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May 19, 2017 logo logo
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[Guidance Overview]

IRS Guidance on Tax Treatment of Benefits Paid by Self-Funded Fixed-Indemnity Plans
"The IRS concludes [in CCM 2017 19025] that because these plans do not involve a risk of economic loss as a result of overpayments or rewards for wellness plan participation, this is not insurance for federal tax purposes. Therefore, since the plans are neither insurance nor have the effect of insurance, amounts received by employees are not excluded from the employees' income and are subject to FICA payments from both the employer and employees."
The Wagner Law Group


Online Learning Course: Family and Medical Leave Act (FMLA)

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

This course identifies coverage and eligibility requirements of employees and responsibilities of employers, and describes how to avoid common administration mistakes, implement best practices and be aware of interactions with other laws.

[Guidance Overview]

2018 Inflation-Adjusted Amounts for Heath Savings Accounts
"The HSA contribution limit for the 2018 calendar year for individual coverage will be $3,450, and the limit for family coverage will be $6,900.... What about the California HDHP rules? ... What about the American Health Care Act?"
ABD Insurance & Financial Services

GM Didn't Violate FMLA by Suspending Electrician Who Failed to Follow Union-Negotiated Policy for Calling In Absences
"An employee who was approved for intermittent FMLA leave, and subsequently placed on several weeks of unpaid suspensions for failing to follow company policy for timely reporting unplanned absences, failed to revive his claims of FMLA interference since the FMLA and accompanying regulations require employees to follow their employer's 'usual and customary' procedures for requesting FMLA leave absent 'unusual circumstances'[.]" [Acker v. General Motors, LLC, No. 16-11174 (5th Cir. Apr. 10, 2017)]
Wolters Kluwer Law & Business

Appeals Court Affirms Ruling that Pittsburgh's Paid Sick Days Ordinance is Invalid
"On May 17, 2017, the Pennsylvania Commonwealth Court upheld a 2015 trial court ruling that the City of Pittsburgh did not have the authority under state law to enact the Paid Sick Days Ordinance.... [The] Ordinance ... would require employers to provide employees with a minimum of one hour of paid sick leave for every 35 hours an employee works in the city limits[.]"

Can a Qualified Transportation Plan Reimburse Employees' Expenses for Carpooling with Their Own Vehicles?
"Because of the seating capacity and mileage-use requirements, most family vehicles used for carpooling cannot qualify as commuter highway vehicles and thus do not qualify for vanpooling benefits. Even if a family minivan or SUV satisfies the seating capacity requirement, a family vehicle generally cannot satisfy the 80% usage requirement."
Thomson Reuters / EBIA


2017 Health Savings Accounts Facts

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Turn to the new 2017 Health Savings Accounts Facts to obtain vital HSA questions and answers right at your fingertips. Use code BENLINK for 10% discount.

And You Thought There Was Nothing New in Healthcare? Shifting from 'Volume' to 'Value'
"Recently, a new player -- Create -- has come onto the scene in New York and New Jersey and is challenging the traditional idea that employee benefits must be delivered through conventional, big-name insurance carriers. The concept is a marketplace of health systems where employees shop for and select a health system as their exclusive care provider. So rather than carrying an insurance carrier card your health insurance ID would bear the name of the hospital network of your choosing."
Frenkel Benefits

Multimillion Dollar HIPAA Settlements Focus on Encryption and Unauthorized Disclosures
"Encryption continues to be one of OCR's top priorities for mobile devices and storage media.... OCR cited a covered entity's continued use of unencrypted portable devices as an aggravating factor when it recently assessed a $3.2 million civil monetary penalty. And OCR has previously warned that a covered entity is not excused from HIPAA's privacy requirements simply because it believes an individual's identity is already publicly known."
Thomson Reuters / EBIA

California, New York Lead Group of States Seeking to Intervene in Litigation Over Cost-Sharing Reduction Payments
"The states' motion contends that allowing the lower court's order ending the CSR payments until Congress appropriates funding, and subjecting future CSR payments to an unpredictable appropriations process, would lead to higher insurance costs for consumers and to more insurers abandoning the individual health insurance market.... Moreover, the states assert, they have a unique sovereign interest in administering their insurance markets and protecting their residents that no other party to the litigation can represent."
Timothy Jost, in Health Affairs

HHS Expands Direct Obamacare Enrollment: Will Insurers Respond?
"The move could be an early sign the Trump administration will take a backseat to the private sector in getting Americans to sign up for health insurance ... Direct enrollment, when consumers sign up for health insurance directly with the companies selling plans, presents an opportunity for insurers with great websites to capture a larger share of the individual market ... People signing up for insurance won't be directed to, where they can see a host of health plans ... reducing the risk they'll purchase a competitor's product."
Bloomberg BNA


Despite What You've Read, Many Small Businesses Support Obamacare
"While most small business owners agree there are portions of the ACA that can and should be improved, polling shows that a majority of small businesses actually prefer the current law over the GOP replacement plan, and that key provisions of the ACA are helping entrepreneurs succeed."
John Arensmeyer, in Morning Consult

Benefits in General

Two Recent Cases Illustrate Costs of Ignoring Process in Benefits Administration
"In neither case was it likely that problems arose due to a lack of knowledge of the specific rules that should have been followed; what may have been lacking is a good understanding of why it's important to follow those rules.... [E]stablishing, following, and monitoring a compliant process matters. And if the rules seem unworkable, see if you can re-work them and find a way to comply. The cost of noncompliance can be steep."
Stinson Leonard Street

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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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