Health & Welfare Plans Newsletter

May 9, 2017

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Text of CBO Cost Estimate for the American Health Care Act, Incorporating Manager's Amendments 4, 5, 24, and 25
"CBO and JCT estimate that enacting H.R. 1628, with the proposed amendments, would reduce federal deficits by $150 billion over the 2017-2026 period... [In] 2018, 14 million more people would be uninsured under the legislation than under current law.... [The bill] would tend to increase average premiums in the nongroup market before 2020 and lower average premiums thereafter, relative to projections under current law. In 2018 and 2019, according to CBO and JCT's estimates, average premiums for single policyholders in the nongroup market would be 15 percent to 20 percent higher under the legislation than under current law."
Congressional Budget Office [CBO]

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Preeclampsia Screening Must Now Be Covered by Group Health Plans
"The U.S. Preventive Services Task Force [USPTF] has published a final recommendation statement and evidence summary ... [which] recommends screening pregnant women for preeclampsia with blood pressure measurements throughout pregnancy. This is a B recommendation, [therefore] non-grandfathered group health plans may not impose any cost-sharing requirements (such as a copayment, coinsurance, or a deductible) and must provide coverage with respect to preeclampsia screening[.]"
Wolters Kluwer Law & Business

Employer Case Studies on Use of Wearable Tracking Devices in Wellness Programs (PDF)
17 pages. "Nearly one half (46%) of employers responding to the survey offer or sponsor some type of wearable as part of a wellness program.... Of initial users, 54% of employers report that more than half of their employees continue use of the device after six months.... [T]he most common metrics monitored included number of participants (84%), total and average steps (6 6%), and participant satisfaction (57%)."
HERO

Button Up Your HIPAA Business Associate Agreements or Pay the Price
"The CCDH settlement is a timely reminder of the importance of a business associate agreement even if no electronic protected health information is involved and demonstrates OCR's readiness to require a settlement agreement, resolution amount and corrective action plan even in the absence of any protected health information being made public.... [P]lan administrators should ensure that as they enter into arrangements with new service providers for their group health plans no protected health information is transferred until the business associate agreement (and not just the service agreement) has been executed."
Benefits Bryan Cave

Top Five HIPAA Myths That Arise in Higher Education
"[1] HIPAA applies to all medical information we maintain as a college or university.... [2] If we release medical information about a student or employee we can be sued for violating HIPAA.... [3] HIPAA prohibits a college or university from asking an employee or student for medical information.... [4] HIPAA applies to any person with medical training and a professional license.... [5] HIPAA prohibits employees from talking about the health situation of their co-workers or their students."
Husch Blackwell

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Forget Taxes, Warren Buffett Says -- The Real Problem Is Health Care
"In truth, Mr. Buffett said, a specter much more sinister than corporate taxes is looming over American businesses: health care costs. And chief executives who have been maniacally focused on seeking relief from their tax bills would be smart to shift their attention to these costs, which are swelling and swallowing their profits."
The New York Times; subscription may be required

The Path to ACA Repeal -- House Resuscitates the AHCA
"As it currently stands, the House bill leaves several open-ended questions for large employer-sponsored plans. First, it is unclear how the waivers for essential health benefits in the MacArthur Amendment will impact self-insured plans and the existing [HHS] regulations allowing such plans to choose a state 'benchmark' plan in order to define essential health benefits. Further, ... the pending CBO cost estimate may cause Congress to seek alternative funding sources for the bill, meaning that self-insured plan sponsors could find themselves in the crosshairs."
Eversheds Sutherland

What the AHCA Means for Employers
"For larger employers not in the small group market, the AHCA creates an opportunity to choose a benchmark plan that offers a significantly lower level of benefits to employees.... The provisions of the GOP plan will be implemented over a 10-year period.... [T]he most important aspect of this for employers is to understand the trend in health insurance, which is undeniably moving in the direction of consumerism."
Corporate Synergies

House Version of Repeal-and-Replace Health Bill Would Make Significant Changes to HSAs
"[T]he AHCA would [1] increase annual HSA contribution limits to equal the maximum HDHP out-of-pocket payment amounts ... [2] treat an HSA as having been established on the date HDHP coverage begins if the HSA is established within 60 days of such date.... [3] restore the 10 percent additional penalty tax on HSA distributions that are not used for qualified medical expenses ... [4] allow spouses that are both eligible to make catch-up contributions to choose which of their HSAs will receive the additional contributions; and [5] allow over-the-counter (i.e., nonprescription) medications to be considered HSA-eligible expenses."
Ascensus

AHCA Passed by Narrow Vote, But Effect Still Unknown
"The precise impact on employer reporting continues to remain unclear. The requirement imposed on employers to offer coverage to full-time employees, and to measure and report part-time or full-time status, appears to remain intact."
Hodges-Mace

Effect of the ACA on Health Care Access
"[G]aining insurance coverage through the expansions decreased the probability of not receiving medical care by between 20.9 percent and 25 percent. Gaining insurance coverage also increased the probability of having a usual place of care by between 47.1 percent and 86.5 percent. These findings suggest that not only has the ACA decreased the number of uninsured Americans, but has substantially improved access to care for those who gained coverage."
The Commonwealth Fund

House Budget Panel to Assume ACA Repeal Enactment
"The House Budget Committee will assume enactment of the House-passed health care bill when it marks up a budget resolution after the Memorial Day break, a stance that may make tax-writers' jobs easier as they look to revamp the tax code.... The nature of the health care bill, which uses sharp cuts in health care spending -- much of it for the poor -- to more than offset the revenue lost by repealing taxes that hit the wealthy, has another potential impact: making the later argument over who benefits from a tax overhaul easier."
Bloomberg BNA

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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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