Health & Welfare Plans Newsletter

May 18, 2017 logo logo
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Employee Benefits Jobs

Participant Service Representative
Professional Capital Services
in PA

Director, 401k Client Services
Mutual of Omaha
in NE

Retirement Plan Specialist
Hills Pension Associates, Inc.
in MA, Telecommute

Seasonal Licensed Benefit Advisor
Willis Towers Watson
in FL, Telecommute

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Webcasts and Conferences

Fore! Your Benefits Employee Benefits Update
May 24, 2017 in IL

Developments in DC Plans
June 6, 2017 WEBCAST
Society of Actuaries

Current State of Multiple Employer Plans
June 14, 2017 WEBCAST
ASPPA [American Society of Pension Professionals & Actuaries]

2017 Retirement Research Consortium Meeting
August 3, 2017 in DC
Center for Retirement Research at Boston College

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New Comments and Topics

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[Official Guidance]

Text of DOL Advisory Opinion 2017-02AC
Question addressed: [1] Whether a sub-group of employer members of a trade association could constitute a 'group or association of employers' within the meaning of ERISA section 3(5) capable of sponsoring a multiple employer plan; [2] Whether a group health plan proposed by the sub-group would constitute a multiple employer welfare arrangement within the meaning of ERISA section 3(40).
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]


ACA Repeal: Where Things Stand -- And What Lies Ahead

Sponsored by Trucker Huss

Did you hear?! The House passed AHCA in the first step to "repeal and replace" the ACA. AHCA includes eight amendments and would significantly change healthcare rules that impact group health plans and employers. Register for our WEBINAR on 5/24!

[Guidance Overview]

Paid Sick Leave for Federal Contractors (PDF)
"Obligations of the contractor would include allowing employees to accrue at least one hour of paid sick leave for every 30 hours worked on, or in connection with, a covered contract, for a total of 56 hours per year. Contractors would be required to inform each employee of their unused but accrued sick leave at least once a pay period, or once a month, whichever interval is shorter, and may not deny an employee's request to use any or all of his or her accrued sick leave.... Contractors will also be required to make and maintain records for no less than three years from the completion of a covered contract for inspection by an authorized representative of the DOL."

[Guidance Overview]

Draft Regs Issued for Illinois Cook County's Ordinance on Paid Sick Leave
"Employers may define the 'accrual period.' ... Employees must be eligible for [FMLA] to qualify for Ordinance's FMLA-restricted earned sick leave.... Employees working in municipalities that opted out of the Ordinance still may be covered.... Employers are not required to allow accrual for time working outside Cook County or in municipalities that opted out.... Employers may be covered even if they do not have a place of business in Cook County.... Employers may not limit how an employee can provide notice of a foreseeable absence.... Pre-existing paid time off policies may satisfy an employer's obligations."
Jackson Lewis P.C.

[Guidance Overview]

Paid Family Leave Expands to DC
"The Act applies to nearly all private employers in DC, regardless of size, and, beginning July 2020, will provide certain employees with employer-funded paid leave for up to [1] eight weeks to care for a new child (by birth, adoption, or foster care placement), [2] six weeks to care for a family member with a serious health condition, and [3] two weeks for personal illness.... Efforts to modify the Act are already underway."
Andrews Kurth

[Guidance Overview]

CMS to Expand Direct Enrollment on
"CMS 'may release' future guidance on privacy and security requirements, and also that privacy and security issues will be a subject for the third-party compliance audits that [direct enrollment] entities must undergo.... Entities seeking to participate in the proxy direct enrollment process must retain third-party auditors to validate their compliance with requirements and undergo compliance audits and CMS testing and readiness review before they begin using the process."
Timothy Jost, in Health Affairs


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ACA Repeal: A Look at the Process and an Estimated Timeline
"The road to repeal and replacing the ACA is complicated and will take some time to be successful.... This estimated timeline is designed to provide a easy visual of what the next steps might look like. The complicated process combined with the gravity of its impact suggest the ultimate result may require a bi-partisan solution."

Trump Administration Starts to Chip Away at ACA Regs
"Starting in the next open enrollment period, consumers who use an approved third-party website to enroll in ACA exchange plans will be able to finish the enrollment process through that website, rather than being redirected to to finish their application ... Consumer feedback indicated that the redirect process confused potential enrollees and made it more difficult for them to finish their applications[.]"

American Health Care Act Would Affect Key Components of Medicare
"Low-income Medicare beneficiaries who also are enrolled in Medicaid -- often referred to as 'dual eligibles' -- could be disproportionately affected by congressional efforts to cut and cap federal Medicaid financing. Not only do these older adults account for one-third of all Medicaid spending, much of the Medicaid spending for low-income Medicare beneficiaries is 'optional' for states."
The Commonwealth Fund

Feds to Nix Enrollment for Small Business Plans
"Under the CMS plan, not yet released as a proposed rule, employers would no longer be able to enroll in SHOP plans through the federally run SHOP exchanges available in 33 states through the portal. Employers could still use the federal portal to check if they qualify for the small business tax credit."
Society for Human Resource Management [SHRM]


SHOP's a Flop
"The SHOP Exchange was created to provide employers with less than 50 employees an easy to use process to enroll employees in group health insurance.... Turns out SHOP enrollment is extremely cumbersome, there are less plan options compared to the off exchange market, and that tax credit, well it hasn't been worthwhile for most employers. Plus it's only available for a maximum of two years.... Less than 3% of projected enrollment. That is why SHOP should be dropped."

Benefits in General

The Fifth Circuit Calls Into Question Its Standard of Review in ERISA Denial of Benefits Cases
"The Plan ... did not provide deference to the decisions of Plan Administrator. However ... the Court applied the abuse of discretion standard to examine the plan administrator's factual determinations.... [T]he Court noted that it is the only circuit that would apply deference to factual determinations made by a plan administrator when the plan does not vest them with that discretion, and also pointed to the growing number of state laws prohibiting discretionary clauses in insurance contracts." [Ariana M. v. Humana Health Plan of Texas, Inc., No. 16-20174 (5th Cir. Apr. 21, 2017)]
National Law Review

It May Be Time to Start Thinking About Equitable Claims Again
"A recent decision by the Eighth Circuit Court of Appeals ... provides another signal that those of us defending against benefit claims increasingly may have to contend with simultaneous equitable claims for breach of fiduciary duty. Though the law is developing in this area ... and likely will vary from circuit to circuit, you can expect more plaintiffs to add an equitable claim to a benefits complaint, and you can expect at least some courts to allow those claims to go forward. What strategies will prove most effective in responding to this latest tactic?"
Robinson & Cole LLP

Executive Compensation
and Nonqualified Plans

2017 Executive Compensation Trends and Developments
"[The survey] and its results are intended to provide an overview of the current environment and signal the direction in which companies are moving with respect to executive compensation and corporate governance practices. This survey features responses from 118 companies across a diverse range of industries, covering topics such as annual and long-term incentive plan designs, Say on Pay, the CEO pay ratio, and more."
Meridian Compensation Partners, LLC

Discussions on
the BenefitsLink Message Boards

Can an Employer Self-Fund a Disability Plan and Get Stop-Loss Insurance?
"Many employers do not use health insurance for a health plan, and instead pay claims from the employer's general assets. Some of these employers buy a stop-loss insurance contract to protect the employer (not the participants) against its risk of outsize claims under the health plan. Can an employer do the same thing with a disability plan? Is there a ready market?"
BenefitsLink Message Boards

Press Releases

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David Rhett Baker, J.D., Editor and Publisher
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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2017, 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, 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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