Health & Welfare Plans Newsletter

July 6, 2017

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Employee Benefits Jobs

Enrolled Actuary Remote
Expanding Nationwide TPA Firm
in CA, Telecommute

Retirement Plan Administrator
Guidant Financial
in WA, Telecommute

Retirement Plan Administrator
Benetrends, Inc.
in PA

Counsel, Employee Benefits
Discover Financial Services
in IL

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Webcasts and Conferences

ASB Exposure Draft on EBP Reporting
July 10, 2017 WEBCAST
AICPA

IRA Update 2017
July 18, 2017 WEBCAST
Collin W. Fritz & Associates, Ltd.

ERISA Basics Part I: For Employees ERISA Plans - Advising Participants and Beneficiaries About Their Rights and Responsibilities
July 18, 2017 WEBCAST
American Bar Association Section of Real Property, Trust and Estate Law

Paid Family Leave Benefits Are Coming to New York: What Employers Need to Know Now
July 19, 2017 in NY
Nixon Peabody LLP

Strategies For Managing FMLA Abuse & Catching The 'FMLA Gamers' Who Are Manipulating The System
July 25, 2017 WEBCAST
HRTrainingCenter.com

GASB No. 74 & 75: Best Practices in OPEB Accounting & Auditing
July 27, 2017 WEBCAST
AICPA

ERISA Reporting and Disclosure Requirements
July 27, 2017 WEBCAST
Cowden Associates, Inc.

EPCRS Part II - Correction Tips and Tricks
August 15, 2017 WEBCAST
ERISApedia.com

S Corporation ESOPs: Administrative Issues
September 5, 2017 WEBCAST
National Center for Employee Ownership [NCEO]

S Corporation ESOPs: Valuation Issues
September 12, 2017 WEBCAST
National Center for Employee Ownership [NCEO]

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Discussions

New Topics on the BenefitsLink Message Boards

New Comments and Topics

All Topics, Grouped by Forum


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[Guidance Overview]

Think Your PTO Policy Complies With the Chicago or Cook County Paid Sick Leave Ordinances?
"Based on 'safe harbor' provisions in both Ordinances, many employers are assuming that their Paid Time Off (PTO) policies are sufficient -- as written -- to comply with these new PSL obligations. However, a careful reading of the Ordinances and their respective rules leads to the inescapable conclusion that almost no traditional PTO policy satisfies the Ordinances' burdensome and somewhat complex requirements."
Bryan Cave LLP

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[Guidance Overview]

IRS Form 14581-A: Fringe Benefits Compliance Self-Assessment for Public Employers (PDF)
"The self-assessment tools are designed to help public employers identify areas that indicate potential compliance issues. They are intended to be completed by those responsible for withholding and paying employment taxes and filing required information returns." [June 2017]
Internal Revenue Service [IRS]

[Guidance Overview]

IRS Form 14581-C: Medicare Coverage Compliance Self-Assessment for State and Local Government Employers (PDF)
"The self-assessment tools are designed to help public employers identify areas that indicate potential compliance issues. They are intended to be completed by those responsible for withholding and paying employment taxes and filing required information returns." [June 2017]
Internal Revenue Service [IRS]

HHS Provides Cyberattack Checklist for HIPAA-Covered Entities
"The Office for Civil Rights presumes that most cyber-related security incidents in which PHI was accessed, acquired, used or disclosed are reportable breaches. Health plan sponsors (and affiliates) who experience a ransomware attack or other cyber-related security incident should follow the OCR checklist. Coordination will likely be required between the employer's information technology and HR departments to properly respond to a cyberattack."
Willis Towers Watson

55 Wellness Initiatives for Your Workplace
"[A recent survey] found that 90% of employers offer at least one wellness initiative. And while the old standbys (think weight-loss challenges and 10,000-step programs) are still going strong, ... efforts are growing in areas like mental health and worker growth."
International Foundation of Employee Benefit Plans [IFEBP]

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Using Mobile, On-Site and Remote Medical Providers to Reduce Health Care Costs

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Error to Hold That Benign Mass on Foot Could Not Be FMLA 'Serious Health Condition'
"Post-operative appointments for wound care constituted 'continuing treatment' of an employee's benign growth on her foot... [T]he appeals court also found that her employer failed to prove her condition did not involve at least three consecutive days of incapacity absent medical treatment. The fact that she worked until the day of her surgery was not dispositive because she and her doctor viewed the condition as worsening." [Pollard v. The New York Methodist Hospital, No. 15-3231 (2d Cir. June 30, 2017)]
Wolters Kluwer

Ted Cruz's Plan to Save Republican Health Care Bill Gains Traction
"Senate Republican leaders ... are giving serious consideration to a proposal by Sen. Ted Cruz (R-Tx.) to let insurers that sell plans that conform to the [ACA's] regulations also sell policies that don't. The idea... would allow insurers to offer cheaper, less-comprehensive policies, likely to be bought by healthier people.... Senate Majority Leader Mitch McConnell (R-Ky.) asked the nonpartisan [CBO] to analyze the Cruz provision's impact on the federal budget and on insurance coverage ... a sign Senate leaders are genuinely contemplating it."
The Wall Street Journal; subscription may be required

2016 Employer Stop-Loss Market (PDF)
12 pages. "Approximately 58% of respondents achieved over 6% premium growth from January 1, 2016, to January 1, 2017 ... Loss ratios (net of commissions) increased from 75% in 2015 to 77% in 2016.... Third-party carriers are more willing to pay supplemental commissions to brokers for stop-loss placements than health plan carriers.... Sixty percent of total premium is concentrated in deductibles of less than $150,000 per individual (60%). Seventy-five percent of total premium is derived by employers who have 1,000 or fewer subscribers."
Milliman

Health Plans Scrambling to Upgrade, Keep Up with Changes
"Insurers are scrambling to keep up with legal and societal changes that upend everything they have known in past years, says Harry Merkin, vice president of marketing at of HealthEdge, a company providing software management for payers. They are being forced to modernize in costly ways that could affect their overall financial health as much as anything that happens to them in the insurance market, he says."
HealthLeaders Media

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Benefits in General

Dive in Plaintiff Victories Not Seen in ERISA Cases
"The number of ERISA cases studied -- which included only those resolved by judicial action and not through settlement or voluntary dismissal -- jumped from 1,477 cases terminated in 1985 to 3,019 cases terminated in 2009.... [A] 2012 research paper found that just over half the ERISA cases filed between 2006 and 2010 involved claims for multiemployer benefit fund contributions."
Bloomberg BNA

Discussions on
the BenefitsLink Message Boards

Is a Qualified Small Employer Health Reimbursement Arrangement an ERISA-governed Welfare Plan?
"If an employer's arrangement to reimburse an eligible employee's payment of a premium for an individual health insurance contract follows all the rules and conditions for a qualified small employer health reimbursement arrangement [QSEHRA] described in Internal Revenue Code section 9831(d), the arrangement is not a group health plan for ERISA section 607(1) or 733(a)(1). But do other ERISA issues remain? Does the employer's reimbursement of its employee's premium paid for individual health insurance make the arrangement a welfare plan defined in ERISA section 3? Must a QSEHRA be stated by a written plan? Must a QSEHRA's administrator furnish a summary plan description? Must a QSEHRA's administrator adopt and follow a claims procedure? What further issues should we think about?"
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Lois Baker, J.D., President  loisbaker@benefitslink.com
David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
Holly Horton, Business Manager  hollyhorton@benefitslink.com

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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