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[Guidance Overview]
Massachusetts Proposes Regs for Employer Tax Assessments to Help Offset State Costs
"Beginning with the first quarter of 2018, employer medical assistance contributions (EMAC) included in unemployment insurance payments will increase from a maximum of $51 per employee to $77 per employee. In addition, a new $750 supplemental employer assessment will apply for each non-disabled employee who declines employer-sponsored health insurance and instead enrolls in MassHealth or buys coverage on Massachusetts' health insurance marketplace for a continuous period of at least 14 days."
Lockton
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[Guidance Overview]
San Francisco Issues New Health Care Security Ordinance Waiver Form
"The new rules require that all of the following conditions be satisfied for the waiver to be valid: [1] The exact Employee Voluntary Waiver Form must be used. Employers may not change the form in any way, and no other form qualifies.... [2] The employee must voluntarily complete the form without any pressure or coercion from the employee's coworkers or the employer (including supervisor, manager, agents, etc.). [3] The employee must complete the section of the form stating how the employee is covered under another employer-sponsored group health plan (e.g., spouse, domestic partner, parent)."
ABD Insurance & Financial Services
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ACA Risk Corridors Update: Administration Releases 2016 Amounts, Paving the Way for Litigation Over Amounts Owed
"CMS's [Nov. 15] announcement makes obvious that HHS is still woefully short on these payments, stating that 'HHS will use 2016 benefit year Risk Corridors collections to make additional payments toward 2014 benefit year payment balances.' ... [T]he announcement enhances the chances that the appeals court will reach a decision on the merits. Although the briefing for the appeal is now compete, the parties are still waiting for a date for oral argument, and the court is not likely to issue a decision until well into next year."
Faegre Baker Daniels
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Fourth Circuit Affirms Health Care Fraud Convictions for Billing Insurers for Medically Unnecessary Services
"Generally, where patients were uninsured, the defendants would use the cheaper test, but where patients were insured, the defendants would use the more expensive test.... Defendants impliedly argued that because they billed for services actually rendered, and told the payors which services were rendered, no fraud occurred. The Fourth Circuit rejected defendants' arguments ... Although this case involved a criminal conviction for fraudulently billing private insurers, the facts potentially apply equally to civil actions and disputes involving other payors, including ERISA Plans." [U.S. v. Palin, No. 16-4522 (4th Cir. Oct. 30, 2017)]
Seyfarth Shaw LLP
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Embedded Deductibles and Out-of-Pocket Maximums Can Present Compliance Challenges
"Embedded [out-of-pocket maximums (OOPMs)] work the same way as embedded deductibles. However, unlike embedded deductibles, embedded OOPMs are required [by the Affordable Care Act].... HDHPs have a separate maximum on the family OOPM. This means HDHPs must have an overall family OOPM that is the lesser of the HDHP OOPM ($13,300 for 2018) or the HHS-required family OOPM ($14,700 for 2018)."
HUB International
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California Fines Anthem $5 Million for Failing to Address Consumer Grievances
"The state Department of Managed Health Care criticized Anthem, the nation's second-largest health insurer, for systemic violations and a long history of flouting the law in regard to consumer complaints.... Before this latest action, California had already fined Anthem more than $6 million collectively for grievance-system violations since 2002."
Kaiser Health News
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Benefits in General
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Executive Compensation and Nonqualified Plans
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Should You Make Your Annual Incentive Bonuses Deductible in 2017?
"A potential sticking point for many companies is that they require their employees to be employed on the day bonuses are paid, usually in March 2018. Ordinarily, that requirement would cause the bonus program to fail the 'all events test' under Code Section 461 and, consequently, prevent deduction in 2017. However, there are other methods of satisfying the 'all events test' to allow a company to deduct in 2017, employee bonuses paid in 2018."
Winston & Strawn LLP
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2017 End of Year Plan Sponsor 'To Do' List, Part 3: Executive Comp
"Last chance to correct certain Section 409A document failures discovered in 2017 ... Nonqualified deferred compensation deferral elections should be made on or before December 31, 2017 ... Consider shareholder reapproval of Section 162(m) performance compensation plans approved in 2013 ... Review whether your equity-based compensation plan has sufficient shares remaining for 2018 awards ... Consider adding separate annual limits on director equity awards ... Section 6039 information statements due by January 31, 2018 ... Consider revising stock-based incentive programs in response to FASB's new approach to share-based withholding."
Snell & Wilmer
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Discussions on the BenefitsLink Message Boards
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Applying a Document's Provision for Termination Upon Acquisition of the Plan Sponsor
Employer A merges with employer B. Employer B gives stock in B to A in exchange for all of the stock in A. (I would say this is treated like a stock sale.) Employer A never terminated its plan. A wants to terminate its plan so the owner can do a rollover. Typically since B now owns the stock in A it would decide what to do with A's Plan. But our plan document says that if the employer is acquired and the new employer doesn't continue the plan then the plan terminates automatically. B would eventually want to start a new plan (maybe next year) but they haven't yet done so, leaving A's plan alone for the moment. Can the owners of A rely on that provision in their plan to pay their plan out rather than be forced to merge it with B's future Plan or relinquish control of its plan to B?
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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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