Health & Welfare Plans Newsletter

September 12, 2017

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[Guidance Overview]

Federal Sick Leave Health and Welfare Benefit Changes Bring Enhanced Compliance Challenges for Federal Service Contractors (PDF)
"[F]ederal service contractors need to closely manage ... [1] the application of differing H&W rates to service contracts and individual service employees; [2] the differing standards for incorporation of the federal sick leave obligations and the new [Service Contract Act (SCA)] fringe benefits levels; and [3] the impact of the new sick leave H&W level on potential price adjustments under the FAR price adjustment clause. This white paper discusses these challenges as well as strategies for managing these SCA compliance issues."
Wiley Rein LLP

[Advert.]

Certificate in Global Benefits Management

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Last Call Ė The Certificate in Global Benefits Management provides the comprehensive knowledge needed to administer and manage a global benefits program. Build your network of peers and interact with industry experts while earning your certificate.


Student Loan Debt Repayment Benefits
"Unlike tuition reimbursement, any dollars provided by employers that offer any level of student loan repayment are considered taxable income. To date, attempts to make this new type of employee benefit tax-advantaged for employees and/or employers have yet to succeed. However, the scale of student loan debt is so vast, more employers are likely to pursue this benefit -- even without the tax advantages."
Frenkel Benefits

Beware These Carrier Contract Pitfalls
"In any standard carrier contract, whether it's for medical coverage, pharmacy coverage or any number of voluntary benefits, much of the language is standard and non-negotiable. But a small percentage of content in every contract -- typically around 10% -- is specific to your plan and the carrier and should be reviewed. How these parts are written could affect how the plan is administered and how claims are paid out. If you don't know what to watch out for, you -- or the plan members -- could be surprised."
Corporate Synergies

New Value-Based Insurance Model Aims to Turn High-Deductible Plans on Their Heads
"[H]igh-deductible health plans (HDHPs)] keep costs down by reducing the actuarial value of health plans -- meaning more of the cost burden is shifted to individuals ... HDHPs can encourage consumer behavior that is counterproductive, such as avoiding necessary medical care out of concern about costs ... MESA, on the other hand, is based on a reference-pricing model, which encourages consumers to choose service providers that offer high-quality care at a lower price. To aid that decision-making process, the model proposes a data analysis tool that will allow consumers to select providers based on quality and cost of care."
FierceHealthcare

Republicans to Hurl One Last 'Hail Mary' Pass to Repeal Obamacare
"Sens. Bill Cassidy (R-LA) and Lindsey Graham (R-SC) are unveiling the latest version of their health care bill this week.... Obamacare's individual mandate would be repealed, as would some of the law's taxes. But the foundation of the plan would be a block grant formula that would give each state a set amount of money to spend on their own health care programs, based on how much they would receive under Obamacare. Very few strings would be attached."
Vox

[Advert.]

ACA Reporting Requirements and Lessons Learned

Sponsored by Lorman and BenefitsLink

Sept. 15 webinar. Despite the uncertainty of the ACA's future it remains the law of the land. This webinar covers lessons learned from the past two years and identifies focus areas to prevent problems next year. CE credits. Discount for BenefitsLink readers.


Income, Poverty and Health Insurance Coverage in the U.S. During 2016
"The percentage of people without health insurance coverage for the entire 2016 calendar year was 8.8 percent, down from 9.1 percent in 2015. The number of people without health insurance declined to 28.1 million from 29.0 million over the period."
U.S. Census Bureau

[Opinion]

How Single-Payer Health Care Could Trip Up Democrats
"Like 'repeal and replace,' 'single-payer' is a broadly popular slogan that papers over intraparty disagreements and wrenching policy choices. Republicans fumbled multiple attempts to replace the [ACA] this year. If the Democrats eventually wrested back power, they could find themselves similarly factionalized and stymied over the details."
Margot Sanger-Katz, in The New York Times; subscription may be required

[Opinion]

Health Insurance Availability: Is Choice the Real Issue?
"Healthcare consolidation is the result of economic reality: the private market in healthcare is shrinking, the public market is growing and choices for consumers are fewer. And the public market is not as profitable as the private market, so access to capital and positive operating margins are increasingly achieved by fewer and bigger organizations. And that means fewer choices for consumers in choosing with whom they'll do business."
Paul Keckley

[Opinion]

Drawing a Line in the Sand: Employers Must Rethink Pharmacy Benefit Strategies (PDF)
"This report offers a call to action on the key issues and important steps public and private employers can take to: [1] Understand how today's pharmacy benefits model, with multiple parties in the middle, contributes to higher costs in the supply chain; [2] Identify ways to work with intermediaries to reduce unnecessary costs and drive efficiency."
Midwest Business Group on Health [MBGH]

[Opinion]

How Congress Should Clarify and Expand the ACA's State Innovation Waivers
"States are just beginning to seriously explore the potential of 1332 waivers.... Congress should enact waiver legislation that clarifies the availability of federal subsidies for the purposes of evaluating waivers' deficit neutrality ... Congress should also instruct HHS to create a set of standardized, expedited waivers that could be quickly approved, to enhance confidence in the process. Congress should also allow states to form multi-state compacts to share costs and develop the necessary implementation infrastructure."
Manhattan Institute for Policy Research

Benefits in General

[Official Guidance]

Text of IRS Information Release IR-2017-150: Tax Relief for Victims of Hurricane Irma; Additional Relief Planned
"Hurricane Irma victims in parts of Florida and elsewhere have until Jan. 31, 2018, to file certain individual and business tax returns and make certain tax payments ... This includes an additional filing extension for taxpayers with valid extensions that run out on Oct. 16, and businesses with extensions that run out on Sept. 15.... The IRS is offering this relief to any area designated by the Federal Emergency Management Agency (FEMA), as qualifying for individual assistance. Parts of Florida, Puerto Rico and the Virgin Islands are currently eligible, but taxpayers in localities added later to the disaster area, including those in other states, will automatically receive the same filing and payment relief.... [A]ffected individuals and businesses will have until Jan. 31, 2018, to file returns and pay any taxes that were originally due during this period."
Internal Revenue Service [IRS]

Second Circuit Holds ERISA Claim for Statutory Penalties Is Barred by One-Year Statute of Limitations
"Acknowledging that it was being asked to consider, for the first time, whether section 502(c)(1) was punitive in nature (as opposed to remedial), the Second Circuit held that this section of ERISA was punitive because the amount of the fine imposed by the District Court was both discretionary and meant to punish the ERISA administrator for its failings, rather than compensate the plaintiff for any loss.... Analyzing Connecticut's limitations periods for breach of contract and unfair trade practices, the Second Circuit ... upheld the District Court's decision dismissing Plaintiff's suit for failing to meet its one-year limitations period." [Brown v. Rawlings Fin. Services, LLC, No. 16-3748 (2d Cir. Aug. 22, 2017) ]
Robinson & Cole LLP

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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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