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[Official Guidance]
Text of Draft 2017 IRS Form 1095-C (PDF)
"This Form 1095-C includes information about the health insurance coverage offered to you by your employer. Form 1095-C, Part II, includes information about the coverage, if any, your employer offered to you and your spouse and dependent(s). If you purchased health insurance coverage through the Health Insurance Marketplace and wish to claim the premium tax credit, this information will assist you in determining whether you are eligible."
Internal Revenue Service [IRS]
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Blue Cross Michigan Hit with Flurry of ERISA Lawsuits
"Blue Cross Blue Shield of Michigan has been sued more than 30 times in the past week by employers that say the insurer skimmed unauthorized fees from their health plans. The lawsuits, filed between Aug. 9 and 11 in federal court in Michigan, accuse Blue Cross of charging hidden and unauthorized fees to the employers' health plan assets as a means of improving its financial position without alienating customers. The lawsuits build from a 2014 appeals court decision holding Blue Cross liable for this conduct under [ERISA] and upholding a $6 million judgment against the insurer."
Bloomberg BNA
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Getting Tech Employees Engaged in Worksite Wellness
"Technology employees, like many office workers, are challenged with high stress and long hours, putting them at risk for the 'sitting disease' -- or sitting all day at their desk -- resulting in increased risk for poor health and disease.... [1] Change their perception of how much time it takes to be healthy -- offering short, convenient sessions for fitting in fitness.... [2] Play to a common characteristic found in tech employees: Competitiveness.... [3] Tech employees naturally are comfortable with technology -- and expect to use it[.]"
HealthFitness
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If Cost-Sharing Reduction Payments End, States Can Use 1332 Waivers to Fund Their Own
"Creating a State-administered CSR mechanism will undoubtedly require expenditure from the State. While some will argue that the limited resources available in State budgets would render the idea all but theoretical, it would be beneficial to examine how States can use Section 1332 of the ACA to fund -- and potentially profit from -- providing CSR."
Health Affairs
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[Advert.]
Your Go-To Specialists for ERISA Compliance

We help employers get into compliance and stay there with our proprietary Wrap-TightSM system and proactive annual reviews. And we help professional advisors -- accountants, attorneys, benefits consultants, brokers – enhance and expand their clientele.
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Subsidizing Health Insurance for Low-Income Adults: Evidence from Massachusetts
"Using administrative data from Massachusetts' subsidized insurance exchange, ... [the authors] estimate willingness to pay and costs of insurance among low-income adults. As subsidies decline, insurance take-up falls rapidly, dropping about 25% for each $40 increase in monthly enrollee premiums. Marginal enrollees tend to be lower-cost, consistent with adverse selection into insurance. But across the entire distribution we can observe -- approximately the bottom 70% of the willingness to pay distribution -- enrollee willingness to pay is always less than half of own expected costs."
National Bureau of Economic Research [NBER]
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[Opinion]
Insurers, Providers and Employers on a Collision Course
"Historically, insurers have been able to use competing health providers as leverage against each other in their provider negotiations.... Cost transparency tools and claims analysis are showing us that there are large cost differences between certain systems.... Employers and insurers are gearing up for a fight with the hospital systems and the dispute will undoubtedly spill over to state lawmakers as restrictive contractual covenants will be challenged."
Frenkel Benefits
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[Opinion]
How Federal Regulators Can Reform Obamacare Without Help from Congress
"With health reform at an impasse in Congress for the time being, here are four ideas that HHS and the states can explore and expand. [1] Expand state reinsurance options.... [2] Allow innovative pilot plan designs for high cost patients.... [3] Give states more authority on how exchanges are run -- including contracting out to a private exchange.... [4] [A]llow unused federal tax credits to cover the employees' portion of insurance for small-to-medium sized businesses."
Manhattan Institute for Policy Research
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[Opinion]
Subsidizing Health Insurance Cannot Ever Get U.S. to Universal Coverage
"This study looked at low-income individuals and showed that ... the willingness to pay for a percentage of the premium is far below the insurers' average costs. Even with 90% of the premium subsidized, 20% of the individuals would remain uninsured, and the percent insured dropped off rapidly as the individuals' share increased."
Physicians for a National Health Program [PNHP]
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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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