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[Guidance Overview]

Employer Shared Responsibility: Have Penalties Been -- Or Will Penalties Ever Be -- Assessed?
"By not expanding the matching program, information return reporting leads to mismatches and unnecessary notices ... [The authors] have been unable to determine whether any of these types of penalties have been assessed, although based on the [Taxpayer Advocate Service], it appears that none have as of yet.... This is of particular concern to ALEs because efforts that must be taken to either correct or confirm that correct information was submitted to the IRS are costly and time-consuming."
Perkins Coie LLP


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Text of D.C. Circuit Opinion Upholding Prohibition of Anthem-Cigna Merger (PDF)
66 pages. "Anthem and Cigna challenge the district court's decision and order permanently enjoining the merger on the principal ground that the court improperly declined to consider the claimed billions of dollars in medical savings.... [W]e hold that the district court did not abuse its discretion in enjoining the merger based on Anthem's failure to show the kind of extraordinary efficiencies necessary to offset the conceded anticompetitive effect of the merger in the fourteen Anthem states: the loss of Cigna, an innovative competitor in a highly concentrated market." [U.S. v. Anthem, No. 17-5024 (D.C. Cir. Apr. 28, 2017)]
U.S. Court of Appeals for the District of Columbia Circuit

No Vote on Healthcare Bill This Week in U.S. House
"U.S. House leaders have decided against holding a vote on a reworked healthcare system overhaul this week after failing to find the necessary support, congressional aides said on Thursday.... The Republican healthcare bill would replace Obamacare's income-based tax credit with an age-based credit, roll back an expansion of the Medicaid government health insurance program for the poor and repeal most Obamacare taxes."

IRS Information Letter Addresses HSA Ineligibility Due to Medicare Entitlement
"Medicare entitlement is automatic for some individuals ... Other individuals must file an application to be entitled to benefits (e.g., working individuals beyond age 65 who are eligible to receive Social Security benefits but who have not applied for them). Employers rehiring retirees should be aware of these rules and avoid setting up HSAs for Medicare-entitled employees. Excess pre-tax contributions to a preexisting HSA caused by failing to recognize an employee's ineligibility could trigger an additional 6% excise tax ... if the amounts are not timely distributed."
Thomson Reuters / EBIA

HSAs are Poised for the Spotlight in the Trump Era
"Although the AHCA's initial failure led to uncertainty on the specifics of health care reform, there appears to be a broad push to increase the use of [HSAs]. Various proposals have included plans to remove the requirement to have a high-deductible health plan in order to contribute to an HSA, raise contribution limits to $6,550 for individuals and $13,100 for families (from their current limits of $3,400 and $6,750, respectively), and to create a new type of account called a Roth HSA."
Manning & Napier


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TIGTA Report Underscores IRS's Difficulties in Implementing Employer Shared Responsibility
"In early January, the IRS updated its employer shared responsibility webpage to note that it expected to send letters 'beginning in early 2017' informing ALEs of potential Code Section 4980H liability for the 2015 year ... [T]he webpage [has been] updated to state that the letters will be issued 'in 2017' -- perhaps a tacit acknowledgment of the delay resulting from the complexity and struggles involved in implementing employer shared responsibility, as underscored by the report."
Thomson Reuters / EBIA

Employees Still Can't Find Out How Much Health Providers Charge
"More Americans are enrolling in high-deductible health plans, which means they'll pay more out of pocket for 'commodity' health services -- whether lab tests or common surgeries such as hip and knee replacements. They can shop around for high-quality providers that charge less, but they are finding it difficult to do so."
Society for Human Resource Management [SHRM]

Health Insurance Exchange (HIX) Compare: Data on Marketplace Plans from Every State & District of Columbia
"HIX Compare datasets examine every marketplace plan from 2014 to 2017. This is the only nationally comprehensive, public dataset that includes information on all plans offered in the health insurance marketplaces. HIX Compare includes information on premiums, deductibles and out-of-pocket maximums, as well as cost-sharing requirements for primary care and specialist visits, prescription drugs, emergency room services and inpatient and outpatient visits for all plans across all 50 states and the District of Columbia."
Robert Wood Johnson Foundation

ACA Repeal-and-Replace Continues: What Employers Need to Know About the MacArthur Amendment
"Because the MacArthur Amendment allows states to obtain waivers with respect to essential health benefits ... [it] could result in significant opportunities for employer group health plans.... Under the ACA, an employer with a self-funded health plan can choose any state as its point of reference for essential health benefit purposes. If even one state obtains a waiver and eliminates prescription drug coverage from the list of essential health benefits, any employer with a self-funded health plan -- no matter where the employer is located -- could impose annual and lifetime limits on prescription drugs and could exclude prescription drugs from the out-of-pocket maximum."
Venable LLP


Managing Benefit Options for Part-Time, Seasonal and Hourly Employees

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U.S. and Canada Announce Independent Competitions to Improve Wellness Data Collection
"[T]he Healthy Behavior Data Challenges competition will focus on the use of new technologies such as wearable devices and mobile applications to collect data related to nutrition, sleep, physical activity, and sedentary behavior. The competitions will include parallel data challenges that will run separately in both the U.S. and Canada."
U.S. Department of Health and Human Services [HHS]

Single Payer Takes a Step Forward in California
"[On April 26, the California Senate Health Committee] voted decisively to move S.B. 562 to the floor of the Senate. The Healthy California Act would establish a single-payer, Medicare-for-all system in the state, ensuring that all Californians have access to affordable healthcare."
Consumer Watchdog


Where Does the Health Insurance Premium Dollar Go?
"Much more troublesome is the 18 cents per premium dollar reported to cover the insurers' 'operating costs.' These include the cost of marketing, determining eligibility, utilization controls ... claims processing, and negotiating fees with each and every physician, hospital, and other health care workers and facilities. These operating costs are about twice as high as are the overhead costs of insurers in simpler health insurance systems in other countries."
JAMA Forum


Revised ACA Repeal and Replace Bill Likely to Increase the Uninsured Rate and Health Insurance Costs for Many
"The new amendment specifically allows states to weaken consumer protections ... Beginning in 2019, states could waive the ban on charging people with preexisting conditions higher premiums, as long as states set up special programs to help people with conditions like cancer or heart disease who could no longer afford coverage."
The Commonwealth Fund

Benefits in General

Alex Acosta Becomes Secretary of Labor
"Secretary Acosta will face an entrenched bureaucracy at the labor department that may resist his efforts to undo many of the regulations they helped draft over the past eight years ... Among the sub-regulatory challenges will likely be restoring agency-binding, case-by-case 'opinion letters' in place of administrative interpretations, which replaced opinion letters in the previous administration[.]"
Ogletree Deakins

Health Savings Accounts (HSAs) and How They Intersect with Defined Contribution Plans: Survey Results
11 pages. "The majority (75.3 percent) of employers view the HSA as part of their retirement benefits strategy. Nearly 60 percent of employers believe HSAs should replace Flexible Spending Accounts (FSAs), and nearly three-fourths of employers think that HSAs should be open to all employees, not just those enrolled in a high-deductible health plan."
Plan Sponsor Council of America [PSCA]

Press Releases

New CEBS Designation Curriculum Model Announced
International Foundation of Employee Benefit Plans [IFEBP]

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