Health & Welfare Plans Newsletter

September 21, 2017

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Jobs

Pension Administrative Consultant
Polycomp Administrative Services, Inc.
in CA

Senior Pension Administrator
Scholz & Friends Enlightened Retirement Group, Inc.
in TX

Retirement Benefits Consultant
Cargill, Inc.
in MN

Retirement Plan Services Compliance Officer
Heartland Financial
in AZ, CA, CO, IA, IL, KS, MN, NM, WI

Senior Administrator ERISA / Fiduciary Services
Vantage Benefits
in TX

Defined Benefits Combo Consultant
Loren D. Stark Company
in TX, Telecommute

Senior Trust Officer
GreatBanc Trust Company
in IL

Plan Compliance Consultant
T. Rowe Price
in CO, MD

Director, Employee Benefit Services
Healthcare Association of New York State
in NY

Defined Contribution - Implementation Analyst
Milliman
in TX

►See 146 Jobs

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Webcasts, Conferences

Opioid Addiction and Substance Abuse: What's a Plan to Do?
October 3, 2017 WEBCAST
American Bar Association Joint Committee on Employee Benefits [JCEB]

Enforceability of ERISA Class Action Waivers and Mandatory Arbitration Agreements
October 24, 2017 WEBCAST
Strafford

Structuring Executive Compensation and Demystifying Internal Revenue Code Section 409A
September 21, 2017 in PA
Pepper Hamilton LLP

Executive Compensation National Institute 2017
November 2, 2017 in DC
American Bar Association Joint Committee on Employee Benefits [JCEB]

►See 182 Upcoming Webcasts and Conferences

►See 1278 Recorded Webcasts


Discussions

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New Comments and Topics

All Topics, Grouped by Forum


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[Guidance Overview]

Responding to Mental Health Parity Model Disclosure Request Form
"While intended to provide clarity, the model form leaves plan sponsors and third party administrators (TPAs) with plenty of questions. ERISA requires numerous disclosures around plan documentation and the claims procedures. MHPAEA adds additional requirements, but they generally run parallel to the claims procedures. Given all of the required disclosures, how should a plan sponsor respond to this type of request? Does a plan sponsor need to respond and, if so, how much information should it provide? Will TPAs cooperate with the plan sponsor to ensure the submitter receives the appropriate information?"
Fox Rothschild LLP

[Advert.]

Online Learning Course: COBRA

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

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Does Your Wellness Program Offer a Reasonable Alternative?
"[If] your wellness program requires an individual to satisfy a standard related to a health factor to earn a reward, it must satisfy 5 requirements under HIPAA. The requirements are slightly different if the program is an activity-only program (e.g., reward for walking 10,000 steps a day) or an outcome-based program (e.g., not using tobacco or attaining a certain result on a biometric test)."
Graydon Head & Ritchey LLP

Creating Effective Open Marketplaces for a Wide Menu of Benefits
"Since the average working adult only spends 15 minutes on their benefits purchases, they make extremely fast buying decisions. Our challenge is two-fold regarding these speed purchases: employees often make these decisions without considering benefits within the context of their lives (despite our best efforts), and the choices they make rarely consider new information nor do they deviate from their past histories."
Human Resource Executive Online

What Is Healthcare Consumerism and How Does It Affect Healthcare?
"Healthcare consumerism transforms an employer's health benefit plan, putting the economic purchasing power and decision-making in the hands of plan participants.... [The] goal is to enable patients to become wholly involved in their healthcare decisions. However, many plans don't ask much of participants in terms of how they consume healthcare services."
DataPath

Pharmacy Benefit Management of Opioid Prescribing: The Role of Employers and Insurers
"[In] a given year, at a company with 100,000 employees, 61 employees would avoid addiction if prescriptions were reduced to align with the doses and duration of use consistent with the CDC Guideline. For employers, this translates into substantial health care cost savings, as a person struggling with addiction would have more than $15,000 in additional health care costs a year as compared to a person who is not dealing with substance abuse."
Health Affairs

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2017 Health Savings Accounts Facts

