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[Guidance Overview]
What's Next for Plan Sponsors After Failed Congressional Attempts to Repeal/Replace the ACA?
"Although the IRS has acknowledged glitches in the ACA reporting system, the IRS has confirmed that an applicable large employer is still subject to an employer shared responsibility payment if it (i) fails to offer coverage to 95% of its full-time employees or (ii) has a full-time employee who obtains coverage on the insurance marketplace and receives premium assistance or a tax credit, and the employer's coverage is not affordable or did not provide minimum value.... Congress can still pass narrowly tailored relief in the form of standalone legislation or by including reforms in a bipartisan bill to stabilize the insurance markets.... [R]egulatory guidance from the departments with ACA oversight ... may give employers relief[.]"
Winston & Strawn LLP
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Breaking Down the Graham-Cassidy ACA Replacement Proposal
"In the aftermath of the HCFA's defeat, the only remaining proposal that appears to have any chance at seeing a Senate vote is a complex overhaul of the current ACA landscape from Republican Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La. The crux of the Graham-Cassidy amendment is to replace the ACA's insurance subsidies and Medicaid expansion with comparatively smaller block grants to states."
Trucker Huss
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Appellate Ruling Deals Setback to Opponents of Contraceptive Coverage Mandate
"[T]he case involved two issues: [1] whether the government must exempt an employer that objects on moral, as opposed to religious, grounds to contraceptive coverage from the requirement to provide such coverage, and [2] whether individuals who object to contraceptives on religious grounds must be allowed to purchase insurance that does not cover contraceptives. Two of the three judges on the appellate panel answered both questions in the negative." [Real Alternatives v. HHS, No. 16-1275 (3d Cir. Aug. 4, 2017)]
Health Affairs
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Court Rules That Government Owes Molina Healthcare $52M in Risk Corridor Payments
"The partial summary judgment ... is the second win for an insurer in a risk corridor case. The court ruled in February that the government owes Moda Health $214 million in payments from the program. The courts sided with the government, however, in a case brought by Maine Community Health Options and one brought by Land of Lincoln Mutual Health Insurance Company. In another case, brought by Blue Cross Blue Shield of North Carolina, the court ruled that the insurer's claims were premature. Cases brought by other insurers are still winding their way through the court system."
FierceHealthcare
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Why a Pennsylvania Insurer's Collapse Could Whack Insurers, Policyholders Across the Country
"Insurance company failures are rare, but when they happen, other companies are responsible to help pay off the company's claims and protect policyholders through groups known as state guarantee associations. Those industry assessments are typically based on market share, so larger insurers pay more.... Penn Treaty's liquidation poses a 'potential shock to the health marketplace' as the losses pile up ... Industry analysts estimate the parent company has long-term claims liabilities approaching $4 billion, but only about $700 million in assets."
Kaiser Health News
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Florida Insurance Regulator Asks Payers to File Backup Rate Proposals
"The Florida Office of Insurance Regulation asked the nine payers that participate in the state exchanges to file rates in case the CSR payments don't come through ... The average rate increase was already 17.8% for 2018 ... With CSR payments out of the picture, rates are more than likely to jump."
FierceHealthcare
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[Opinion]
Preventive Care Actually Does Not Save Money
"As counterintuitive as it seems, preventive measures generally increase rather than decrease costs. This in no way suggests that we shouldn't pursue preventive measures. It simply means that we shouldn't spend time dreaming up ways to spend the savings that will result."
Benefit Revolution
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[Opinion]
An Open Letter to the Senate HELP Committee
"[T]he individual insurance market is only 4% of the 285 million who are insured.... The stability of individual insurance market is a legitimate issue but it's small relative to policies and strategies that impact every employer and household. Your charter must be bigger than reducing risks for insurers; it must be about the viability and sustainability of the entire health system."
Paul Keckley
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Executive Compensation and Nonqualified Plans
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2018 ISS Policy Survey Queries Use of Pay Ratio
"ISS asks two questions about how the U.S. pay ratio will be used.... [1] [H]ow the data will be analyzed and whether it will be used to compare companies, to assess year-on-year changes at an individual company, or not used at all.... [2] [H]ow shareholders should use the pay ratio -- as a data point for evaluating compensation related votes, for evaluating director votes, to assist in engaging with companies, as a 'risk factor' in making investment, or not at all because it will not be meaningful to investors."
HR Policy Association
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Press Releases
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David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager
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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