Health & Welfare Plans Newsletter

September 14, 2017

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Jobs

Defined Contribution Account Manager
Nova 401(k) Associates
Telecommute

401K Retirement Plan Consultant
Ascensus
in IN

Retirement Account Manager
Ascensus
in PA

ERISA Attorney
Jennings Law Firm, Ltd.
in IL

Conversion Project Manager
Newport Group
in CA

Client Consultant - West, Mid-West
Unified Trust Company, N.A.
Telecommute

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[Official Guidance]

Text of IRS Publication 5258: ACA Information Returns (AIR) Submission Composition and Reference Guide (PDF)
126 pages; rev. Oct. 2017. "The purpose of this document is to provide guidance to all types of external transmitters about composing and successfully transmitting compliant submissions to IRS. The audience of this document is: [1] Issuer: A business filing their own ACA Information Returns regardless of whether they are required to file electronically (transmit 250 or more of the same type of information return) or volunteer to file electronically ... [2] Transmitter -- A third-party sending the electronic information return data directly to the IRS on behalf of any business required to file. [3] Software Developer -- An organization writing either origination or transmission software according to IRS specifications."
Internal Revenue Service [IRS]

[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.


[Official Guidance]

Text of IRS Publication 5165: Guide for Electronically Filing ACA Information Returns for Software Developers and Transmitters (PDF)
62 pages, rev. Oct. 2017. "[This publication] outlines the communication procedures, transmission formats, business rules and validation procedures for information returns transmitted electronically through the AIR System.... The procedures in this publication should be used when the following information returns are transmitted electronically for TY2015, TY2016 and TY2017 in PY2018: Form 1094-B ... Form 1095-B... Form 1094-C ... Form 1095-C ... This publication does not contain information or procedures for filing Form 1095-A."
Internal Revenue Service [IRS]

New Graham-Cassidy Bill: A Last GOP Shot at ACA Repeal and Replace Through Reconciliation
"The fundamental idea of the Graham-Cassidy bill is to terminate the ACA's Medicaid expansions, premium tax credits, cost-sharing reduction payments, small business tax credits, and Basic Health Program as of 2019 and redistribute the money funding those programs to the states, using a complex formula ... The bill would also impose per capita caps on Medicaid funding generally, also offering the states the alternative of a broader Medicaid block grant. Finally, the bill contains a number of tax cuts and health care regulation changes taken from earlier Senate repeal bills."
Timothy Jost, in Health Affairs

Republicans Announce Long-Shot Effort on Health Care Reform
"Despite opposition and little time, Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La., proposed legislation that would do away with many of the subsidies and mandates of the 2010 law and instead would provide block grants to the states to help individuals pay for health coverage.... The senators said that some states would get more money to provide health care than they get through the current system."
InsuranceNewsNet.com

After Years of Erosion, Employer Health Insurance Offer Rate Ticks Up in 2016
"[O]ver the last year, there is evidence of what may be a rebound in employment-based coverage offer rates among firms with 10 to 99 employees.... [F]rom 2015 to 2016: For employers with 10 to 24 employees, those offering health benefits increased from 48.9 percent to 49.4 percent. For employers with 25 to 99 employees, those offering health benefits increased from 73.5 percent to 74.6 percent."
Wolters Kluwer Law & Business

[Advert.]

Online Learning Course: COBRA

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Even with ACA coverage easier for individuals to obtain, group health plans must continue to offer COBRA coverage. This course explains technicalities of COBRA, including who is entitled and how to administer.


