Health & Welfare Plans Newsletter

August 16, 2017

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Webcasts and Conferences

Paid Sick and Paid Family Leave: Navigating Change
RECORDED
Conduent

Tax Traps for the Unwary in Annuity Planning
August 22, 2017 WEBCAST
American Bar Association Section of Real Property, Trust and Estate Law

Roth IRA Training
August 24, 2017 WEBCAST
Wolters Kluwer

Fast Break: ERISA
August 31, 2017 WEBCAST
Morgan Lewis & Bockius LLP

Intermediate IRA Training Part 1
September 19, 2017 WEBCAST
Wolters Kluwer

Upcoming Changes with HIPAA - 2017
September 25, 2017 WEBCAST
MentorHealth

New IRS Procedures for Pre-Approved Plans
September 26, 2017 WEBCAST
ASC

Half-Day Benefits Symposium
September 27, 2017 in NE
PSCA [Plan Sponsor Council of America]

Las Vegas ESOP Conference & Trade Show
November 9, 2017 in NV
ESOP Association

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[Guidance Overview]

The 2017 Forms 1094-C and 1095-C: Not Much Has Changed
"Employers should begin preparing to report on the Forms 1094-C and 1095-C for 2017. It appears little has changed with respect to these Forms compared to previous years. However, we won't know for certain until the draft instructions are released."
Accord Systems, LLC

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[Guidance Overview]

Chicago and Cook County Paid Sick Leave Ordinances May Apply to Your Organization
"Myth 1: Our company does not have a physical location in Chicago or Cook County, so the PSLOs do not apply to us.... Myth 2: Our company has a physical location in Cook County, but it is in a municipality that 'opted out' of the PSLO, so the PSLO does not apply to us.... Myth 3: We already have a sick leave policy that is more generous than the PSLOs require, so we don't need to make any changes to the policy.... Myth 4: We have an 'unlimited PTO' policy, so surely we are already in compliance."
Jackson Lewis P.C.

Siblings Aren't FMLA-Covered Family Members, Are They?
"There is no specific test or set of duties, responsibilities, or factors that will definitively establish an in loco parentis relationship ... There is even some difference in opinion between the drafted FMLA regulations and the [DOL's] interpretation as to whether an in loco parentis relationship requires both financial support and care, or whether one or the other is sufficient.... [A] sibling could be a covered family member if -- and that can be a big if -- an in loco parentis relationship exists between the sibling and the covered employee."
HR Daily Advisor

Teller Fired While Using Intermittent Leave Could Not Show FMLA Retaliation
"The court found that Walker had not offered any evidence that she was terminated because she took intermittent FMLA leave. Walker did not show that there were any employees who also performed poorly but were not terminated because they had not used FMLA leave. Rather, the facts showed that she was terminated because of her performance failings." [Walker v. J.P. Morgan Chase Bank, N.A., No. 15-7911 (N.D. Ill. June 26, 2017)]
Society for Human Resource Management [SHRM]

Bringing Telemedicine to the Workplace: What Employers Should Know
"Providing telemedicine services to employees can raise a number of legal issues -- the most common being compliance with federal laws such as ERISA, COBRA and HIPAA, as well as state laws concerning medical licensure and practice and informed consent. Employers offering access to a telemedicine program for all employees -- regardless of group health plan enrollment status -- could inadvertently create a separate ERISA group health plan."
The Akron Legal News

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ACA Reporting Requirements and Lessons Learned

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Recess Update on the ACA and Its Repeal and Replacement
"To date, ACA rules on employers sponsoring group and individual health care coverage appear to have received little attention from regulators, and most of the requirements remain in place.... This means, among other things, that the Summary of Benefits and Coverage Rule template, updated effective April 1, 2017, must be addressed by employer plans and, as of now, employer reporting obligations will continue in January 2018."
Ballard Spahr LLP

Accountable Care Organizations: The Next Wave?
"HR professionals working directly with ACOs or accessing them through a traditional health insurance network need to review their financial and health outcomes reports and ask plenty of questions ... [What] types of fees your company will pay? What types of savings and outcomes are being generated? How? How much of provider compensation is tied to the delivery of care? What different quality metrics are being used to measure performance? ... While ACOs provide a legal framework for health plans and employers that's compliant with federal health regulations, successful ACOs encourage providers to cut costs through serious financial incentives[.]"
Human Resource Executive Online

CBO Report: The Effects of Terminating Payments for Cost-Sharing Reductions (PDF)
14 pages. "As a result of the increase in total subsidies under the policy, CBO and JCT project these outcomes, compared with what would occur if the CSR payments were continued: [1] The fraction of people living in areas with no insurers offering nongroup plans would be greater during the next two years and about the same starting in 2020; [2] Gross premiums for silver plans offered through the marketplaces would be 20 percent higher in 2018 and 25 percent higher by 2020 -- boosting the amount of premium tax credits according to the statutory formula; [3] Most people would pay net premiums (after accounting for premium tax credits) for nongroup insurance throughout the next decade that were similar to or less than what they would pay otherwise -- although the share of people facing slight increases would be higher during the next two years; [4] Federal deficits would increase by $6 billion in 2018, $21 billion in 2020, and $26 billion in 2026; and [5] The number of people uninsured would be slightly higher in 2018 but slightly lower starting in 2020."
Congressional Budget Office [CBO]

Terminating CSR Payments Would Increase Deficits, CBO Finds
"The CBO affirms what earlier analyses have concluded: in the long run the primary loser if CSR payments are terminated would be the federal budget, which would see a net increase in the deficit of $194 billion over the 2017 to 2026 budget window. The report also projects, however, that market instability would increase in the short run[.]"
Timothy Jost, in Health Affairs

CMS Releases Hospice Comparison Website
"The site displays information in a ready-to-use format and provides a snapshot of the quality of care each hospice facility offers to its patients.... By ensuring patients have the information they need to understand their options, CMS is helping individuals make informed healthcare decisions for themselves and their families based on objective measures of quality."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

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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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