Health & Welfare Plans Newsletter

December 12, 2017

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[Guidance Overview]

Texas Medical Board Substantially Revises Telemedicine Regs
"[T]he Board repealed two prior requirements that restricted the use of telemedicine in the state: [1] its requirement that the provider conduct an in-person evaluation prior to issuing a prescription, and [2] its requirement that telemedicine services be provided only at 'established medical sites.' ... The Board further relaxed restrictions on the provision of mental health services via telemedicine[.]"
Sheppard Mullin

[Advert.]

New Strategies and Effective Tools at HBCE -- Details Now Available!

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Using a powerful selection of employer case studies and expert led sessions, HBCE addresses critical topics like the opioid epidemic, solutions for a safe work environment, pharmaceutical cost containment and more. Full details available. Register Today!


[Guidance Overview]

San Francisco Increases Health Care Contribution Requirement
"Even though contributions are only owed for employees doing work within the city and county of San Francisco, the level of employer contribution is based on the number of workers (whether or not they are employees) the employer has worldwide."
HUB International

New York Paid Family Leave: How Do We Determine Tax Obligations?
"[T]ax issues raised by the NYPFL law [include]: Are employee premium payments withheld pre- or post-tax? Are employee premium payments subject to payroll taxes, such as FICA and FUTA? Are premium payments taxable if the employer pays on behalf of employees? Are benefits taxable to employees? How are tax payments or liabilities reported?"
Lockton

2018 Planning for Health & Welfare Benefit Plan Operations (PDF)
"[1] Employer reporting and shared responsibility enforcement ... [2] Wellness programs ... [3] Health and welfare plan nondiscrimination testing ... [4] HHS to reconsider prohibitions on gender identity, pregnancy termination discrimination ... [5] PCORI fee."
Conduent

Online Tool: The Health Spending Explorer
"This interactive tool provides up-to-date information on U.S. health spending by federal and local governments, private companies, and individuals."
The Peterson-Kaiser Health System Tracker

[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.


Are Drugs Cheaper Using Cash?
"Generic drugs reflect 80% of all drugs dispensed but account for less than 30% of an employer's prescription plan costs. The contracts intermediated by employers are largely targeting big-ticket items (brand and specialty drugs) ... even if they will get repeatedly outpriced on the lower-cost drugs as pricing apps, drugstores and generic manufacturers try to gain market share by publicizing cheaper alternatives to the health plan."
Frenkel Benefits

Experts Tell Congress How to Cut Drug Prices
"[1] Allow the federal government to negotiate drug prices ... [2] Speed approvals of safe and effective generics and biosimilars ... [3] Transparency ... [4] Discourage the pharmaceuticual industry's direct-to-consumer advertising ... [5] Limit what Medicare enrollees pay for drugs ... [6] Increasing oversight of a very specific federal drug discount program ... [7] Revise the Orphan Drug Act ... [8] Make sure doctors prescribe drugs for the right reasons."
Kaiser Health News

Cadillac Tax Dispute Complicates Congress' Talks Over Health Insurance Tax Delay
"The GOP, some Democrats and business lobbyists told the publication, may be planning to use the threat of the Cadillac tax as leverage next year -- when it's aiming to enact policies that limit the tax-exempt status of employer plans."
FierceHealthcare

What Happens If Tax Reform Scuttles Employers' Deduction for Commuter Benefits?
"One-third of recently polled employers (32.9 percent) offer incentives to employees who use mass transportation, carpool, bike or walk to work ... Among employers that offer mass transportation incentives, 56.8 percent have a pretax benefit program in place, enabling their workers to exclude mass transit or carpool costs from their gross taxable income."
Society for Human Resource Management [SHRM]

Employees Fail to Take Advantage of Health Savings Accounts
"To encourage greater participation, a majority (62%) of employers that offer HSAs are giving their employees a head start by contributing seed money to these accounts. In 2017, median seed amounts ranged from $300 to $750 for employee-only coverage and $700 to $1,400 for family coverage, depending on whether employers offered automatic seed money or automatic plus 'earned' seed money."
Willis Towers Watson

[Opinion]

Letter from Trade Groups to Congress Requesting Relief from Cadillac Tax by Year End (PDF)
"The Cadillac tax must be addressed well in advance of the implementation date to spare employees from even higher deductibles and copays. We are once again approaching that critical two-year window prior to which Congress must act to prevent cost increases and benefit reductions that will hurt millions of American families."
Employers Council on Flexible Compensation [ECFC] and 36 other employer and trade organizations

Benefits in General

Text of Amicus Brief to Supreme Court: Claim for Misrepresentation-Based ERISA Fiduciary Breach Requires Participant's Detrimental Reliance
"The Second Circuit's holding that reliance is not an element of a claim for misrepresentation-based fiduciary breach is squarely at odds with the other courts' decisions and the ERISA principles underlying them. But the holding also sanctions claims that are jurisdictionally infirm. A plan participant who did not rely on a misleading communication has no standing to challenge it, because she cannot establish an injury -in-fact that was caused by the alleged ERISA violation.... Plaintiffs' real concern here -- the implementation of less advantageous plan terms -- derives from plan sponsor decisions that are permitted by ERISA, not from the defective communications plaintiffs now challenge." [Osberg v. Foot Locker, Inc., No. 15-3602 (2d Cir. July 6, 2017; cert. pet. filed Nov. 8, 2017)]
American Benefits Council

DOL Extends Relief for Victims of Hurricane Maria and October California Wildfires (PDF)
"DOL will not pursue ERISA violations against plans that are complying with IRS relief in connection with hardship withdrawals and loans of Hurricane Maria and October 2017 California wildfire victims. Additionally, DOL extended certain ERISA deadlines for plan sponsors, participants, and beneficiaries affected by Hurricane Maria -- in some circumstances on a mandatory basis."
Conduent

[Opinion]

American Benefits Council Letter to DOL on Claims Procedure for Plans Providing Disability Benefits
14 pages. "[We] urge the Department to [1] delay the application of the Final Rule as long as needed to permit the Department to engage in fulsome analysis of the potential effects of the Final Rule's provisions, and [2] take the necessary steps to strike a more appropriate balance between the goal of ensuring a full and fair review of all claims with the need for continued employee access to affordable disability coverage."
American Benefits Council

Press Releases

Equius Partners is Certified for Fiduciary Excellence
Centre for Fiduciary Excellence [CEFEX]

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Lois Baker, J.D., President  loisbaker@benefitslink.com
David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
Holly Horton, Business Manager  hollyhorton@benefitslink.com

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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