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Jr. Plan Document Associate
Professional Capital Services
in PA

DB / DC Plan Administrator (3+yrs Cash Balance exp)
Ingham Retirement Group
in FL, Telecommute

Retirement Plan Consultant
MHM Retirement Plan Solutions
in KS, MO

Team Lead / 401(k) Pension Administrator
Nicholas Pension Consultants
in CA

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Does a Midyear Change to a Plan's Deductible Require an Update to the SBC?
"A 'notice of material modification' of a summary of benefits and coverage (SBC) must be provided if a plan makes a material modification in the plan terms affecting the content of an SBC. A material modification includes any modification to the coverage offered under a plan -- an enhancement or reduction -- that would be considered by an average plan participant to be an important change in covered benefits or other terms of coverage under the plan."
Thomson Reuters / EBIA


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.

The Secret to Open Enrollment Tech: Don't Overthink It
"At a base level, employees just want programs that make the most important questions easier to answer. For example: What will my dependents and I pay out-of-pocket when (insert health problem) happens? Should I stick with a PPO, or would I save more with a high-deductible plan? Where and how can I take advantage of wellness incentives? ... [P]eople need their questions answered as painlessly as possible. That's the biggest driver of meaningful tech trends in today's space[.]"
HR Dive

Communication Planning, 8 Weeks Before Open Enrollment
"Sending multiple staff-wide emails the week before open enrollment, each with too many attachments and impending deadlines, can be overwhelming... and it's the first step to causing employees to give up and disengage.... [C]ompile a calendar of important dates to release the information you've deemed most important ... [P]lan for the tone of your messages to shift as open enrollment approaches, and then arrives; moving from education and announcements to actual instructions for action, and then shift again to tackle your last-minute reminders."
Grooms Benefit Solutions

How to Make Your Employees Even Smarter on Benefits Decisions
"[1] Consider a decision support system.... [2] Provide phone support for your benefits enrollment system.... [3] Upgrade and differentiate your educational materials.... [4] Make employee benefits education a year-round activity.... [5] Embrace consumerism in benefits."
Willis Towers Watson

Employer Premiums Rise Nearly 7% in 2017; Employees Absorb More of the Health Insurance Cost
"Premium renewal rates for employer sponsored health insurance rose an average of 6.6% -- a significant increase from the five-year average increase of 5.6% ... Connecticut saw a 24% increase in premiums in 2017, up to $655 from $530; New York also saw a large increase of 14%, up to $712 in 2017 over $624 in 2016.... Arizona and Washington [saw] 2% and 10% decreases, respectively."
United Benefit Advisors


New COBRA Audit Guidelines

Sponsored by Lorman and BenefitsLink

Nov. 28 webinar. In addition to general COBRA compliance, we'll review the IRS Audit guidelines, to help you identify and prepare for the areas of focus in an IRS COBRA audit. Discount for BenefitsLink readers.

Tension Between High-Deductible Health Plans and Payment and Delivery Reform
"As HDHPs are growing, employers and health plans have made a push toward population-based reforms, which require providers to take on financial risk for their patients' care. And from what we know, providers are not willing to assume financial risk for a patient population unless they are set up to manage and coordinate care, including primary and secondary preventive care that keeps their patients out of the hospital.... [R]eforms on the consumer side and the provider side are on a collision course."
Health Affairs

Childhood Cancer Survivors Face Job Lock to Keep Insurance Coverage
"[T]he survey asked the participants if they have stayed at a job for the health insurance and recorded their current insurance status, marital status, income, and past issues with paying for healthcare. Of the 522 eligible participants employed full-time, 394 were survivors and 128 were siblings. Job lock was found to be more prevalent among survivors than siblings. Additionally, job lock was similar among female survivors and siblings, while there was a nonsignificant difference among male survivors and siblings. Also, survivors reported having more problems paying medical bills than siblings."
American Journal of Managed Care

