Health & Welfare Plans Newsletter

July 20, 2017

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Webcasts and Conferences

Beneficiary Administration Training
July 27, 2017 WEBCAST
Wolters Kluwer

Basic IRA Training
August 8, 2017 WEBCAST
Wolters Kluwer

Preparing for the CEO Pay Ratio Disclosure Rule: Overcoming Key Challenges
August 9, 2017 WEBCAST
American Law Institute Continuing Legal Education Group [ALI CLE]

Engaging in Corporate Wellness
August 9, 2017 in TX
Worldwide Employee Benefits Network [WEB] - Houston Chapter

5500 Update
August 17, 2017 WEBCAST
ERISApedia.com

Corporate Role in Community Health
August 22, 2017 WEBCAST
The Alliance

How to Conduct a HIPAA Risk Assessment
September 4, 2017 WEBCAST
MentorHealth

ESOPs and Business Transitions: Structuring a Win-Win-Win Succession Plan
September 13, 2017 WEBCAST
ASPPA [American Society of Pension Professionals & Actuaries]

Breaking Myths in Health Care
September 28, 2017 in WI
The Alliance

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[Guidance Overview]

Final Regs for New York State Paid Family Leave Law Adopted
"[E]mployers are permitted to begin employee wage deductions under the PFLL at any time between now and January 1, 2018, when paid family leave (PFL) benefits become available to eligible employees.... The final regulations include amendments to Section 380-2.5(c), addressing how to compute an employee's benefit rate for purposes of PFL taken in single-day increments ... [D]uring the first year of PFLL implementation in 2018, the 52-week 'look back' period will extend back into 2017."
Proskauer's Law and the Workplace

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Can a Chiropractor Certify FMLA Leave for a Chronic Bad Back? Are There Limits?
"In determining whether you are required to grant FMLA leave in situations involving chiropractic care, you should confirm through medical certification: [1] Whether an x-ray of the back was taken; [2] Whether the chiropractor has found and is treating for subluxation of the spine; [3] Whether the chiropractor has then certified a condition (relating to treatment of subluxation) requiring continuous or intermittent leave. Anything short of this is not protected by FMLA."
FMLA Insights

Implementation of Private Payer Parity Laws for Telehealth Services
"At this point, most states have implemented some form of private payer parity law, although the specifics of each state's laws vary. One of the most common is a rule such as Montana's, which requires insurers to offer coverage for health care services provided by a health care provider by means of telemedicine if the services are otherwise covered by the plan. Some states, like Iowa, only mandate parity within their Medicaid programs without extending the mandate to private payers. Other states only require parity for certain types of services, like mental health services in Alaska. Lastly, Illinois and Massachusetts, require parity only when insurers opt to provide telehealth services."
Epstein Becker Green

Choice and Incremental Increases in Cost Sharing Characterize Health Benefits for State Employees (PDF)
23 pages. "Most states provide their employees with a range of choices in medical plan types as well as multiple premium tiers. Employees' premium contributions remain fairly consistent as a percentage of total costs, yet on a dollar basis those contributions are increasing as the cost of coverage rises. Employees' out-of-pocket costs are also increasing as states increase deductibles, copayments and out-of-pocket limits.... States continue to use plan design to manage prescription drug costs by influencing utilization towards more efficient delivery channels and more cost-effective medications."
Segal Consulting

What Happens to Your HSA in Retirement?
"In addition to gauging HSA quality, long-term HSA investors need to consider the logistics of managing their HSAs, especially if their plan is to carry the HSA assets into retirement. How should HSA assets be allocated during retirement? Where in the retirement-funding queue do these accounts belong? And importantly, what would happen to your HSA if you were to pass away before you spent all the money?"
Morningstar

[Advert.]

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

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Learn how to avoid common administration mistakes, implement best practices and be aware of interactions with other laws. Use code BL2017 for 15% discount - good through July 31.


