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Retirement Plan Solutions, Inc.
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Blade Benefit Consulting
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in WI, Telecommute

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in FL

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[Official Guidance]

Text of CMS Guidance: Notice of Revocation of the Accommodation for Certain Preventive Services (PDF)
"[If] an objecting entity ... newly elects to provide the accommodation, but later wishes to revoke the accommodation, notice of the revocation of the accommodation must be provided to the participants and beneficiaries in the group health plan.... We consider this requirement to be satisfied if the eligible organization itself, its group health plan, or its TPA provides the written notice instead of the issuer....If an objecting entity cannot, or chooses not to, use the SBC notification process to notify the participants and beneficiaries in the group health plan of the revocation of the accommodation, and instructs that an issuer or TPA must not use the SBC notification process on its behalf, then the objecting entity itself, its group health plan, issuer, or TPA must send a separate written notice of the revocation to the participants and beneficiaries no later than 30 days before the first day of the first plan year in which the revocation will be effective. Unlike the SBC notification process, which can effectuate a modification of benefits in the middle of a plan year provided it is allowed by State law and the contract of the policy, the 30 day notification process can only effectuate a benefit modification at the beginning of a plan year." [Unnumbered document, Nov. 30, 2017]
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]


States & Localities Pose Serious Threat to Employee Benefits

Sponsored by The ERISA Industry Committee [ERIC]

Join The ERISA Industry Committee and corporate compensation executives for analysis of what to expect at the state and local level and how proposed rules could be shaped or reversed to allow your company to retain benefits flexibility. Register now.

[Official Guidance]

2017 Benefit Year Risk Adjustment: HHS-Developed Risk Adjustment Model Algorithm 'Do It Yourself (DIY)' Software (PDF)
21 pages. "This document provides instructions for the HHS risk adjustment models for the 2017 benefit year, with revisions from the software instructions posted on the CCIIO website on July 21, 2017." [Also online: Technical Details (XLSX file) and 2017 Benefit Year Risk Adjustment SAS Version of HHS-Developed Risk Adjustment Model Algorithm Software (ZIP file)]
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

Your Not So Kind (Or Welcome) Early Holiday Gift from the IRS: Letter 226J
"[In] late December 2015 ... the IRS extended the mandated filing periods for Forms 1094/1095, which gave employers more time to comply with the ACA's new reporting obligations.... [T]he IRS also communicated that employers would not be penalized for filing incorrect or incomplete Forms 1094/1095 if the forms were actually filed by the extended deadlines and filers could show they 'made good faith efforts to comply with the information reporting requirements for 2015.' It comes then as somewhat of a surprise to many that the IRS has not only moved forward with its efforts to review previously filed Forms 1094/1095, but actually has begun enforcement efforts against employers for the 2015 reporting period."
Jackson Lewis P.C.

[Guidance Overview]

Watch Your Mail: IRS Begins Collection of Employer Mandate Penalties
"ACA reporting is done on an entity by entity basis, so the mailroom at each of your affiliated companies should be on the lookout for a Letter 226-J from the IRS. The IRS often sends correspondence without addressing it to a particular individual or department, and getting the Letter 226-J into the right hands quickly will be critical."
Foley & Lardner LLP

Court Applies Medicare Secondary Payer Nondiscrimination Rules to Retiree with End State Renal Disease
"Unlike the rules for age-based and disability-based Medicare entitlement, the ESRD-based [Medicare secondary payer] prohibitions apply regardless of whether the individual has coverage by virtue of current employment status, and do not include an exception for small employers.... Medicare will remain primary for individuals who are already entitled to Medicare due to age or disability when they become eligible for ESRD-based Medicare." [Renal Care Group Indiana, LLC v. City of Fort Wayne, No.17-65 (N.D. Ind. Nov. 2, 2017)]
Thomson Reuters / EBIA


2018 SALGBA National Conference in Jacksonville, FL

Sponsored by SALGBA [State and Local Government Benefits Association]

The 2018 SALGBA National Conference is April 29 - May 2 in Jacksonville, FL at the Hyatt Regency Riverside. More information please visit

