Health & Welfare Plans Newsletter

October 9, 2017

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Retirement Plan Consultant
Intac Actuarial Services
in NJ, NY

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Estate & Pension Advisory Board
in NJ

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Newport Group
in AL, AZ, CA, FL, IA, IL, IN, KS, MA, MD, MI, MN, MO, NC, NY, OH, PA, TX, VA, WI, Telecommute

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UNITE HERE HEALTH
in IL

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National TPA
in AZ, CA, CO, GA, IL, NC, OH, TX

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[Official Guidance]

Text of IRS Notice 2017-61: Insured and Self -Insured Health Plans -- Adjusted Applicable Dollar Amount for Fee Imposed by Sections 4375 and 4376 (PDF)
"The fee imposed by Sections 4375 and 4376 helps to fund the Patient-Centered Outcomes Research Trust Fund (PCORTF) ... The applicable dollar amount ... for policy years and plan years that end on or after October 1, 2017, and before October 1, 2018, is $2.39.... [T]he adjusted applicable dollar amount for policy years and plan years ending in the previous Federal fiscal year [was] $2.26[.]"
Internal Revenue Service [IRS]

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[Official Guidance]

Text of IRS Notice 2017-62: Treatment of Amounts Paid to Section 170(C) Organizations Under Employer Leave-Based Donation Programs to Aid Victims of Hurricane and Tropical Storm Maria (PDF)
"The [IRS] will not assert that cash payments an employer makes to Section 170(c) organizations in exchange for vacation, sick, or personal leave that its employees elect to forgo constitute gross income or wages of the employees if the payments are: [1] made to the Section 170(c) organizations for the relief of victims of Hurricane and Tropical Storm Maria; and [2] paid to the Section 170(c) organizations before January 1, 2019.... Cash payments to which this guidance applies need not be included in Box 1, 3 (if applicable), or 5 of the Form W-2"
Internal Revenue Service [IRS]

[Guidance Overview]

Rhode Island Enacts Paid Sick Leave Law
"Employers with fewer than 18 employees are not required to provide paid time off ... [C]overed employers must allow employees to use paid sick time: [1] For an employee's or family member's illness, injury, or health condition; [2] When the employee's workplace or a child's school is closed due to a public health emergency; and [3] For reasons relating to domestic violence, sexual assault, or stalking."
Jackson Lewis P.C.

How to Address Intermittent Leave Under the FMLA
"[1] Address scheduling issues early in the process.... [2] Provide the healthcare provider with necessary information.... [3] Recertify FMLA leave every six months.... [4] Enforce company call-in policies and procedures.... [5] Consider a transfer when appropriate."
McDonald Hopkins

Not Every Aspect of Form 1095-C Can Be Outsourced
"Outsourcing the processing of Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, is common. But employers remain responsible for the accuracy of the form ... and should be knowledgeable about it when employees have questions.... The form uses indicator codes ... listed in the form instructions, to show the type of health care coverage that was offered to the employee."
Society for Human Resource Management [SHRM]

[Advert.]

New Parental Leave Laws in Washington D.C.

Sponsored by Lorman and BenefitsLink

Oct. 25 webinar. What you need to know about D.C. Paid Family Leave, from leave, notice and recordkeeping obligations to the consequences of noncompliance -- practical advice to help avoid costly penalties and litigation. Discount for BenefitsLink readers.


What to Do When You Receive an Out-of-Network Shakedown Letter
"A physician-owned, out-of-network health care service provider -- such as an ambulatory surgery center or a sleep center -- sends a demand letter to the plan administrator. The letter asserts an appeal of a denied benefits claim by one of the plan's participants; requests copies of a lengthy list of plan-related documents; and alleges that the plan administrator, the plan sponsor, the plan's third-party claims administrator, the insurance carrier and/or the plan itself have violated ERISA and other federal or state laws relating to plan administration or the participant's benefits claim.... What should you do when you receive this kind of shakedown letter? And more importantly, what should you be doing to avoid getting a letter like this in the first place?"
Society for Human Resource Management [SHRM]

