Health & Welfare Plans Newsletter

July 31, 2017

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[Guidance Overview]

DOL Essentially Erases Federal Contractor Sick Leave Benefit Provided by Obama Executive Order
"Federal contractors will soon encounter a new hybrid Health & Welfare benefit for annual Wage Determinations (WDs) issued by the [DOL] that will be challenging to apply and may result negative price adjustments under contracts subject to the Service Contract Labor Standards (SCLS).... DOL issued AAM No. 225 announcing the new H&W rate for the coming year.... DOL also issued a separate H&W rate for workers covered under the new sick leave regulations promulgated pursuant to Executive Order (EO) 13706."
Holland & Knight

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[Guidance Overview]

Preparing for New York State's Paid Family Leave Benefits Law
"Starting January 1, 2018, eligible employees may take job-protected leave and receive PFLL wage-replacement benefits for any of the following 'family leave' purposes: [1] To bond with a new child within the first 12 months after birth, adoption or foster care placement; [2] To care for a family member with a serious health condition; [3] For qualifying exigencies arising when the employee's family member is on, or called to, active duty in the U.S. Armed Forces. Leave for an employee's own illness, however, does not qualify as a basis for paid family leave under the PFLL."
Goodwin Procter

Open Enrollment: SBC, HIPAA, GINA, WHCRA, NMHPA, CHIPRA, EOB, OOPM, HSA, HCFSA, DCFSA ...
"The new SBC requirements apply to all group health plans for plan years beginning on or after April 1, 2017.... Among other changes, ... a new introductory paragraph has been added; certain questions have been eliminated, added (e.g., are there services covered before you meet your deductible?), or rephrased; and a third coverage example has been added."
Benefits Bryan Cave

District Court Allows Veteran to Proceed with Claim Employer Reduced His Salary by Disability Benefits Amount
"Refusing to dismiss a former marine's USERRA discrimination claim, a federal district court in Florida found that he sufficiently alleged that the employer reduced his pay by the amount of disability benefits he received from the Department of Veterans Affairs (VA), which was the same as claiming that military service was the 'motivating factor' for the adverse decision.... [T]he court rejected the owner's assertion that he could not be individually liable, because the employee claimed the owner exercised control over the terms of employment and was the individual who made the adverse pay decision." [Rimbey v. The Mucky Duck, Inc., No. 17-103 (M.D. Fla. June 29, 2017)]
Wolters Kluwer Law & Business

Whirlpool's Retiree Health Benefit Cuts Go Down the Drain
"After previously finding that Whirlpool owed lifetime health benefits to many of its retirees, the judge ruled July 27 that Whirlpool couldn't fulfill this obligation if it carried out its plan to raise premiums, deductibles, copayments, and out-of-pocket maximums. The parties to the relevant collective bargaining agreements couldn't have intended to give Whirlpool latitude to make these modifications, because the agreements expressly established specific premiums, deductibles, and other terms while providing no mechanism for altering them, the judge said." [Zino v. Whirlpool Corp., No. 11-1676 (N.D. Ohio July 27, 2017)]
Bloomberg BNA

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Early Retirement Health Care Quandary Keeps Workers on the Job
"Many employees who would like to retire stay on the job so that they can keep their health care coverage. Employers that want to help ease their transition can look into private health care exchanges and the [ACA's] public marketplace exchanges for opportunities to subsidize coverage without having to maintain a group health plan for former employees."
Society for Human Resource Management [SHRM]

[Opinion]

Repairing the Healthcare Law: Tricky But Not Impossible
"There is widespread agreement that the first order of business is to calm very jittery insurance markets.... The most significant step would be to guarantee continued funding to reimburse insurers for waiving deductibles and co-payments for low-income customers, as the health law requires companies to do. The Trump administration has threatened to stop making the payments; insurers are now getting them on a month-to-month basis."
The New York Times; subscription may be required

[Opinion]

In the Aftermath of the Senate Vote to Repeal and Replace
"Congress needs to set up permanent appropriation to pay insurers for the cost sharing reductions they are required to offer lower-income enrollees in the marketplaces.... Congress should ensure that all Americans who buy coverage in the individual market have a health plan to enroll in.... Appropriating $10 billion to $15 billion for reinsurance ... would help insurers selling in the individual markets by partially reimbursing them for unexpectedly high enrollee costs."
The Commonwealth Fund

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Discussions on
the BenefitsLink Message Boards

File Form 5558 Now, Despite Upcoming Filing for DFVC Relief?
"Plan Sponsor of H&W plan has never filed Form 5500 and is preparing all past years with intention to submit to the DOL under the Delinquent Filer Voluntary Compliance Program. The sponsor has asked that Form 5558 not be filed for the most recent year because it could trigger an alert to the IRS that they have not been filing and hence could be penalized. Both the broker and CPA have so advised. Has anyone had this happen (i.e., is there any connection between the Form 5558's and the examination division)? Personally, I like the idea of having one less plan year be late."
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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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