Ohio Takes Drug Price Measure to Voting Booth
"More than $109 million was spent last year to defeat California's Proposition 61, which would have prohibited the state from purchasing prescription drugs at a higher price than what the Veterans Affairs Department pays. Ohio voters will take up a similar proposal in November amid growing public outcry over the climbing cost of prescription drugs."
Bloomberg BNA

Senate Committee Releases Revised Discussion Draft of Better Care Reconciliation Act, Updated July 20, 2017
"Eliminates the individual and employer mandate penalties.... Expanded tax-free Health Savings Accounts to give Americans greater flexibility and control over medical costs; increased contribution limits to help pay for out-of-pocket health costs and expensive prescription medications. Additionally, for the first time, individuals will be able to use HSAs to pay for their premiums in excess of any tax benefit they already receive for the purchase of health care.... Repeals costly Obamacare taxes that contribute to premium increases and hurt life-saving health care innovation, like the taxes on health insurance, prescription drugs, medical devices, and 'high-cost' employer sponsored plans."
U.S. Senate Committee on the Budget

CBO Cost Estimate for the Obamacare Repeal Reconciliation Act of 2017
"The number of people who are uninsured would increase by 17 million in 2018, compared with the number under current law. That number would increase to 27 million in 2020 ... Average premiums in the nongroup market (for individual policies purchased through the marketplaces or directly from insurers) would increase by roughly 25 percent -- relative to projections under current law -- in 2018. The increase would reach about 50 percent in 2020, and premiums would about double by 2026.... In CBO and JCT's estimation, under this legislation, about half of the nation's population would live in areas having no insurer participating in the nongroup market in 2020 because of downward pressure on enrollment and upward pressure on premiums."
Congressional Budget Office [CBO]

The Obamacare Repeal Reconciliation Act: What Repeal and Delay Would Mean for Coverage, Premiums, and the Budget
"The main difference between the [Obamacare Repeal Reconciliation Act (ORRA) of 2017] and the 2015 reconciliation bill is that the effective dates are two years later. The bill does include a couple of provisions not included in the 2015 bill. First, it would prohibit the use of premium tax credits or small business tax credits for health plans that cover abortions (other than those necessary to save the life of the mother or in cases of rape or incest). The bill would also fund reimbursements to insurers for cost-sharing reductions through 2019, when the payment would end."
Timothy Jost, in Health Affairs

2018 Projected Health Insurance Exchange Coverage Map, Updated July 19, 2017
This frequently updated map of counties in all 50 states is colored to show the CMS' current projection of how many issuers will participate on the Health Insurance Exchanges in 2018, based on issuer public announcements through July 19, 2017 (not on actual Exchange application submissions).
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Medicare's Financial Condition: Beyond Actuarial Balance (PDF)
"The projected [hospital insurance (HI)] deficit over the next 75 years is 0.64 percent of taxable payroll. Eliminating this deficit would require an immediate 22 percent increase in standard payroll taxes or an immediate 14 percent reduction in expenditures -- or some combination of the two. Delaying action would require more severe changes in the future."
American Academy of Actuaries

Benefits in General

[Guidance Overview]

The Case for Tackling the New Disability Claims Procedures Before Year-End
"[K]ey changes implemented by the new rule are ... [1] New independence and impartiality provisions.... [2] Enhanced review rights.... [3] New deemed exhausted provisions.... [4] Expanded definition of adverse benefit determination.... [5] New culturally and linguistically appropriate standards.... [6] New disclosure requirements."
Benefits Bryan Cave

Pension/OPEB 2017 Assumption and Disclosure Study (PDF)
23 pages. "The 2016 median discount rate for pension plans in the study decreased 20 basis points since 2015 and has decreased more than two full percentage since 2007 ... Median plan funding levels remained unchanged from 2015, with pension plan assets equal to approximately 82% of the projected benefit obligation (PBO) in 2016 and 2015.... The 2016 median discount rate for OPEB plans in the study decreased 25 basis points since 2015 and has decreased by more than two full percentage points since 2007 ... For OPEB plans that are funded, the median plan funding level has remained essentially unchanged, with OPEB plan assets equal to approximately 53% of the accumulated postretirement obligation (APBO) in 2016 compared with 54% in 2015."
PricewaterhouseCoopers

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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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