Health & Welfare Plans Newsletter

May 5, 2017

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Webcasts and Conferences

DB / DC Update on New Regulations Opens Retirement Plan Innovation
May 11, 2017 WEBCAST
Western Pension & Benefits Council

Executive Compensation: Current Trends and Design Challenges
May 16, 2017 WEBCAST
Morgan Lewis & Bockius LLP

Offering the Right Mix of Medical Plan Choices
May 17, 2017 WEBCAST
Fidelity Health Marketplace

Defined Contribution Compliance Reboot
May 18, 2017 WEBCAST
Western Pension & Benefits Council

Trends Impacting Pharmacy Affordability: Potential Strategies to Preserve Benefit Affordability
May 25, 2017 in DC
Worldwide Employee Benefits Network [WEB] - Washington Metropolitan Chapter

Plan Sponsors' Biggest Surprises about 3(38)
May 31, 2017 WEBCAST
CAPTRUST Financial Advisors

California Leaves of Absence Compliance Including FMLA, Pregnancy Disability, and Military Leave
June 8, 2017 WEBCAST
ComplianceOnline

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[Official Guidance]

Text of IRS Rev. Proc. 2017-36: Indexing Adjustments for Calculations of Premium Tax Credit and Eligibility for Minimum Essential Coverage (PDF)
"This revenue procedure ... [1] updates the Applicable Percentage Table ... for 2018. This table is used to calculate an individual's premium tax credit....[2] updates the required contribution percentage ... for plan years beginning after calendar year 2017. The percentage is used to determine whether an individual is eligible for affordable employer-sponsored minimum essential coverage under Section 36B.... [3] cross-references the required contribution percentage ... for plan years beginning after calendar year 2017 ... The percentage is used to determine whether an individual is eligible for an exemption from the individual shared responsibility payment because of a lack of affordable minimum essential coverage."
Internal Revenue Service [IRS]

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[Official Guidance]

Text of IRS Rev. Proc. 2017-37: 2018 Inflation Adjusted Amounts for Health Savings Accounts (HSAs) (PDF)
"For calendar year 2018, the annual limitation on deductions ... for an individual with self-only coverage under a high deductible health plan is $3,450. For calendar year 2018, the annual limitation on deductions ... for an individual with family coverage under a high deductible health plan is $6,900. For calendar year 2018, a 'high deductible health plan' is defined ... as a health plan with an annual deductible that is not less than $1,350 for self-only coverage or $2,700 for family coverage, and the annual out-of-pocket expenses (deductibles, co-payments, and other amounts, but not premiums) do not exceed $6,650 for self-only coverage or $13,300 for family coverage."
Internal Revenue Service [IRS]

[Guidance Overview]

CRS Report on H.R. 1628: The American Health Care Act (AHCA) (PDF)
72 pages. "This report contains three tables that, together, provide an overview of all the AHCA provisions. Table 1 includes provisions that apply to the private health insurance market, Table 2 includes provisions that affect the Medicaid program, and Table 3 includes provisions related to public health and taxes. Each table contains a column identifying whether the AHCA provision is related to an ACA provision (e.g., whether it repeals an ACA-related provision). In addition to the three tables, the report includes more detailed summaries of each AHCA provision, and two graphics showing the effective dates of AHCA provisions." [Report R44785, May 4, 2017]
Congressional Research Service [CRS]

[Guidance Overview]

A Primer on New York's Impending Paid Family Leave: Are Employers Prepared?
"Private employers with at least one employee will be required to provide PFL benefits under the new law. Employers may choose to either purchase a PFL insurance policy to be financed through employee payroll deductions or to self-insure. Employers may begin collecting the weekly employee contribution on July 1, 2017.... Employees may not opt out, except in the limited circumstance where an employee's regular work schedule is less than the threshold for eligibility (e.g., short term or temporary employees)."
Fisher Phillips

[Guidance Overview]

Audit Reveals Pay-or-Play Enforcement Issues (PDF)
"At this time, the IRS has been unable to identify the employers potentially subject to an employer shared responsibility penalty or to assess any penalties. To enforce these rules going forward, the IRS plans to mail a letter to ALEs informing them of their potential liability for a penalty.... These letters are separate from the Section 1411 Certification sent by [HHS] that employers began receiving in 2016.... Section 1411 Certifications do not trigger or assess any penalties for any employers[.]"
Cowden Associates, Inc.

