Health & Welfare Plans Newsletter

April 21, 2017

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Retirement Plan Administrator
Continental Benefits Group, Inc.
in NJ

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DST Systems
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Haynes Benefits PC
in MO

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Oasis DEG, Inc.
in MN

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Employer Liable for Failing to Provide Life Insurance Conversion Information to Disabled Employee
"Notwithstanding that the right to convert to an individual insurance policy had long since expired, the court crafted a remedy under ERISA that imposed a surcharge on the employer equal to the $750,000 in life insurance that the physician employee would have elected to convert to an individual policy but for the plan administrator's breach of its fiduciary duty; the court also awarded the physician's spouse interest, legal fees and costs associated with bringing the lawsuit. Because the ability to convert to an individual policy was no longer available, the employer, and not the insurance company, is obligated to make all of these payments." [Erwood v. Life Insurance Company of North America and Wellstar Health System, Inc. Group Life Insurance Program, No. 14-1284 (W.D. Penn. Apr. 13, 2017)]
Buchanan Ingersoll & Rooney PC

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Trio of Retiree Health Benefit Decisions Delivered by 6th Circuit
"All three cases involve collective bargaining agreements with the United Auto Workers. In each ruling, the court closely examined the language of the parties' CBAs to determine whether retiree health benefits were intended to vest for a retiree's lifetime ... the Sixth Circuit's new trio of opinions suggests that the proper inquiry is very fact-specific and will depend largely on the language of the relevant bargaining agreements. The opinions also suggest that Sixth Circuit judges may not [all] be on the same page in interpreting post-Tackett rulings[.]"
Bloomberg BNA

EEOC Settles Wellness Case, Requires Payment to Employee and Workforce Training
"The Orion case gives the EEOC a more favorable result on the safe harbor issue, including a favorable ruling on the EEOC's recently issued regulations ... but it then undercuts the importance of those regulations by taking an extraordinarily broad view of what it means to act voluntarily. For now, at least, it seems that the boundaries and effect of these exceptions remain elusive."
Thomson Reuters / EBIA

California Law Barring Enforcement of Discretionary Clauses Not Preempted as to Insured Plan
"Many state insurance laws -- like the California law at issue in this case -- prohibit or restrict discretionary clauses because they make it more difficult for courts to fully address potentially problematic claims practices. The application of these laws to insured plans is relatively clear, but their applicability to self-insured plans is less settled[.]"
Thomson Reuters / EBIA

Employee Miscommunication: The Wall that Divides
"Reviewing claims, understanding workplace demographics, and analyzing health & welfare benefits utilization patterns are key in understanding if the messages you're sending are resonating.... Think beyond the printed benefit guidebook to things like online access to summaries, on-demand webinars, and even social media. And don't think that one message delivered prior to or during open enrollment is enough.... Tailoring a benefits administration platform to communicate with employees as they are making their elections will help eliminate surprises down the road. It also gives you a channel to communicate with spouses[.]"
Corporate Synergies

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A New Attempt Emerges to Bridge GOP Divisions on AHCA
"The proposal would first 'Reinstate Essential Health Benefits as the federal standard.'.... [T]he amendment would maintain most of the ACA's market reforms ... Waivers that would allow states to permit health status underwriting could dramatically increase premiums for people with high cost conditions to unaffordable levels. High risk pools could reduce the cost of coverage, but would have to be adequately funded."
Timothy Jost, in Health Affairs

White House Officials Push Revised Health Bill
"[Under] this [ACA] replacement, states could seek waivers from many of those mandates if they demonstrate that premiums would be lowered, the number of insured people would increase, or 'the public interest of the state' would be advanced. States could request an exemption from the rule intended to ensure that people with pre-existing conditions could not be charged prohibitive premiums -- but only if those states establish a high-risk insurance pool."
The New York Times; subscription may be required

How Would Sales of Health Insurance Across State Lines Affect Competition and Pricing? (PDF)
"The intent of permitting insurance companies to sell across state lines is to increase competition and reduce the costs of health insurance. There is a good possibility the most likely scenario will be to decrease competition and, without affecting the cost of health care, allow premium rates to increase faster than required by the rise in health care costs."
Lawrence Mitchell, FCA, FSA-R, MAAA

Benefits in General

Employee Benefits Considerations in Mergers and Acquisitions
"Due diligence is a critical first step in a merger or acquisition transaction.... Don't rely on the seller's representation of the condition of the benefit plans.... As you consider the impact of benefit plans on the transaction, also take into account how the type of deal -- asset or stock -- can impact the buyer's or seller's perspective.... [D]on't wait until after closing to develop a game plan for integration."
Milliman Retirement Town Hall

Avoid Costly Litigation Over Beneficiary Designations
"Language in plan documents, employee communications, and Summary Plan Descriptions should be clear and consistent. Plan administrators may also want to regularly (i.e. annually) remind participants on how to update their beneficiaries in light of life-changing events and provide them with the necessary beneficiary designation forms to do so."
Butterfield Schechter LLP

Get Your ROI on Employee Benefits Spending
"[M]ost companies hand their new hires a 20-page benefit guide with countless details, benefit jargon, and acronyms, and expect employees to figure it out.... Employees want more communication. They want more information, they want it more frequently, and they want it to be personalized. They expect to receive information through multiple channels, including video, online, mobile, and print.... [T]hey want to be educated consumers who have the information they need to make smarter decisions."
Ron Shah of Hodges-Mace, via CFO

Press Releases

DOL Recovers More Than $41K for the St. Paul-based Weinhagen Tire Co. Inc. 401(k) Plan
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

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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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