Health & Welfare Plans Newsletter

July 25, 2017

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Employee Benefits Jobs

Retirement Plan Compliance Director
Newport Group
in IL

Pension Administrative Consultant
Polycomp Administrative Services, Inc.
in CA

Sales Account Executive - Employee Benefit Services
Healthcare Association of New York State
in NY

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Webcasts and Conferences

HIPAA Comes of Age: 21 Years of Privacy and Security
August 17, 2017 WEBCAST
Bradley Arant Boult Cummings LLP

Developing HIPAA Policies and Procedures
September 8, 2017 WEBCAST
MentorHealth

Employee Benefit Plans of Tax-Exempt and Governmental Employers 2017
October 5, 2017 in DC
American Law Institute Continuing Legal Education Group [ALI CLE]

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[Official Guidance]

Text of GASB Proposed Implementation Guide: Accounting and Financial Reporting for Postemployment Benefits Other Than Pensions
281 pages. "The objective of this Implementation Guide is to provide guidance that clarifies, explains, or elaborates on the requirements of Statement No. 75, Accounting and Financial Reporting for Postemployment Benefits Other Than Pensions, as amended, and Statement No. 74, Financial Reporting for Postemployment Benefit Plans Other Than Pension Plans, as amended. Questions and answers in this Implementation Guide address issues related to accounting and financial reporting for postemployment benefits other than pensions and for plans that are used to administer those benefits.... The requirements of this Implementation Guide apply to the financial statements of all state and local governments." [June 28, 2017; comments due to GASB by Sept. 25, 2017.].
Governmental Accounting Standards Board [GASB]

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[Official Guidance]

Text of IRS Final Regs: Health Insurance Premium Tax Credit
44 pages. "These regulations affect individuals who enroll in qualified health plans through Affordable Insurance Exchanges ... and claim the premium tax credit and Exchanges that make qualified health plans available to individuals.... After consideration of all the comments, the proposed regulations are adopted by this Treasury decision, with one technical correction that was not identified in the comments."
Internal Revenue Service [IRS]

Disability Plan Can't Offset Pension Benefits Rolled Into IRA
"The Verizon SPD warned that certain benefits offset long-term disability benefits, including 'pension plan benefits from a Verizon pension plan if you elect to receive them.' The case turned on the phrase 'elect to receive.' ... [T]he 5th Circuit held that because the pension benefits were rolled over into an IRA, [the participant] did not 'receive' them. Thus, MetLife could not offset those pension benefits." [Thomason v. Metro. Life Ins. Co., No. 16-10634 (5th Cir. July 18, 2017; unpub.)]
Thompson Coburn

Second Circuit Adopts 'Motivating Factor' Causation Standard for FMLA Retaliation Claims
"The U.S. Court of Appeals for the Second Circuit recently clarified that the 'motivating factor' standard of causation applies to [FMLA] retaliation claims, instead of the 'but for' causation standard applied in Title VII and ADEA retaliation cases.... The less burdensome 'motivating factor' causation standard requires the plaintiff to show only that the action was motivated at least in part by discriminatory or retaliatory animus." [Woods v. START Treatment & Recovery Ctrs., Inc., No. 16-1318 (2d Cir. July 19, 2017)]
Epstein Becker Green

Premiums Are the Big Factor in Health Plan Enrollment
"After eliminating employee premiums for all coverage tiers, HSA-eligible health plan enrollment increased from 4 percent to 25 percent among individuals with employee-only coverage and from 2 percent to 31 percent among individuals with family coverage.... Offering coverage with no payroll deduction attracted individual enrollees who were marginally healthier than those who would have enrolled without this financial incentive in place, therefore not mitigating adverse selection as anticipated."
Wolters Kluwer Law & Business

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The Company Behind Many Surprise Emergency Room Bills
"Early last year, executives at a small hospital ... started using a company called EmCare to staff and run their emergency room.... Although the hospital had negotiated rates for its fees with many major health insurers, the EmCare physicians were not part of those networks.... For a patient needing care with the highest-level billing code, the hospital's previous physicians had been charging $467; EmCare's charged $1,649.... Newport's experience with EmCare, now one of the nation's largest physician-staffing companies for emergency rooms, is part of a pattern."
The New York Times; subscription may be required

ACA Has Little Impact on Reducing ER Visits
"Emergency department visits in Maryland fell by 1% statewide in the months after Medicaid expanded. The number of Medicaid ED visits increased 6%, with a corresponding 6% drop in the number of uninsured emergency department visits."
HealthLeaders Media

Cost-Sharing Reductions: What Are They and Why Do They Need to Be Funded? (PDF)
"Decisions not to pay the reimbursements or even uncertainty about the reimbursements could result in 2018 premium increases averaging nearly 20 percent for silver plans, over and above premium increases due to medical inflation and other factors.... Although those who receive premium subsidies would be insulated from the full increase in premiums, nonsubsidized enrollees would face the full increase, potentially reducing their enrollment, increasing the uninsured population, and deteriorating the risk pool."
American Academy of Actuaries

[Opinion]

73% of CBO's 'Coverage Losses' Are in Fact Individual Choices After Repeal of ACA Mandate
"Nearly three-fourths of the difference in coverage between Obamacare and the various GOP plans derives from a single feature of the Republican bills: their repeal of Obamacare's individual mandate. But the CBO has never published a year-by-year breakout of the impact of the individual mandate on its coverage estimates.... [Of] the 22 million fewer people who will have health insurance in 2026 under the Senate bill, 16 million will voluntarily drop out of the market because they will no longer face a financial penalty for doing so: 73 percent of the total."
Avik Roy, in National Review

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[Opinion]

'Small Business Health Plans' Undermine State Authority
"States currently have a wide range of approaches to regulating health insurance. Some have enacted numerous consumer protections, others are more hands-off. Because insurers will most likely gravitate to states with the least regulation, SBHPs would undermine states' autonomy to determine the type of consumer protections and level of insurance oversight that is appropriate for their residents."
The Commonwealth Fund

Press Releases

IRS Office of Appeals Pilots Virtual Service
IRS [Internal Revenue Service]

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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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