Health & Welfare Plans Newsletter

May 8, 2017

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Benefits & Executive Compensation Associate
Faegre Baker Daniels LLP
in IN

Associate Partner - Defined Contribution Consulting
Aon
in FL, GA, MO, NJ, NY

Retirement Plans Manager
Oasis Outsourcing
in FL

Senior Retirement Plan Administrator
Forrestall CPAs
in GA

401k Service Administrator
Retirement Direct
in NC

401(k) Relationship Manager
MVP Plan Administrators, Inc.
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Webcasts and Conferences

Voluntary Fiduciary Correction Program
May 17, 2017 in UT
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

2017 Technology May-rathon: Benefits and Compensation – Mission Critical for Tech Company Success
May 23, 2017 WEBCAST
Morgan Lewis & Bockius LLP

5500 Update
May 25, 2017 WEBCAST
ERISApedia.com

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[Guidance Overview]

IRS Announces HSA and HDHP Limitations for 2018
"ACA out-of-pocket maximums are higher than the maximums for HDHPs.... [T]he ACA requires that the family out-of-pocket maximum include 'embedded' self-only maximums on essential health benefits.... The HDHP rules do not have a similar rule, and therefore, one family member could incur expenses above the HDHP self-only out-of-pocket maximum ($6,650 in 2018)."
Proskauer's ERISA Practice Center

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Second Circuit Upholds Dismissal of ERISA Claims Against Plan Defendants for Alleged 'Cross-Subsidization' Scheme
"[P]laintiffs alleged that Family Dollar negotiated a discount on the basic life insurance premium it paid, and that the Hartford offset some of this discount by increasing the supplemental life insurance premium charged to the employees who purchased supplemental coverage.... The Court determined that Family Dollar used plaintiffs' premiums for the sole purpose of covering insurance costs under the Plan, and that its use of cost-reduction strategies to minimize its cost of providing employees with basic and supplemental life insurance did not constitute a transfer for its own benefit or self-dealing in its own interest." [Hannan v. Hartford Financial Services, Inc., No. 16-1316 (2d Cir. Apr. 25, 2017)]
Robinson & Cole LLP

Retirees of Automotive Manufacturer Established Entitlement to Lifetime Health Benefits
"A collective bargaining agreement and plant closing agreement provided retirees of an automotive parts manufacturer and their spouses with healthcare insurance benefits that survived the expiration of a collective bargaining agreement, ruled a divided Sixth Circuit.... [The court] found that during the long bargaining history between the employer and union, the parties came to rely on prior judicial decisions interpreting language included in decades of CBAs. " [UAW v. Kelsey-Hayes Co., No. 15-2285 (6th Cir. Apr. 20, 2017)]
Wolters Kluwer Law & Business

For Large Employers, House-Passed ACA Reform Bill Mostly Significant for What It Does Not Do
"[T]he underlying mandate to offer coverage would remain in the law and could be enforced by an ERISA lawsuit, and the IRS reporting requirements would remain in place along with the penalty for non-reporting.... [T]he requirements to provide dependent coverage until age 26, the prohibition on annual and lifetime limits, first-dollar coverage for preventive care, and 90-day waiting period limitation all remain in place along with their penalties for noncompliance."
HR Policy Association

Summary of Key Provisions of the American Health Care Act (PDF)
13 pages. "The bill's key provisions include: [1] eliminating the individual shared responsibility and employer shared responsibility penalties; ... [2] funding for state-based high risk pools, a continuous coverage requirement, and a 5:1 community rating provision with state flexibility; [3] creating state waivers for age rating, essential health benefits (EHBs), and, where an individual's coverage has lapsed, community rating; [4] replacing the ACA premium subsidies with age-based tax credits of $2,000-$4,000 ... [5] delaying the implementation of the Cadillac tax[.]"
Groom Law Group

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

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House Passes American Health Care Act
"The AHCA would eliminate assessments under the employer mandate ... retroactively to 2016.... The Cadillac Tax on high-cost employer-sponsored health coverage would be delayed to 2026, but not eliminated by the AHCA.... The cap on health flexible spending arrangements (FSAs) would be removed; the annual contribution limit on health savings accounts (HSAs) would increase; over-the-counter drugs could again be purchased or reimbursed through FSAs or HSAs; insurance premiums could be paid or reimbursed through HSAs[.]"
Ballard Spahr LLP

