Health & Welfare Plans Newsletter

October 2, 2017

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[Guidance Overview]

Is Your Business Ready for the New York State Paid Family Leave Law?
"Starting January 1, 2018, paid family leave (PFL) becomes a mandatory benefit throughout New York State, providing job-protected paid time off to employees to [1] bond with a new child, [2] care for a family member with a serious health condition, or [3] address family matters due to a qualifying military exigency. All private employers (including those located outside New York State) with one or more employees in New York State are required to comply[.]"
Duane Morris LLP

[Advert.]

Online Learning Course: Family and Medical Leave Act (FMLA)

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Learn how to avoid common administration mistakes, implement best practices and be aware of interactions with other laws.


[Guidance Overview]

On the Rhode Again: Paid Sick Leave Drought Ends with New Rhode Island Law
"The Healthy and Safe Families and Workplaces Act sets statewide standards. The provisions become operative on July 1, 2018, giving employers less than one year to review existing, or create new, policies to comply with the law.... The law requires employers with 18 or more employees in Rhode Island to allow employees to accrue and use paid sick and safe leave. It is unclear whether the law imposes unpaid leave requirements on smaller employers. It is hoped that the labor department will clarify this issue via guidance or regulations."
Littler

[Guidance Overview]

CRS Report: Resources for Frequently Asked Questions about the Affordable Care Act (PDF)
35 pages. "This report provides resources to help congressional staff respond to constituents' frequently asked questions about the law. The report lists selected resources regarding consumers, employers, and other stakeholders, with a focus on federal sources. It also lists CRS reports that summarize the ACA's provisions." [Report R43215, updated Sept. 28, 2017]
Congressional Research Service [CRS]

Signing Release to Settle Workers' Comp Claim Did Not Waive Right to File FMLA Claims
"Pointing to the plain language and structure of a settlement agreement, which made clear it was to settle any 'work injury claims' arising from an employee's prior injury, the Third Circuit concluded that the release did not bar the employee's lawsuit, which alleged that the employer failed to notify him of his FMLA rights, failed to designate his leave as FMLA-protected, and fired him for exercising his FMLA and workers' compensation rights. He was not bringing an additional 'work injury claim,' explained the court, reversing the dismissal of his suit." [Zuber v. Boscov's, No. 16-3217 (3d Cir. Sept. 11, 2017)]
Wolters Kluwer Law & Business

How to Humanize Benefits Communications with Technology
"A 22-year-old new hire who doesn't know what a deductible is needs basic education that large group sessions can provide ... while the 40-year-old working mother may not want to spend time in meetings when she and her spouse can view her benefits on a microsite at home and make benefits decisions together. Communication methods might include print materials and the digital communication tools ... as well as gaming and automated marketing e-mails[.]"
Society for Human Resource Management [SHRM]

[Advert.]

New York State Paid Family Leave Benefits Law (PFL)

Sponsored by Lorman and BenefitsLink

Oct. 25 webinar. Covers employers and employees to whom the PFL applies, qualifying circumstances and events for PFL benefits, and how the PFL interacts with other leave laws. Discount for BenefitsLink readers.


New Age Rating Methodology Could Impact Small Group Renewal Premiums
"[HHS] issued a rule in December 2016, modifying the insurance rating methodology for individuals under the age of 21. The new rating methodology is likely to result in an increase in premiums for small group employers renewing in 2018.... Now, instead of a single age rating band from ages 0-20, for 2018, carriers can apply one age rating band from 0-14 and a separate rating band for each age from 15 to 20.... States that do not adopt these bands would still have one age rating band from 0-20."
HUB International

A Majority of Companies Now Like the ACA
"Only about one-third of 300 health benefits professionals surveyed by Mercer in mid-September said they favor a full repeal and replacement ... 95% of participants said they favored simplifying the required shared-responsibility reporting. Additionally, concern over the 40% excise tax on high-cost health plans, currently slated to take effect in 2020, remains rampant."
CFO

