Health & Welfare Plans Newsletter

September 11, 2017

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[Guidance Overview]

What Employers Need to Know About New York's Impending Paid Family Leave Benefits Law and Final Regulations (PDF)
10 pages. "When fully implemented, New York's [Paid Family Leave (PFL) Benefits Law] will provide up to 12 weeks of PFL during a 52-consecutive week period to employees for [certain] purposes ... [T]he amount of leave available to an employee is measured by reviewing how much PFL or New York State short-term disability benefits the employee has taken in the previous 52 weeks, as of the first date that PFL benefits would begin.... Employers must provide employees who are not eligible for PFL (i.e., those employees who, in connection with their regular work schedules, never achieve 26 consecutive weeks or 175 days in a 52-consecuitive-week-period) with the option to file a waiver of PFL benefits. This waiver would exempt an employee from the obligation to have PFL payroll contributions withheld from his or her wages."
Epstein Becker Green

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Ninth Circuit: ACA Does Not Prohibit Lifetime Benefit Maximum for Certain Retiree-Only Health Plans
"[T]he court held that ERISA, as amended by the [ACA], does not ban lifetime benefit maximums for certain retiree-only plans. Plaintiff argued, but the court rejected, that the exception in 29 U.S.C. Section 1191a(a) has been impliedly repealed by the ACA's amendments to the Public Health Service Act [PHSA] which introduced a ban on lifetime benefit limits, but also eliminated a similar exception for certain retiree-only plans. The court did not see that the lifetime benefit limits in the PHSA and the exception for certain retiree-only plans in ERISA are in irreconcilable conflict." [King v. Blue Cross & Blue Shield of Ill., No. 15-55880 (9th Cir. Sept. 8, 2017)]
Roberts Bartolic

Crossing the Threshold: Small Business to 'ALE'
"A business that averaged 50 or more full-time employees (including full-time equivalent employees) in 2016 is an [applicable large employer (ALE)] for reporting and penalty purposes in 2017.... If your business has crossed the threshold to ALE status, consider your vulnerability to the (nondeductible) employer penalties ... An ALE that escapes the penalty still is subject to the ACA's employer reporting requirements."
Jackson Lewis P.C.

This Open Enrollment, Think of Employees as Shoppers
"Typically, medical, dental, and vision benefits appear first in all enrollment materials. Health savings accounts or flexible spending accounts are offered at the end of their enrollment experience and voluntary benefits may be offered through a separate site.... [An] integrated enrollment site improves the employee's experience and increases awareness and value of voluntary benefits offerings. Consider moving HSAs and FSAs after medical and follow with accident and other supplemental health policies that can be used by employees to complement their medical plan."
Mercer

2018 Open Enrollment: Developing Your Game Plan
"It's never too late to have a post-mortem of last year's open enrollment ... Define objectives and how you plan to measure success.... Address who your audiences are and what your overall and targeted messages will be.... [S]et some quantifiable 'hard' goals based on numbers.... [U]se data analytics to help employees make smarter benefits decisions ... Communications planning also is vital to ensuring a successful open enrollment."
Society for Human Resource Management [SHRM]

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The Price Isn't Right: States' Drug Pricing Transparency Laws
"[S]tates such as Ohio and California have put drug pricing transparency initiatives on their ballots to force the issue.... Vermont was the first state to require greater transparency from drug manufacturers regarding price increases, passing legislation in 2016. But other states' attempts to pass transparency initiatives, including ones this summer in Massachusetts and California, have failed in the face of fierce opposition from the pharmaceutical industry."
Bloomberg BNA

How Would Coverage, Federal Spending, and Private Premiums Change If the Federal Government Stopped Reimbursing Insurers for the ACA's Cost-Sharing Reductions?
14 pages. "[1] If insurers have enough time before the start of the plan year to incorporate their anticipated CSR costs into a surcharge placed on silver marketplace premiums ... silver premiums [would increase] by 23 percent in 2018.... [and] the federal government would spend 18 percent more on premium tax credits than it would have spent on tax credits and CSRs combined under current law, an additional $7.2 billion in 2018. [2] If insurers exit the marketplaces in response to the loss of CSRs ... nongroup premiums would rise by 37 percent. Eliminating the tax credits and CSRs would reduce federal spending on this assistance by $40.7 billion in 2018. [3] If lawmakers alter the ACA in response to the elimination of CSRs such that insurers are no longer required to pay CSRs to eligible enrollees, ... nongroup premiums would rise by 12 percent."
Urban Institute

Benefits in General

[Official Guidance]

Text of IRS Disaster Relief Notice VI-2017-01, for Victims of Hurricane Irma in U.S. Virgin Islands
"Victims of Hurricane Irma that took place beginning on Sept. 6, 2017 in parts of U.S. Virgin Islands may qualify for tax relief from the [IRS].... Individuals who reside or have a business in the Islands of St. John and St. Thomas may qualify for tax relief.... [C]ertain deadlines falling on or after Sept. 6, 2017 and before Jan. 31, 2018, are granted additional time to file through Jan. 31, 2018."
Internal Revenue Service [IRS]

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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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