Health & Welfare Plans Newsletter

August 15, 2017

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HIPAA Covered Entities: Managing the HIPAA Business Associate Process
RECORDED
MentorHealth

IRA Policies and Procedures
August 23, 2017 WEBCAST
Wolters Kluwer

IRA Self Audit Training
August 23, 2017 WEBCAST
Wolters Kluwer

Demystifying Financial Wellness
August 30, 2017 WEBCAST
CAPTRUST Financial Advisors

Fundamentals Series 03: Compensation and HCEs [2017]
September 25, 2017 WEBCAST
FIS Relius Education

403(b) Plans for 401(k) Administrators Workshop
October 9, 2017 in CO
FIS Relius Education

Basics of HIPAA Privacy & Security for Employer-Sponsored Health Plans
October 17, 2017 WEBCAST
HRWebAdvisor

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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

Third Circuit Determines Religious Exemption to Contraceptive Mandate Does Not Extend to Nonreligious Employers
" 'After careful review, but without any hesitation,' the Third Circuit U.S. Court of Appeals determined that the religious exemption to the [ACA's] contraceptive mandate does not apply to a secular anti-abortion group with no religious affiliation and affirmed the district court's grant of summary judgment to the federal government. It also found that an employee's religious beliefs are not substantially burdened by the mandate." [Real Alternatives v. HHS, No. 16-1275 (3d Cir. Aug. 4, 2017)]
Wolters Kluwer Law & Business

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

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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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]

[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

[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

[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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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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