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401k Plan Administrator
Atlantic Pension Services Inc
in PA

Senior Compliance Specialist
Alerus Financial
in MI, MN, NH

Regional Sales Director - Mid-Atlantic
Fringe Benefit Group
in DC, DE, FL, GA, MD, SC, VA

Defined Benefit Administrator
TPA firm
in AZ

ERISA Attorney
Schwartz, Steinsapir, Dohrmann & Sommers
in CA

Client Relationship Account Manager
in NC

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[Guidance Overview]

IRS and DOL Provide Disaster Relief Guidance for Health Plans
"The DOL guidance advises plan fiduciaries to make reasonable accommodations to prevent plan participants who miss deadlines for filing benefit claims and COBRA elections from losing benefits. The DOL also recognizes that full compliance by group health plans may not be possible in a disaster situation. Employers should prioritize helping participants, even if that means temporarily relaxing certain rules."
Trucker Huss


50th Anniversary Sale

Sponsored by DATAIR Employee Benefit Systems, Inc.

DATAIR is having a 50th Anniversary Sale and ALL software is offered at 50% off the license fee. Contact us today for more information: 888-328-2474 or

[Guidance Overview]

New York Issues Model Paid Family Leave Forms
"Employers should review their handbooks to ensure that they have proper policies in place providing for leave under the [New York Paid Family Leave Law]. Employers should also visit the PFLL website in order to download the PFLL forms in advance of January 1, 2018 so that they can properly respond to employee requests for leave under the PFLL in compliance with the law."
Fox Rothschild LLP

New York Paid Family Leave: Game Changer?
"This benefit will be incorporated under the state's statutory disability policy ... It follows a growing trend of providing guaranteed wage replacement for employees to have time to bond with a new child, provide care for a close relative or relieve family pressures related to military service.... Even if you don't have employees in one of four states that provide paid family leave, the federal government may make this a requirement in the future. It may, indeed, be time to consider a more consistent policy across organizations."
Willis Towers Watson

CBO Report: Repealing the Individual Health Insurance Mandate -- An Updated Estimate (PDF)
"The analysis underlying this estimate incorporates revised projections of enrollment in health insurance, premiums, and other factors ... CBO and JCT estimate that repealing that mandate starting in 2019 -- and making no other changes to current law -- would have the following effects: [1] Federal budget deficits would be reduced by about $338 billion between 2018 and 2027. [2] The number of people with health insurance would decrease by 4 million in 2019 and 13 million in 2027.... [3] Nongroup insurance markets would continue to be stable in almost all areas of the country throughout the coming decade. [4] Average premiums in the nongroup market would increase by about 10 percent in most years of the decade[.]"
Congressional Budget Office [CBO]

How Many of the Uninsured Can Purchase a Marketplace Plan for Less Than Their Shared Responsibility Penalty?
"Just over half (54%) of uninsured individuals who are eligible to purchase a marketplace plan with or without a subsidy would better off financially if they purchased a bronze plan rather than remaining uninsured. Of the 10.7 million people who are currently uninsured and eligible to purchase marketplace coverage, around 7.7 million people will be subject to the shared responsibility penalty. Most of these people will have access to at least some subsidies (6.3 million) to purchase a Marketplace plan."
Henry J. Kaiser Family Foundation


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.

Drug Pricing Crisis and the Role of the Intermediary: How Did We End Up Here? (PPT)
14 PowerPoint slides. Topics include: [1] Contributing factors; [2] Independent pharmacy marketplace realities; [3] PBM influence in U.S. supply chain; [4] PBMs, plan benefit design and lack of fiduciary responsibility; [5] PBM revenue streams; [6] Maximum Allowable Cost (MAC) pricing: PBM proprietary drug pricing standard.
National Community Pharmacists Association [NCPA]

The New Contraception Coverage Rules: Four Things to Know
"[1] The rules offer new exemptions.... [2] Multiple types of employers can quality for exemptions.... [3] Not very many employers are expected to take advantage of the new rulings.... [4] Preparing now will ease headaches later."
Managed Healthcare Executive

The Next Generation ACO Program: Financial Results for 2016 (PDF)
"Across all NGACOs in 2016, the program had $48 million in gross savings and $3 8 million in shared savings. Shared savings are the net amounts paid by CMS to the NGACOs. If we separate the NGACOs into those that had savings and those that had losses (as shown in Figure 1), we see that the former had $58 million in shared savings and the latter $20 million in shared losses."

Individual Stop-Loss Is Now Optional for Next Generation ACOs (PDF)
"As [Next Generation Accountable Care Organizations (NGACOs)] evaluate whether they should participate in the individual NGACO stop -- loss program, many aspects of the NGACO stop -- loss methodology must be considered. Several factors will make it difficult for an NGACO to choose whether to have its financial settlement based upon capped or uncapped claims[.]"


HSAs Play Important Role in Addressing America's Retirement Challenge
"[I]ncreasing the annual HSA limits to align with high-deductible health plan out-of-pocket maximums and enacting policies to encourage the use of HSAs to save for medical expenses in retirement could be important components in closing the retirement savings gap and enabling more Americans to retire with confidence."


Koskinen's Parting Gift from the IRS
"IRS Commissioner John Koskinen has made no secret of his contempt for Republicans who tried to hold his agency to account for Tea Party targeting. His payback as he walks out the door is a major hit on employers. The IRS confirmed Tuesday that it is now for the first time beginning to enforce the ObamaCare employer mandate, issuing thousands of penalty letters to noncompliant companies.... The letters reach back to 2015, setting up companies for years of penalties.... Nobody knows how many businesses will be hit, but by some estimates it will be tens of thousands."
The Wall Street Journal; subscription may be required

Benefits in General

Hearing Set for EBSA Nominee
"On Nov. 15 the [Senate Health, Education Labor & Pensions (HELP) Committee] will question Preston Rutledge, President Trump's candidate to head the EBSA, who was nominated last month. Rutledge currently serves as senior tax and benefits counsel on the Majority Tax Staff of the U.S. Senate Finance Committee, where his responsibilities include employee benefits, retirement issues, tax-exempt organizations, health tax issues and the tax provisions of the [ACA]."
National Association of Plan Advisors [NAPA]

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Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager

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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