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[Guidance Overview]
IRS Allows Employees to Donate PTO Value for Hurricane Harvey Victims
"[E]mployers may contribute the value of the PTO contributed by their employees as Harvey relief to a non-profit organization and will be entitled to a deduction that may be treated as a business expense, rather than a charitable contribution, as long as the donations are specifically for the relief of Harvey victims and are made by January 1, 2019. The employees who make the donations will not be entitled to take charitable deductions, but will not be subject to income or Social Security taxes on the amounts donated."
Seyfarth Shaw LLP
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Can a Health Plan Impose a 'Fail-First' Requirement for Opioid Use Disorder Treatments?
"A 'fail-first' requirement is a health plan provision that excludes coverage of higher-cost treatments until a participant demonstrates that a lower-cost treatment is not effective.... To comply with the federal mental health parity rules, your plan cannot impose a fail-first requirement on [medication assisted treatment (MAT)] coverage for opioid use disorder unless the processes, strategies, standards, and other factors considered by the plan in designing and imposing the requirement are comparable to, and applied no more stringently than, those used in applying fail-first requirements to medical/surgical prescription drug benefits."
Thomson Reuters / EBIA
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Don't Forget the Possibility of ACA Retaliation Claims
"[E]mployer mandate taxes that accrued in January of 2015 must be assessed by January of 2018. The statute requires that notices be provided to employers at least 60 days prior to the end of the year.... It would not be good to let the time limit to appeal an assessment expire.... [It] is against the law to retaliate against an employee for receiving a subsidy.... OSHA is the agency charged with retaliation investigations, and OSHA, unlike the IRS, is more than adequately staffed to enforce anti-retaliation requirements."
Ogletree Deakins
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Employees Poised to Spend an Average of $5,200 on Health Care in 2018
"The average health care cost increase for U.S. employees is projected to be 7.2 percent in 2018, up from 6.9 percent in 2017. Average health care costs for U.S. employees (including employee premiums and out-of-pocket costs) are projected to be $5,248 in 2018, up from $4,895 in 2017. Employee premium costs are projected to be an average of $2,678 in 2018. This is 18 percent of the total health care cost, which is consistent with cost sharing percentages over the past seven years."
Wolters Kluwer Law & Business
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GAO Report: IRS Should Mitigate Limitations of Data to Be Used for the Age and Gender Adjustment for the Tax on High-Cost Health Plans
"Starting in 2020, the [ACA] is scheduled to impose a 40% tax on high-cost health plans when an employee's annual cost of coverage exceeds a certain dollar limit. The limit may be adjusted if an employer's workforce -- based on age and gender -- is likely to have higher than average health costs. The adjustment is to be made based on the costs of the federal employee BlueCross BlueShield Standard plan, but [GAO] found that an adjustment based on this plan's costs alone may not be effective due to the relatively high costs incurred by its young members." [GAO-17-661, published and released Sept. 6, 2017]
U.S. Government Accountability Office [GAO]
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State Insurance Commissioners Talk Reinsurance, CSR Payments at Senate ACA Stabilization Hearings
"Some common themes emerged at the first of four hearings: [1] Continue funding cost-sharing reduction (CSR) payments -- and not just for one year. [2] Invest in reinsurance programs and set up high-risk pools. [3] Reverse cuts to navigator programs and funds for marketing the individual exchanges. [5] And give states more freedom to run health insurance programs, with or without federal help."
FierceHealthcare
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2018 Projected Health Insurance Exchange Coverage Map, Updated Sept. 6, 2017 (PDF)
[CMS] has posted an update to the Health Insurance Exchanges Issuer County Map. This map is of projected issuer participation on the Health Insurance Exchanges in 2018 based on the known issuer public announcements through September 6, 2017. Participation is expected to fluctuate and does not represent actual Exchange application submissions.
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]
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Following the ACA Repeal-and-Replace Effort, Where Does the U.S. Stand on Insurance Coverage?
"The uninsured rate among 19-to-64-year-old adults was 14 percent in 2017, or an estimated 27 million people, statistically unchanged from one year earlier. Uninsured rates ticked up significantly in three subgroups: 35-to-49-year-olds, adults with incomes of 400 percent of poverty or more (about $48,000 for an individual), and adults living in states that had not expanded Medicaid. Half of uninsured adults, or an estimated 13 million, are likely eligible for marketplace subsidies or the Medicaid expansion in their state. Four of 10 uninsured adults are unaware of the marketplaces. Adults in marketplace plans with incomes below 250 percent of poverty are much more likely to view their premiums as easy to afford compared with people with higher incomes."
The Commonwealth Fund
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Benefits in General
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Comprehensive FAQs for Employers on Hurricanes and Other Workplace Disasters
"This list of frequently asked questions was originally prepared ... in response to Hurricanes Katrina, Rita and Wilma. It has been updated several times over the course of the past 12 years, most recently in the aftermath of Hurricane Harvey striking Texas and Louisiana in August 2017, and in anticipation of Hurricane Irma striking Florida in September 2017. This article addresses many employment-related issues facing employers in the wake of hurricane-related disasters; ... in addition to federal laws, [it covers] certain state laws, especially those in the Gulf Coast area."
Fisher Phillips
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Executive Compensation
and Nonqualified Plans
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Get Ready for the Pay Ratio Disclosure Rule (PDF)
"[C]ompanies should be working on the assumption that pay ratio disclosure will be required for 2018 proxy statements.... While it is still possible that the SEC could delay the implementation date for pay ratio disclosure, there have been no public announcements from the SEC that this is under consideration. In addition, it does not seem likely that the SEC would take action on the pay ratio requirement before any of the currently vacant commissioner positions are filled."
Mayer Brown
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Executive Compensation Priorities, Fall 2017
"Preparations for CEO pay ratio disclosures should be underway.... Check equity plans and bonus plans to determine whether shareholder reapproval is necessary.... Review the performance metrics and targets used for 2017 annual and long-term grants to determine whether changes should be made for 2018 grants.... Review compliance with Section 409A of the IRC.... Ensure that 'top hat' plans continue to be limited to a select group of management or highly compensated employees."
Morgan Lewis
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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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