House Passes American Health Care Act to Repeal and Replace the ACA
"[A] heated battle in the Senate is expected, with the AHCA likely to be significantly amended ... Of particular importance will be discussions around pre-existing conditions and essential health benefits.... Even though the repeal and replacement of the ACA seems on its way, the ACA still remains the law of the land. Employers should continue to follow its requirements until the AHCA receives the signature of President Trump." [Includes a comparison chart of ACA and AHCA provisions, with proposed effective dates.]
Duane Morris LLP

ACA Round-Up: Developments Outside Congress
"Although attention has been focused on efforts in Congress to repeal and replace the [ACA], there has been ACA-related activity in the courts and on the administrative front as well. [1] The Franciscan Alliance case: defining gender discrimination under the ACA ... [2] Land of Lincoln and Moda Health Plan cases: risk corridor litigation ... [3] Administrative action: risk adjustment data validation and QHP certification."
Timothy Jost, in Health Affairs

Anthem to Petition Supreme Court to Review Rulings Blocking Cigna Deal
"Anthem said its petition would focus on the stance of the third judge, Brett Kavanaugh, who sided with its defense of the deal.... If the court did take the case, it could take a year to resolve. That would be a timing challenge under the best of circumstances, but more so here because Cigna is fighting to terminate the deal."
The Wall Street Journal; subscription may be required

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Oscar Is Disrupting Health Care in a Hurricane
"Oscar does not remove all the pain from health insurance: Its members are covered only for doctors within its network, and it exercises some of the cost control that virtually all of its competitors use.... Nonetheless, Oscar has built an interface to health care that, at its best, is as refreshing as other experiences transformed by tech."
Backchannel

Did Medicare Part D Reduce Mortality?
"[The authors] investigate the implementation of Medicare Part D and estimate that this prescription drug benefit program reduced elderly mortality by 2.2% annually. This was driven primarily by a reduction in cardiovascular mortality, the leading cause of death for the elderly. There was no effect on deaths due to cancer, a condition whose drug treatments are covered under Medicare Part B.... [T]he value of the mortality reduction is equal to $5 billion per year."
Journal of Health Economics; purchase required

Final Results of the Actuarial Challenge
Provides links to the text of 14 papers submitted by collaborative teams in response to the Actuarial Challenge, which was an invitation to "move the individual insurance market further toward the goal universal access to quality health services and providers in a financially secure and stable way with consideration of the costs the solution places upon individuals, employers, health care providers, taxpayers (present and future), and other health sector stakeholders." Of the 14 papers, five were selected to be modeled and quantified through use of a simulation system (the Milliman Health Care Reform Financing Model). Modeling results are provided.
Robert Wood Johnson Foundation, American Academy of Actuaries, and Milliman

[Opinion]

Health Reform: What's Next?
"As Senator Alexander's working group goes about the task of crafting its repeal and replace plan ... it might start by clarifying three concepts muddled by industry noise and partisan bickering of late:.... [1] Affordability is about more than insurance premiums.... [2] Access is about more than carrying an insurance card.... [3] Our health system is about neither health or a system."
Paul Keckley

Benefits in General

Canadian Court Dismisses ERISA 'Controlled Group' Claim
"The decision holds that an ERISA controlled group claim fails because the claim raises a question of corporate personality -- namely, whether corporate separateness may be disregarded to impose a plan sponsor's liability on its affiliates -- and that the law of the place of incorporation, rather than US law, applies to such questions. Because the laws of the places of incorporation, British Columbia and Alberta, do not include ERISA, and because ERISA's controlled group provisions were the sole basis for liability, the claim fails. The decision creates an important guide to the limits of controlled group liability in Canada, and potentially in other jurisdictions guided by the decision." [Walter Energy Canada Holdings, Inc. (Re), 2017 BCSC 709, May 1, 2017]
Latham & Watkins

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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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