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What a Difference an 'H' Makes ... Again
"[In] many respects, the AHCA is less 'repeal and replace' and more 'retool and repurpose,' but there are some significant changes that could affect employers, if this bill becomes law as-is. [This article includes] a brief summary of the most important points... [T]he employer reporting requirement is not removed by this bill, so that will continue to be a compliance obligation. The open question is whether this bill will make it through the Senate."
Benefits Bryan Cave

House Passes AHCA: How It Happened, What It Would Do, and Its Uncertain Senate Future
"The final AHCA as passed ... [1] Eliminates the taxes and tax increases imposed by the ACA; ... [2] Removes the individual and employer mandate penalties: [3] Increases age rating ratios from 1 to 3 to 1 to 5 in the individual and small group market and allows states to go higher by waiver; [4] Permits states to waive the ACA's essential health benefit requirements; [5] Imposes a penalty on individuals who do not maintain continuous coverage; ... [6] Creates funds of $138 billion to assist states in dealing with high-cost consumers and for other purposes; [7] Ends the ACA's means tested subsidies as of 2020 and substitutes for them age-adjusted fixed-dollar tax credits."
Timothy Jost, in Health Affairs

GOP Senators to Draft Their Own Obamacare Replacement Bill
"[E]ven though the House spent months on a health care bill that would repeal and replace the [ACA], the Senate will use that legislation as a starting point to draft a separate measure.... The Senate must clear the added hurdle of the chamber's parliamentarian, who decides whether the legislation complies with the Byrd rule that allows Republicans to pass a bill with a simple majority of 51 votes under budget reconciliation. The parliamentarian can rule specific provisions out of order, stripping them from consideration."
Morning Consult

Frequently Asked Questions About Prescription Drug Pricing and Policy (PDF)
37 pages. "This report will address frequently asked questions about government and private-sector policies that affect drug prices and availability. Among the prescription drug topics covered are federally funded research and development, regulation of direct-to-consumer advertising, legal restrictions on reimportation, and federal price negotiation. The report provides a broad overview of the issues as well as references to more in-depth CRS products. The appendixes provide references to relevant congressional hearings and documents ... and a directory of CRS prescription drug experts[.]" [Report R44832, May 2, 2017]
Congressional Research Service [CRS]

Post-Tackett Cases Provide Guidance for Determining Vested Status of Retiree Medical Benefits
"Recent rulings from the Fourth and Sixth Circuits address the vesting status of medical benefits provided to retirees and their spouses and dependents under various collective bargaining agreements (CBAs).... The outcome in each case turns on the language of the applicable CBA and other facts and circumstances, but certain rules of contract interpretation emerge: [1] Unambiguous contract language controls.... [2] Silence may create ambiguity.... [3] Ambiguity allows for extrinsic evidence.... [4] Reasonable modifications to vested benefits may be permitted."
Thomson Reuters / EBIA

GAO Report on HHS Rule on ACA Market Stabilization for 2018
"GAO reviewed the [HHS] new rule on the [ACA] and market stabilization. GAO found that [1] the final rule (a) makes changes that HHS expects will help stabilize the individual and small group markets and affirm a state regulator role; and (b) 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; and [2] HHS complied with applicable requirements in promulgating the rule."
U.S. Government Accountability Office [GAO]

[Opinion]

This Little-Known Legal Risk Could Force Big Changes to Our Dysfunctional Health-Care System
"Increased outside scrutiny on how ERISA-regulated health plans spend their dollars could create immense potential liability for both company directors and health insurers across the country.... These legal threats could force employers to actively manage health spending the same way they manage other large operational expenses.... [A]pproaches ... focus on proven benefits-design solutions that make poor care decisions more costly and better care decisions less costly to encourage the right behavior. Most importantly, they don't focus on shifting costs to employees."
MarketWatch

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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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