Health & Welfare Plans Newsletter

June 12, 2017

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CBIZ - Savitz
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CBIZ Savitz
in PA

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[Official Guidance]

Text of CMS Bulletin: Display of 2017 Quality Rating System Star Ratings and QHP Enrollee Experience Survey Results (PDF)
Unnumbered document, June 9, 2017. "[CMS] will conduct a second year of consumer pilot testing during the 2018 individual market open enrollment period of the display of [QHP] quality rating information by the Federally-facilitated Exchanges ... CMS intends to use the same criteria for identifying states to participate in the second year of the consumer pilot testing."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

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[Official Guidance]

Text of Updated CMS Bulletin on Network Breadth Information for Qualified Health Plans on Healthcare.gov (PDF)
Unnumbered document, June 9, 2017. "For plan year 2018, [CMS] intends to continue the network breadth pilot for reporting information on the relative size of provider networks that will display in a limited number of states on HealthCare.gov.... The results of the pilot will determine whether CMS expands the pilot to more States for the 2018 plan year."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

Arizona's Paid Sick Leave Law: Accrual and Usage Issues
"One of the Act's more significant anomalies is its apparent requirement that all unused accrued paid sick time be carried forward to the following benefit year (unless the employer 'buys back' unused PST at the end of the benefit year). This apparent unlimited carryover requirement is at odds with the Act's clear limitation on maximum usage hours, which are capped at 40 per year (24 for small employers), unless the employer opts to allow more usage. Fortunately, the ICA has addressed this issue and prepared both a FAQ and a proposed regulation (R20-5-1206(F)) that caps annual mandatory carryover at 40 hours from one benefit year to the next."
Ogletree Deakins

Court Questions Insurer's About-Face on Paying Disability Benefits
"The court was clearly skeptical of an insurer's decision that overturned nearly eight continuous years of benefit payments for a chronic, degenerative medical condition. Although the case was not entirely clear-cut, the actions taken by Unum following Hart's rejection of a buyout offer were suspicious and resulted in the court's determination that there was no reasonable basis for Unum's findings." [Hart v. Unum Life Ins. Co. of America, No 15-5392 (N.D. Cal. May 24, 2017)]
DeBofsky, Sherman & Casciari, PC

The Connection Between Employee Well-Being and Turnover
"The HERO Scorecard is an inventory of about 60 well-being program best practices ... [T]he highest-scoring group was more likely to report improvement in medical trend and health risk. But they also reported an average turnover rate of just 12%, compared to 15% in the medium-scoring group and 17% in the low-scoring group."
Mercer

[Advert.]

Online Learning Course: HSA and HRA Basics

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More Companies Now Offer a 'Summer Friday' Perk
"42 percent of companies now officially sanction starting the weekend early, a doubling of the percentage who offered the benefit in 2015, when 21 percent of companies said they did so.... As flexible work arrangements have grown and the average office worker is just a text or phone call away, many people already duck out early on Friday afternoons, especially before long holiday weekends. Making it official gives the company a way to plug their generosity without spending much at all."
The Washington Post; subscription may be required

HHS Requests Feedback on ACA Regs; Evidence on Effect of CSR Payment Uncertainty Continues to Mount
"Some of these Obama-era initiatives -- in particular, the transitional plans -- were of questionable legality under the ACA, but some of the Trump initiatives -- such as stretching the 'de minimis variation' permitted for health plan variation, push the boundaries in other directions. The request for information seems to contemplate steps that would depart even further from the legal moorings of the ACA."
Timothy Jost, in Health Affairs

'May I Borrow Your Health Reform Bill?' (PDF)
"As details about [the] Senate bill began to emerge ... lo and behold the Senate's outline looks very much like the House bill after all.... [T]he Senate has [apparently] abandoned, at least for purposes of the health reform effort, any notion to begin taxing employees on the value of the employer-provided health insurance.... Nevertheless, there are hints the House and Senate may revisit that issue as part of their tax reform effort later in the year."
Lockton

Two States Make Strong Statements About Their ACA Markets
"The bold actions of New York and Nevada probably do not signal a national trend in the short run. Both are in the minority of states that run their own Exchange ... so they have more control over their Exchange markets than most states.... The Trump administration is committed to empowering states, and Medicaid and Exchange markets are more alike than different. Given this -- and absent large Medicaid cuts that could trigger insurer exits from that market -- more states may be tempted to link the Medicaid and Exchange markets[.]"
Faegre Baker Daniels LLP

[Opinion]

Joint Letter to Congress Regarding Health Care Reform Proposals (PDF)
"Chief among the threats to employer-sponsored coverage are proposals to tax workers' health coverage, whether by preserving the ACA's 40 percent 'Cadillac' tax, or imposing new taxes on employee health care benefits. Legislation that implements a tax on health benefits ('cap on the exclusion') will result in a system that is worse than current law for workers and for employers, and failure to eliminate the Cadillac tax will raise coverage costs for American workers, their families and employers, and work against efforts to lower health care costs."
Employers Council on Flexible Compensation [ECFC] and 52 Other Business and Trade Associations

Executive Compensation
and Nonqualified Plans

ASU 2017-09 Provides Clarity to Modifications to Share-based Compensation Arrangements
"FASB issued Accounting Standards Update (ASU) 2017-09 to reduce the cost and complexity when applying Topic 718 and standardize the practice of applying Topic 718 to financial reporting. The ASU was not developed to fundamentally change the definition of a modification, but instead to provide guidance for what changes would qualify as a modification. This was done by better defining what does not constitute a modification."
Findley Davies | BPS&M

Discussions on
the BenefitsLink Message Boards

Retiree-Only HRA's for Former Employees; OK to Cover Spouse and Dependents?
"For a governmental entity (if it matters), can the employer set up an HRA for former employees that also covers expenses for spouses and dependents? It seems very clear that Retiree Only HRA's are perfectly allowable, but I'm not finding hard guidance that permits coverage for spouses and dependents."
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David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
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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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