Massachusetts Senate Releases Health Care Bill
"The bill, titled 'An Act Furthering Health Empowerment and Affordability by Leveraging Transformative Health Care,' is the most sweeping health care legislation lawmakers have considered in years.... Senate Ways and Means Committee Chairwoman Karen Spilka said that the Masshealth reforms would generate approximately $114 million in savings in the year FY2020. She also said that savings on the commercial and private side could total between $475 and $525 million."
ML Strategies

State of Washington Office of the Insurance Commissioner: Individual Health Insurance Market Stabilization Analyses (PDF)
65 pages. "Washington's individual health insurance market has shown symptoms of destabilization in recent years, including double digit premium increases and threats of areas with no or very low issuer participation.... This document will discuss the potential policies that were considered, the pros and cons of the approach, the effects of the different policies on the 2019 individual market, and the implications of the policies."
Wakely Consulting Group, LLC


Now is a great time to join Worldwide Employee Benefits Network (WEB)

Sponsored by WEB - Worldwide Employee Benefits Network

WEB members represent more than 25 professions and 30 areas of expertise within the pension and benefits industry -- administrators, consultants, attorneys, accountants, investment managers, communications experts and benefits managers. Join today.

Worker Not Entitled to Multi-Month Leave After FMLA Exhaustion
"Though the EEOC filed a brief as amicus curiae urging for reversal, the appeals court rejected its assertion that long-term leave should be considered a reasonable accommodation when certain circumstances are met, since adopting such a position would transform the ADA into a medical-leave statute, which was 'an untenable interpretation of the term 'reasonable accommodation.' " [Severson v. Heartland Woodcraft, Inc., No. 15-3754 (7th Cir. Sept. 20, 2017)]
Wolters Kluwer Law & Business

Changing of the Leaves: EEOC Again Pushes for Additional Leave as ADA Accommodation
"[T]he EEOC believes that leave is a reasonable accommodation and automatic termination when FMLA leave runs out violates the Americans with Disabilities Act. Even though at least one federal court has made clear it disagrees, the EEOC continues to press the point and has recently filed a lawsuit against the Blood Bank of Hawaii for failure to provide reasonable accommodations for and then firing employees who required additional leave time for their disabilities."

Key Facts: Auto-Renewal of Advance Premium Tax Credits for 2018 in
"Each open enrollment period, people receiving advance premium tax credits (APTC) to help them pay for health coverage have to renew their eligibility. [These] questions and answers provide information about how the Federally-Facilitated Marketplace (FFM) will renew eligibility for 2018 APTC and will briefly explain how will assign people to health plans if they don't come back to the marketplace to select a plan."
Center on Budget and Policy Priorities

CVS Reportedly in Talks to Buy Aetna
"CVS Health is reportedly in talks to buy Aetna in a deal that would make major waves in the healthcare industry.... [T]he Wall Street Journal reported that CVS had offered to buy the health insurance company for more than $200 per share. The deal could value Aetna at more than $66 billion."


Start with Pharmacy to Reduce Healthcare Costs
"It's not health insurance that's expensive; it's the cost of healthcare. And the more expensive the drugs, the greater the profits throughout the whole supply chain. While innovation should surely be rewarded, perhaps the prices of drugs should be policed like monopolistic public utilities."
Frenkel Benefits

Benefits in General

[Guidance Overview]

Puerto Rico Agencies Issue Employee-Related Guidance, Tax Relief in Wake of Hurricanes
"[L]ocal government agencies have issued the following measures and guidance related to employers concerning their employees. [1] Income tax exemption for assistance to employees... [2] [G]uidance on payment of salary for days not worked in the wake of Hurricanes Irma and Marķa. PR-DOL Opinion 2017-001 cites the Fair Labor Standards Act and its interpretative regulations in summarizing payment obligations for exempt and non-exempt employees due to natural disasters and recovery.
Jackson Lewis P.C.

Press Releases

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2017, 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, 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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