Health & Welfare Plans Newsletter

December 6, 2017

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HORAN Retirement Advisors
in OH

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Abacus Benefit Consultants, Inc.
in MA, RI

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Webcasts, Conferences

Employers to Be Notified of Penalties Under the Affordable Care Act: Know What to Expect and How to Respond
RECORDED
HRWebAdvisor

Affordable Care Act and Choosing a Retirement Solution
December 19, 2017 WEBCAST
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

2018 SALGBA Regional Conference
January 22, 2018 in NM
State and Local Government Benefits Association [SALGBA]

2018 National Conference: Benefit Times in the Sunshine
April 29, 2018 in FL
State and Local Government Benefits Association [SALGBA]

►See 88 Upcoming Webcasts and Conferences

►See 1359 Recorded Webcasts


Discussions

New Topics on the BenefitsLink Message Boards

New Comments and Topics

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Missing an Appeal Decision Deadline Can Change Policy Terms
"Employers have the right to amend long term disability plans at any time, and to apply the amended version even to employees receiving benefits under the original plan. But which policy applies during a lawsuit? The policy in effect when the ERISA cause of action accrued. And 'accrual' can occur when the claims administrator fails to render an appeal decision by the deadline prescribed in the ERISA regulations." [Vaccaro v. Liberty Life Assurance Company of Boston, No. 16-3220 (N.D. Cal. Nov. 20, 2017)]
Lane Powell PC

[Advert.]

Join EBRI's December 14 Policy Forum!

Sponsored by Employee Benefit Research Institute [EBRI]

Learn about recent EBRI research and hear perspectives on the latest retirement, health, and financial wellbeing research and policy developments from expert panelists. Learn more and register here (attendance is free of charge).


CVS-Aetna Merger Could Change How Employers Buy Health Benefits
"CVS and Aetna argue that their deal will lower health care costs for employees of their large corporate customers, giving the company greater clout to negotiate down drug prices and better manage the use of those medicines.... [One consultant] expects this will lead large companies to turn to their insurer for pharmacy benefits the same way midsize companies have."
Society for Human Resource Management [SHRM]

CBO Estimates of Federal Subsidies for Health Insurance for People Under Age 65: 2017 to 2027
21 presentation slides. "This presentation provides an overview of CBO and JCT's current projections of health insurance coverage and how those projections have changed since March 2016, highlighting changes in Medicaid and CHIP enrollment and nongroup coverage."
Congressional Budget Office [CBO]

Impact of Repealing Obamacare Mandate Could Be Softened
"If Congress enacts legislation to fund subsidies for low-income Obamacare enrollees and payments to insurers who cover sick people, that may help reduce premiums if penalties for lacking coverage are repealed ... The nonpartisan [CBO] has estimated in one report that eliminating the individual mandate would increase premiums about 10 percent ... In [another] analysis the CBO said that eliminating payments to insurers to cover the cost-sharing reductions (CSRs) they are required to provide to low-income people would increase premiums about 20 percent[.]"
Bloomberg BNA

[Opinion]

Doomsday Will Not Follow Repeal of Obamacare's Individual Mandate
"The assumption: Millions of Americans will buy Obamacare coverage -- regardless of whether they want it or like it -- because the government forces them to do it, and penalizes them if they do not. Do we have compelling evidence that this is, in fact, the case? No. Do we have evidence that the mandate is not the 'glue' holding everything together? Sure do."
The Heritage Foundation

[Advert.]

Online Learning Course: Family and Medical Leave Act (FMLA)

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Learn how to avoid common administration mistakes, implement best practices and be aware of interactions with other laws.


[Opinion]

The Decline of Employer-Sponsored Health Insurance
"[In] 2016, nearly a quarter of working-age adults with job-based coverage had such high out-of-pocket costs and deductibles relative to their income that they were effectively 'underinsured.' ... This is more than double what it was in 2003. And it is up sharply from 2014. Historically, most large firms have offered more comprehensive coverage than small ones, but remarkably, employees of firms with 100 or more employees were just as likely as those in smaller companies to be underinsured."
The Commonwealth Fund

[Opinion]

Will CVS-Aetna Merger Lower Costs?
"The real cost of health care is treating patients with severe diseases and/or multiple comorbidities. These more severely ill people-who make up the lion share of Aetna's costs-need to see specialists, not PCPs.... [T]he thought that there will be significant efficiencies from merging to very different business entities, markets and cultures likely is wishful thinking. The one key area where there could be cost savings is through lower drug prices.... One benefit of the merger is that health plans can internalize cost offsets."
Healthcare Economist

Benefits in General

Tax Reform: Comparison of Current Law with House-Passed and Senate-Passed Versions (PDF)
9-page chart compares current employee benefits and executive comp law with provisions included in House and Senate bills.
Groom Law Group

Senate Approves Tax Reform with Differences from House Version (PDF)
"On December 2, the Senate narrowly approved its own version of the Tax Cuts and Jobs Act. Earlier, the House approved a different version of this legislation ... The House has adopted a resolution to send the bills to a conference committee of members of both the House and Senate to resolve differences between the two versions." [7-page chart has side-by-side comparison of current law with the provisions of each bill, with comments.]
Mazursky Constantine LLC

Executive Compensation
and Nonqualified Plans

Preparing for Employee Reactions to CEO Pay Ratio Disclosure
"For many employees ... the real news will be the disclosure of the median employee's compensation. Employees will see quickly if they are paid more or less than the median employee not only at your company but also at other organizations within the same industry or geography. This information may change their perceptions with regard to their current compensation. So, what can you do to get ready to manage potential reactions from employees?"
Conduent

Discussions
on the BenefitsLink Message Boards

Employer to Adopt HRA While Ex-Employee on COBRA Coverage
Employer sponsors a group health plan. Employee terminates in 2017, elects COBRA coverage. Employer considering a modification of health coverage effective 1/1/2018 -- increasing deductibles, out of pocket expenses, etc., for everyone. To somewhat mitigate these effects, employer would institute an HRA. Would the employer be required to offer COBRA coverage on the HRA to this participant for the remainder of the COBRA period established as of the original date of termination of employment? I looked at some of the regulations; it seems to me that (under a "common sense" approach and looking at 54.4980B-3) because the "similarly situated" employees receive the HRA coverage, COBRA participants with the same health coverage should be able to be covered under the HRA. But perhaps a more appropriate reference might be 54.4980B-5, Q-4(c).
BenefitsLink Message Boards

Plan Received IRS Notice of Late 5500 Filing; DFVCP Available?
The plan was merged into another plan and the 2015 final (short plan year) Form 5500 was not filed. The plan sponsor received a notice from the IRS inquiring about the filing. We are proposing DFVCP. Will the IRS notice preclude them from filing under DFVCP? I'm reading that you can file under DFVCP as long as you don't receive a notice from the DOL but there is no reference to IRS.
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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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