DC District Court Remands EEOC Wellness Program Regs for Reconsideration
"On September 21, 2017, the EEOC submitted a status report in accordance with the court's order. The status report clarified that the EEOC intends to issue a notice of proposed rulemaking by August 2018 and a final rule by October 2019. The EEOC further explained that any substantive changes included in the new rule would likely not become effective until the beginning of 2021, at the earliest.... [E]mployers should monitor the EEOC's progress, and think carefully before designing new wellness programs that rely on the current regulations to provide significant incentives. Additionally, wellness program sponsors should be mindful of the potential impact this case will have on participant-driven lawsuits."
Morgan Lewis

What Extra Benefits Can You Offer to Create a Better Workplace?
"From 'paid, paid vacations' to merely saying thank you, there are a wide variety of things you can offer outside of pay to sweeten the deal for employees. Some of the most effective: Two-way communication ... Work/life balance ... Recognition ... Development opportunities ... Fun extras."
PayScale

Trump to Sign Order Easing Health Plan Rules
"The order is aimed at expanding insurance options for Americans who buy coverage on their own or work for a small employer ... Mr. Trump will order [HHS, DOL] and Treasury, to take steps to make it easier for people to band together and buy insurance through 'association health plans' ... The president also will order the agencies to start winding back an Obama-era rule curbing ... 'short-term medical insurance' ... [T]he executive order would order agencies to expand health reimbursement accounts[.]"
The Wall Street Journal; subscription may be required

White House Narrows ACA Contraception Mandate
"HHS officials have stated that, based on the groups that have already filed lawsuits over the provisions, the change will still leave '99.9 percent of women' with access to free birth control through their insurance. Meanwhile women's rights and civil liberties groups are portraying the new rules as a massive discriminatory blow. Regardless, employers that utilize this broadened exemption can expect to be targeted by civil rights and medical rights groups, and should anticipate potential litigation."
Fisher Phillips

Overlooked by ACA: Many People Paying Full Price for Insurance 'Getting Slammed'
"[As] of 2017 there were 17.6 million people in the individual market, 5.4 million of whom bought policies outside the health exchanges, where premium help is not available. Combine that with the percentage of people who bought insurance on the exchanges but earned too much ... to get premium subsidies, and the estimate is 7.5 million, or 43 percent of the total individual market purchasers ... And who are these people? 'They're early retirees,' said [Robert Laszewski]. 'They're people working part time who have substantial outside income. They're people who are self-employed of any age, people who are small employers.' "
Kaiser Health News

House Proposal for Federal Employee Health Program Could Decimate Workers' Benefits
"A proposal to change how the government calculates its contributions to premiums in the federal government's insurance program could make health care all but unaffordable for workers and retirees, employee groups said. The report on the House budget resolution, approved Thursday by a 219-206 vote, includes a provision that advocates changing how the Office of Personnel Management formulates the government's maximum contribution to insurance premiums through the Federal Employees Health Benefits Program."
Government Executive

Executive Compensation
and Nonqualified Plans

[Guidance Overview]

Pay Ratio Disclosure Is 'On Schedule': SEC Issues Additional Guidance
"In testimony last week before the Senate Committee on Banking, Housing and Urban Affairs, [SEC] Chair Jay Clayton advised that the pay ratio disclosure rule 'will continue to be implemented on schedule.' To that end, the SEC and the Staff of the SEC's Division of Corporation Finance recently issued new guidance to assist companies in preparing their pay ratio disclosure as the compliance date approaches."
Drinker Biddle

So, You Think You Don't Need to Worry About Your Clawback Policy Because the SEC Has Not Issued Final Rules?
"Less than 24 hours after news of the data breach at Equifax was reported, we saw politicians and the media demanding compensation clawbacks.... [T]he board of Equifax [is expected] to announce soon its decision on whether to claw back compensation from key executives, particularly the former CEO and former chief security officer, who have both left the company since the news. While we wait to hear from the board, let's look at what might happen if a company does not claw back compensation."
Winston & Strawn LLP

Employee Reaction Is U.S. Employers' Biggest Challenge with Pay Ratio Disclosure
"One half of U.S. companies say their biggest challenge in complying with the forthcoming pay ratio disclosure rule is forecasting how their employees will react ... The poll also found nearly half of respondents haven't considered how, or if, they will communicate the pay ratio even though employees' reaction to the disclosure is their greatest concern."
Willis Towers Watson

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David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
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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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