Health Insurance Providers Fee Returns in 2018 (PDF)
"The [ACA] imposes an annual fee on 'covered entities' that provide health insurance.... Congress suspended the fee for 2017, but it will be in effect for 2018. Insurance companies will include the fee in premiums charged to policyholders, including employer-sponsored health insurance plans. $14.3 billion is expected to be remitted for 2018."
EPIC

Medicare Offers More Health Coverage Choices and Decreased Premiums in 2018
"[T]he average monthly premium for a Medicare Advantage plan will decrease while enrollment in Medicare Advantage is projected to reach a new all-time high. Earlier this year, CMS announced new policies that support increased benefit flexibilities allowing Medicare Advantage plans the ability to offer innovative plans that fit the needs of people with Medicare."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Selection in Health Insurance Markets and Its Policy Remedies
"[The authors] review the theory and evidence concerning selection in competitive health insurance markets and discuss the common policy tools used to address the problems it creates."
National Bureau of Economic Research [NBER]

Latest Snag in ACA Sign-Ups: Those Who Guide Consumers Are Hitting Roadblocks
"In states that use the federal marketplace, healthcare.gov, many navigators -- nonprofit groups and workers who receive federal funding to help consumers enroll -- are hitting snags completing a mandatory certification course. Those credentials are required before they can formally advise consumers or organize educational events about getting coverage."
Kaiser Health News

[Opinion]

Failure to Approve Oklahoma Waiver Undermines Trust Between HHS and States
"By failing to follow through on repeated assurances to Oklahoma that its 1332 reinsurance waiver would be approved on an expedited timeline, the federal government dealt a devastating blow to Oklahoma consumers and magnified suspicions that [HHS] is more interested in undermining the [ACA] than partnering with the states to stabilize the individual market for the nearly 20 million Americans who depend on that market for their health security."
Health Affairs

Benefits in General

Third Circuit Upholds Retirement Plan Administrator's Interpretation of 'Ambiguous' Plan Terms
"[The court determined that] the plan is silent as to how to calculate Final Average Compensation specifically for disabled participants. The court also found that the plan is ambiguous due to its structure, where the relevant plan terms are strewn throughout three Articles of the massive plan document. The court determined that there is nothing unreasonable about the plan administrator's interpretation which harmonizes Credited Service with the calculation of Final Average Compensation." [Dowling v. Pension Plan for Salaried Employees of Union Pac. Corp. & Affiliates, No. 16-1977 (3d Cir. Sept. 15, 2017)]
Roberts Bartolic

Aon Sues Willis Towers Watson, New CFO Over Breaking Non-Compete Agreement
"Willis Towers Watson and its new Chief Financial Officer Michael Burwell, who is scheduled to start Oct. 2, are being sued by rival Aon over allegations that Mr. Burwell violated a two-year non-compete agreement because he had access to Aon trade secrets in his role as a consultant helping restructure the company. The lawsuit ... seeks to prevent Mr. Burwell from working for Willis Towers Watson for two years and is seeking $75 million in damages. It accuses both Willis Towers Watson and Mr. Burwell of violating the Illinois trade secrets act. It also accuses Mr. Burwell of breaching his fiduciary duty and Willis Towers Watson of unfair competition."
Pensions & Investments

Executive Compensation
and Nonqualified Plans

[Guidance Overview]

SEC Relaxes Pay Ratio Rules to Facilitate 2018 Proxy Disclosures
"The SEC expanded the flexibility afforded by the pay ratio disclosure rule. The latest guidance should alleviate some compliance costs and administrative burdens for many issuers.... Now that the pay-ratio rule is confirmed to be in place for reporting in 2018, it is rather unlikely that Congress will take any immediate action that would preclude pay-ratio reporting or otherwise lead the SEC to reconsider the pay ratio rules."
Orrick

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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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