Health & Welfare Plans Newsletter

January 11, 2018

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[Guidance Overview]

Proposed AHP Regs Include Welcome Changes for Employers But Would Present State Regulatory Challenges
"MEWAs have historically attracted fraudulent schemes and operators. It has been the states, and not the Federal government, that have typically taken the lead in policing MEWAs. The proposal would change this. State regulators will also be worried about the impact of the proposal on their small group markets, which could be fragmented by the expanded adoption of AHPs."
Alden Bianchi, Mintz Levin

[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.


[Guidance Overview]

DOL to Expand Association Health Plans
"Under the proposal, AHPs would not be required to comply with all provisions of the ACA. For example, their group health plans would not have to cover all of the 10 essential health benefits' (which include hospitalization, prescription drugs and emergency care). They would also be exempt from an ACA rule requiring insurers to spend at least 80 percent of premium revenue on medical care."
The Wagner Law Group

[Guidance Overview]

DOL Sets April 1 as Applicability Date for Final Disability Claim Regs
"Although the news release indicates that the DOL has decided on an April 1 applicability date, the regulatory provision modified by the November delay specifies that the regulations will apply to claims filed after (not on) April 1, 2018. Plan sponsors and administrators will need to administer claims under two sets of rules, depending on when the claim was filed. And keep in mind that the disability claim regulations affect any benefit claim that involves a determination of disability by the claims adjudicator, not just claims under disability plans."
Thomson Reuters / EBIA

[Guidance Overview]

New Year Brings New Employer Healthcare Taxes in Massachusetts
"The increase in the EMAC tax and the new Supplement tax are both temporary and only apply for 2018 and 2019 ... The EMAC Supplement tax is a new employer assessment of 5% of wages up to the $15,000 unemployment wage base -- $750 maximum -- that applies for any non-disabled employee (including full-time and part-time) who obtains: Health coverage through MassHealth (excluding the premium assistance program), or Subsidized health insurance coverage from the Massachusetts ACA marketplace (Massachusetts ConnectorCare)."
Conduent

The Proposed Association Health Plan Rules: Implications for Professional Employer Organizations
"The Proposed AHP Rule does not reference PEOs or PEO-sponsored coverage, and accordingly, does not directly implicate or call into question a PEO's ability to sponsor health coverage. However, it does have the potential to significantly impact the coverage options available to small employers, and therefore could have a profound effect on PEOs as drafted.... Notably, ... the Proposed AHP Rule imposes fairly rigorous nondiscrimination requirements that may make it difficult for AHPs and their carriers (if the AHP is fully insured) to secure relatively preferential risk from the community-rated insurance markets or even manage the ongoing risk profile of the AHP long-term."
NAPEO

[Advert.]

Complying With W-2 Rules for Reporting Health Care Benefits and HSA Reporting Rules

Sponsored by Lorman and BenefitsLink

Jan. 17 webinar. Learn how to properly complete applicable tax forms and how to communicate relevant tax-reporting information to employees, as well as the due dates for each form. BenefitsLink discount.


Why It May Be Getting Harder to Move Employees Into CDHPs
"For employers that want to both provide choice and manage cost ... the challenge is to steer employees to most cost-efficient level of coverage that makes sense for their financial situation and healthcare needs. Decision-support tools and other resources can empower them to choose the right plan and then get the most out of it ... [A] bundled solution can make sense for some employers, to ensure their employees have access to best-in-class programs that can add value to a high-deductible medical plan."
Mercer

Consumers, Healthcare Organizations Unaligned on Value-Based Drug Pricing
"Most patients (74 percent) are interested in outcomes-based drug pricing, yet the majority of healthcare organizations (59 percent) are not yet working with drug manufacturers to track care outcomes -- and have no plans to do so."
BDO Center for Healthcare Excellence and Innovation

HHS Nominee Sees PBMs as Tool to Lower Drug Costs
"Alex Azar, President Donald Trump's nominee to be the next secretary of HHS, suggested during his testimony before the Senate Finance Committee that pharmacy benefit managers (PBMs) would be the most effective tool to negotiate for lower drug costs, and said that PBMs should negotiate physician-administered drugs covered under Medicare Part B."
American Journal of Managed Care

Your 2018 Benefits Resolution? Get the Most Out of What You Have
"[E]mployers may have to change their understanding of what benefits mean to the modern worker ... Personalization ... has become vital for those who seek to re-shape the way workers use their benefits.... [M]ost large companies tend to confine the release of information to open enrollment season.... [E]mployees are almost certainly more likely to ask about coverage when a problem arises."
HR Dive

Benefits in General

[Guidance Overview]

The Impact of Tax Reform on Qualified Plans and Fringe Benefits
"[1] Are there changes to the plan loan rollover rules? ... [2] What favorable tax treatment is available for plan distributions to individuals living in 2016 disaster areas? ... [3] Are there any changes to the plan hardship distribution rules? ... [4] What happened to Rothification? ... [5] Fringe benefits are generally excluded from an employee's income. Are there any changes to these rules? ... [6] Does the Act change the tax treatment or deduction of meals provided to employees for the convenience of the employer?"
Drinker Biddle

[Guidance Overview]

DOL Green-Lights Disability Claims Regs
"The regulations will apply to most -- but not all -- claims where benefits are conditioned on a finding of disability. This may include certain benefits under retirement plans, in addition to benefits under long-term disability plans and some short-term disability plans.... [T]here are significant exceptions where the regulations will not apply.... A chart [comparing current law with] the new regulations is provided[.]"
Vorys

Executive Compensation
and Nonqualified Plans

Deadlines Approach for Employer Reporting of 2017 ISO and ESPP Transactions
"The deadline for furnishing Copy B of Forms 3921 and 3922 to the employee or former employee for ISO exercises or ESPP shares purchased during 2017 is January 31, 2018. The deadline for filing Copy A of Forms 3921 and 3922 with the IRS depends on whether the returns are required to be filed electronically or manually.... These reporting obligations are in addition to any reporting obligations that arise upon the disqualifying disposition of shares acquired under either an ISO or an ESPP or upon the exercise of an option that does not qualify as an ISO."
Latham & Watkins

Looking for a Silver Lining in the 162(m) Tax Act Changes
"Eliminating the deductibility of performance-based compensation reduces the need for a company to base a substantial portion of its annual compensation on performance factors.... Eliminating the requirement that the performance goals must be established by a compensation committee comprised solely of two or more outside directors will give companies the flexibility to include on their compensation committees board members who would not have qualified as 'outside directors' under the requirements of Section 162(m).... Eliminating the requirement that the material terms of any performance goals must be disclosed to and subsequently approved by the company's shareholders before the compensation is paid will give the compensation committee flexibility to select any performance metrics it wants."
Winston & Strawn LLP

How Can a Tax-Exempt Employer Manage the New Excise Tax on Executive Comp?
"[T]ax-exempt employers may be able to mitigate (or at least manage) the sting of the new excise tax through a combination of traditional supplemental executive retirement plans and long-term incentive plans, and (where possible) well-designed non-competes that comply with the proposed regulations under Code Section 457(f) published last year. In ideal circumstances, a tax-exempt employer may even be able to avoid the excise tax entirely."
Verrill Dana LLP

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2018 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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