Guide to Investing Your HSA Account for Growth
"HSAs offer a triple tax advantage ... Withdrawals for qualified medical expenses are always tax-free, regardless of your age ... After age 65 you can use withdrawals for any expense, although they will be taxed at your normal rate.... With maximum annual contributions and minimal medical expense withdrawals, you can build a hefty nest egg to complement your regular retirement plan."
DataPath

In Health Care, a Good Price Is Hard to Find
"The underlying problem of our health care system -- beyond the corrosive partisan politics -- is its high cost. [The author has] long understood that the lack of price transparency is one reason our system stays so expensive. It was a surprise, though, to find out that this opacity is cemented by legally binding contracts."
Kaiser Health News

If an Employee Attends a Beyonce Concert While on FMLA Leave, Can She Be Terminated?
"Employers often are gun shy about conducting workplace investigations or taking disciplinary action against an employee while the employee is on FMLA leave. This approach is understandable, as employers are worried about the appearance of retaliation because the employee may claim (as she did here) that the employer took action on the heels of an employee's request for FMLA leave. Yet, this court decision is an endorsement to carry on with your internal investigations and disciplinary measures so long as you can show that you would have done the same absent any request for FMLA leave." [Jackson v. BNSF Railway Co., No. 16-695 (N.D. Tex. Aug. 1, 2017)]
FMLA Insights

[Opinion]

American Benefits Council Comment Letter to EBSA on Mental Health Parity Act Disclosure Issues
"A model form that could be used by participants to request information with respect to various [nonquantitative treatment limitations (NQTLs)] could be helpful as long as it is voluntary, in 'plain language' and easy for individuals to understand, and narrowly targeted to specific NQTL disclosure requirements.... We recommend that any model form include a statement, in plain language, providing that the parity analysis, including the NQTL analysis, is not a one-to-one comparison, but rather that the rule requires plans and issuers to adhere to strict standards for testing financial requirements, quantitative treatment limitations and NQTLs."
American Benefits Council

[Opinion]

How the Bernie Sanders Plan Would Both Beef Up and Slim Down Medicare
"In his big new single-payer health care bill, Senator Bernie Sanders says he wants to turn the country's health system into 'Medicare for all.' But his bill actually outlines a system very different from the current Medicare program.... [It] would make it more generous than it has ever been, expanding it to cover new types of benefits and to erase most direct health care costs for consumers.... The changes are intended to make the health care system more affordable, but the details could have big effects on what sorts of care might be developed and made available."
Margot Sanger-Katz, in the New York Times; Subscription May Be Required

Benefits in General

[Guidance Overview]

Retirement Plan and Leave Donation Programs During States of Emergencies
"Employers can offer retirement plans and leave donation programs with features that allow access to retirement funds or paid time off to employees in need. These features can be added using standard plan operational procedures.... [W]hile this relief permits employers to roll out features more quickly, it may come with a potential cost of additional administrative requirements."
Carlton Fields

7,000 Insurance Agents Held to Be Employees for ERISA Purposes
"[T]he Court concluded that the evidence supported both sides but that the amount of control American Family exercised (or could have exercised) tipped the scales in favor of employee status. At the same time, the Court noted that prior case law has been 'nearly unanimous' in finding insurance agents to be independent contractors and that the resolution of damages will be 'unusually complicated.' " [Jammal v. American Family Ins. Group, No. 13-437 (N.D. Ohio Aug. 1, 2017)]
Vorys, Sater, Seymour and Pease LLP

Discussions
on the BenefitsLink Message Boards

Questions Surrounding Taxation of Fertility Benefits
"We are looking at the taxation of benefits to provide for egg extraction and freezing. Publication 502 provides that: 'You can include in medical expenses the cost of the following procedures to overcome an inability to have children -- Procedures such as in vitro fertilization (including temporary storage of eggs or sperm).' Does the reference to 'overcome an inability to have children' refer only to a current inability to have children, or a future inability? For example, suppose someone has cancer, and is just about to have radiation treatments that will forever eliminate the ability have children -- can we provide IVF on a tax-free basis? What about someone who is transgendered who is about to enter hormone treatment that may impair fertility? Or someone who is 35 now and has no partner, but wants to preserve eggs for later use, when her fertility may have declined? How long is 'temporary' storage?"
BenefitsLink Message Boards

Press Releases

Mark Poindexter Named Recipient of the Heart of HERO Award
Health Enhancement Research Organization [HERO]

Glorian Sorensen Named Recipient of the HERO Mark Dundon Research Award
Health Enhancement Research Organization [HERO]

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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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