Sixth Circuit Rejects Honeywell Retiree Claims that CBA Provided Lifetime Health Insurance Benefits
"The Sixth Circuit affirmed a district court's dismissal of a suit by retirees of Honeywell claiming the employer promised, in a collective bargaining agreement, to pay lifetime health insurance. The appeals court found that the general-durational clause in the CBA applied to the employer's promise to provide health care.... None of the retirees' evidence showed that the duration of the agreement contained a patent ambiguity that clearly appeared on the face of a document arising from the language itself." [Watkins v. Honeywell International Inc., No. 17-3032 (6th Cir. Nov. 8, 2017)]
Wolters Kluwer Law & Business

The Next Big Innovation in Health Benefits Design: 'Surgeons of Excellence'
"Self-insured employers, pursuing cost-efficiencies and streamlined care for employees, select certain hospitals to become provider-partners. They label these partners 'Centers of Excellence', and design their benefits packages around them.... Surgeon-level data....enables smarter selection of provider partners.... [and] uncovers variances that could have a tremendous impact on outcomes.... The scope of possible performance disparity can be very broad in any given facility."

If Your Insurer Covers Few Therapists, Is That Really Mental Health Parity?
"In 2015, behavioral care was four to six times more likely to be provided out-of-network than medical or surgical care. Insurers pay primary care providers 20 percent more for the same types of care as they pay addiction and mental health care specialists, including psychiatrists. State statistics vary widely. In New Jersey, 45 percent of office visits for behavioral health care were out-of-network. In Washington D.C., the figure was 63 percent."
Kaiser Health News

Tax Treatment of Employee Hardship and Disaster Relief
"In structuring this assistance, most parties prefer that the payments be tax-deductible to the employer but not constitute taxable income to the employee.... To provide this assistance tax-free to employees, the employer must navigate the detailed maze of provisions governing assistance programs.... it is crucial that the program be documented, including identifying who is eligible, how a particular employee satisfies the eligibility criteria, whether they have insurance to cover any of the types of losses that the employer is planning to fund, and who is on the selection committee."
Pepper Hamilton LLP

IRS Releases 2017 Form 8839 for Excluding Employer-Provided Adoption Benefits
"The maximum adoption credit and exclusion amounts have been adjusted to reflect their 2017 values ... The adoption credit carryforward worksheet in the instructions for line 16, which identifies unused credits that taxpayers may carry forward to 2018, has been modified to reflect that carryforwards to 2018 cannot include 2012 credit carryforwards."
Thomson Reuters / EBIA

Executive Compensation
and Nonqualified Plans

Making Annual Bonus Payments Deductible in 2017 Using Section 162(m)
"[C]ompanies may be able to accelerate into 2017 the vesting, taxation, and deductibility of some performance-based equity awards with performance periods that end on December 31, 2017.... The potential stumbling block is the 162(m) requirement that the 'compensation committee must certify in writing prior to payment of the compensation that the performance goals and any other material terms were in fact satisfied.' However, there are several possibilities for satisfying that requirement in 2017."
Winston & Strawn LLP

Sponsoring a Non-Qualified Deferred Compensation Plan? Don't Forget the FICA Tax! (PDF)
"[It] is not unusual to find ... FICA withholding is overlooked when the contributions are from the employer.... It is better to have language in the plan that does not require you to pay the FICA taxes when the contributions vest, so that if you inadvertently fail to do so you are not in violation of the plan and potentially liable to participants for any increase in their FICA tax at distribution ... If you determine that FICA tax has not been withheld properly for previous periods, you will likely want to correct the error so that FICA will not be due on distribution."
Boutwell Fay LLP

Non-Qualified Deferred Compensation: Not Just for Large Companies (PDF)
"In the same way that large corporations benefit from a NQDC plan for highly compensated employees, so do many small companies, including Sub-S Corps and LLCs. Companies of all sizes can use these plans to retain specific, high performing employees, avoid discrimination testing in the 401(k) plan, create important retention mechanisms, and overall, create a unique wealth accumulation vehicle benefitting the company and its key employees."
Fulcrum Partners, LLC

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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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