAST
Lorman Education Services

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[Official Guidance]

Text of HHS Final Regs: ACA Market Stabilization
139 pages. "This final rule amends standards relating to special enrollment periods, guaranteed availability, and the timing of the annual open enrollment period in the individual market for the 2018 plan year; standards related to network adequacy and essential community providers for qualified health plans; and the rules around actuarial value requirements."
U.S. Department of Health and Human Services [HHS]

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[Official Guidance]

Text of CMS Key Dates for Calendar Year 2017 (PDF)
Revised April 2017. "The dates in [this document] generally supersede Table 1.1 ... [of] the 2018 Letter to Issuers released on December 16, 2016."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Official Guidance]

Text of CMS FAQ on Compliance Safe Harbor for Issuers Affected by an Increase in Enrollment for the 2017 Plan Year (PDF)
"[Q:] What is CMS's approach to compliance for issuers participating in the Federally-facilitated Marketplaces (FFMs)? [A:] To further encourage the participation of issuers in the FFMs and to stabilize the markets while reducing regulatory burdens ... CMS will not use formal enforcement remedies for non-compliance with QHP certification standards when QHP issuers participating in the FFMs in PY 2018 act in good faith and make reasonable efforts to address concerns in an appropriate time frame."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Official Guidance]

Text of CMS Bulletin: Revised Timing of Submission and Posting of Rate Filing Justifications and Qualified Health Plan Certification Applications for the 2017 Filing Year (PDF)
"The deadlines in this bulletin supersede and replace the dates issued in the December 16, 2016 bulletin. The timelines specified [in this document] apply to the rate filings issuers will submit in 2017 (2017 filing year) for single risk pool coverage (including both QHPs and non-QHPs) with plan or policy years beginning on or after January 1, 2018."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Official Guidance]

CMS Actuarial Value Calculator for 2018 (XLSM)
"The Actuarial Value Calculator (AV Calculator) is designed to give an estimate of the actuarial value for a given plan design. This version of the AV Calculator uses data from a large national commercial database to build continuance tables by metal tier."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

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[Guidance Overview]

CMS Issues Final Rule to Increase Choices and Encourage Stability in Health Insurance Market for 2018
"The final rule [1] adjusts the annual open enrollment period for 2018 to more closely align with Medicare and the private market.... [2] promotes program integrity by requiring individuals to submit supporting documentation for special enrollment periods and ensures that only those who are eligible are able to enroll. It will encourage individuals to stay enrolled in coverage all year ... [3] promotes personal responsibility by allowing issuers to require individuals to pay back past due premiums before enrolling into a plan with the same issuer the following year.... [4] allows issuers additional actuarial value flexibility to develop more choices with lower premium options for consumers, and to continue offering existing plans.... [5] reduces waste of taxpayer dollars by eliminating duplicative review of network adequacy by the federal government."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Duration of COBRA Election Period When Beneficiary Is Incapacitated
"[C]ase law shows that when a qualified beneficiary is incapacitated... 'equitable tolling' ... allows COBRA timeframes to be 'tolled,' or held in abeyance, until a legal representative is appointed to act for the qualified beneficiary. Generally, this doctrine can apply to both the election and premium payment periods."
HRDailyAdvisor

GAO Report: Telehealth and Remote Patient Monitoring Use in Medicare and Selected Federal Programs
72 pages. "The Medicare Access and CHIP Reauthorization Act of 2015 includes a provision for GAO to study telehealth and remote patient monitoring. Among other reporting objectives, this report reviews [1] the factors that associations identified as affecting the use of telehealth and remote patient monitoring in Medicare and [2] emerging payment and delivery models that could affect the potential use of telehealth and remote patient monitoring in Medicare." [GAO-17-365, published and released Apr. 14, 2017]
U.S. Government Accountability Office [GAO]

Congressional Efforts to Amend the ACA Stall: What's Next?
"Many speculate that tax reform legislation could repeal (or further delay) the 40 percent excise tax and might also include a cap on the amount of employer-sponsored coverage that an individual may exclude from income and payroll taxes. This tax exclusion is the single largest tax expenditure in the federal budget ... Unlike the 40 percent excise tax on high-cost plans, which would be paid by the plan sponsor, employees themselves would pay the income taxes owed on coverage that exceeds the cap."
Segal Consulting

Trump Is Playing a Risky Game of Chicken with Health Insurers
"The specific issue that insurers and the president are focused on at the moment are cost-sharing reductions, payments to health insurers that help reduce the deductibles and co-pays for 7 million Americans. The way the payments are funded has been successfully challenged in a lawsuit by House Republicans, but the administration has continued paying them while the case is on appeal. If the payments are stopped, insurers will have to decide whether to exit the market completely or raise premiums by around 15 percent -- and the mere possibility that they could go away or be used as a bargaining chip may make some queasy about offering plans at all."
The Washington Post; subscription may be required

Benefits in General

Proposed Form 5500 Package for 2017: Links to Forms, Schedules and Instructions as Submitted for OMB Approval
"The forms and instructions have been updated to reflect the new form year (2017). As noted in the 'Changes to Note' section on the first page of the instructions, revisions include the removal of IRS-only questions, updates to the Authorized Service Provider Signatures to reflect the ability for service providers to sign electronic filings on the plan sponsor and DFE lines, where applicable, in addition to signing on behalf of plan administrators on the plan administrator line, updates to the administrative penalty amounts, clarifications regarding plan name changes, updates to mortality codes in Schedule MB, and a clarification regarding PBGC insurance coverage." [Editor's note: be sure the "All" checkbox is clicked on the target page, in order to see a table with clickable names of the forms, schedules and instructions.]
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

Communicating with Video
"Are you using video to educate your workforce about their benefits? ... [As] technology evolves, the cost of professionally produced videos is decreasing, making them an affordable communication solution for employers.... More employers have realized that investing in video can save time and money, and keep managers at their desks instead of traveling to deliver the same presentation multiple times."
Willis Towers Watson

Executive Compensation
and Nonqualified Plans

Total CEO Pay in U.S. Companies Rose 6% in 2016
"[T]otal pay for CEOs increased 6% in 2016, up from the 4% median increase in 2015. Total pay as reported in the Summary Compensation Table in company proxy statements includes base salary; actual annual and long-term cash bonuses; the grant-date value of long-term incentives (LTIs) including stock options, restricted stock and long-term performance shares; the value of perquisites; earnings from deferred compensation; and the change in value of executive pensions."
Willis Towers Watson

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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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