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Amazon in Talks with PBMs Over Pharma Supply Chain
"Amazon has been hiring more healthcare leaders and expanding its drug and medical supply distribution in recent months, spurring rumors the online retailer is stepping into the pharmacy business.... [It] could take 18 months to 24 months before Amazon can achieve pharmacy licenses in all 50 states[.]"
Becker's Hospital Review

States Moving on Obamacare Waivers to Save Insurance Markets
"To receive approval for the waivers, states must enact legislation and go through a lengthy application process demonstrating that their changes will result in coverage at least as comprehensive, cover as many people, and be as affordable as coverage without the waivers, and won't increase the federal deficit. Hawaii and Alaska have received approval for their 1332 waivers, and Minnesota, Iowa, and Oregon have submitted applications to the HHS."
Bloomberg BNA

Last-Ditch ACA Repeal Attempt Would Eliminate Employer Mandate
"[H.R. 1628] would eliminate penalties imposed on individuals who don't purchase health care (the individual mandate) and against employers ... that don't provide ACA-compliant health care (the employer mandate).... The bill allows states more independence in defining their own essential health benefits (EHBs) ... States that receive funding under the bill also can obtain waivers to permit insurers to charge different premiums based on health status, age or any other factor other than sex or membership in a constitutionally protected class (such as race or national origin). States could also obtain waivers of the ACA's medical-loss ratio rebate requirements."
Society for Human Resource Management [SHRM]

Graham-Cassidy Health Bill Would Cut State Funding
"34 states and Washington, D.C., would lose funding -- more than $10 billion in seven of the states. The biggest losses would be seen in states like California and New York, which had the greatest gains expanding their Medicaid programs. Conversely, states with lower medical costs, skimpy Medicaid benefits and no expansion, would do better. Texas stands to gain the most -- $35 billion from 2020 through 2026."
InsuranceNewsNet.com

[Opinion]

ECFC Letter to Treasury Requesting Disaster Relief for Cafeteria Plans (PDF)
"Like the relief given to retirement plan participants ... from the verification requirements with respect to loans and hardship distributions ... [ECFC] requests that limited relief from the substantiation requirements under the cafeteria plan regulations be provided for certain victims of Hurricanes Harvey and Irma."
Employers Council on Flexible Compensation [ECFC]

[Opinion]

Text of Comment Letters to DOL on Disclosures and Coverage of Treatment for Eating Disorders Under MHPAEA
The 23 letters posted to the DOL website as of Sept. 18, 2017 were submitted to DOL in response to its request for comments on disclosures and on coverage for eating disorders, in ACA FAQ Part 38 (June 16, 2017). Deadline for submission of comments was Sept. 13, 2017.
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

Benefits in General

Discovery of Claims Procedures to Assess Compliance with DOL Regs? Not So Fast.
"[F]ailing to follow [DOL] claims regulations can result in the court using the de novo review standard ... But the court still may apply the abuse of discretion standard: if the plan can establish: [1] it has procedures in full conformity with DOL regulations, and [2] its failure to follow regulations was inadvertent and harmless. So, what is the plan's burden of proof to establish that it has procedures in conformity with DOL regulations? ... [D]oes Plaintiff get to conduct discovery into claims procedures, and the way you handled the specific claim?" [Capretta v. Prudential Ins. Co., No. 16-1929 (S.D.N.Y. Aug. 28, 2017)]
Lane Powell PC

HIPAA Compliance: Protecting Employee Information
"Document employee training.... Procedures should affect every department.... Audit all subcontractors.... Make areas with private information secure.... Use shredders.... Make privacy a workplace culture.... Shut off the auto-complete option.... Protect employee files.... Ask for outside help."
Lindquist LLP

Employer-Provided Benefit Cost Varies Sharply by Industry
"Health care costs are substantial across all sectors, ranging from 10.4% of pay in the retail sector to 12.7% of pay in the oil, gas and electric (OG&E) sector. The disparities among industries are much more pronounced for retirement benefits ... Total retirement benefits, for example, averaged 12% of pay in the OG&E sector compared with roughly 5.5% of pay in the health care, high-tech, general services and retail industries."
Willis Towers Watson

Press Releases

Charles Asubonten Named as CFO of CalPERS
CalPERS [California Public Employees' Retirement System]

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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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