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[Guidance Overview]
What the Proposed Rule on Association Health Plans Means for Employers
"The lack of ERISA preemption could be a significant impediment to cost-effective implementation of self-funded AHPs. Currently, many states highly regulate (or prohibit altogether) self-funded MEWAs. On the other hand, implementation of insured AHPs could be a viable structure for some employer groups.... If the issue of preemption of state laws is not resolved by final rule, then it is difficult to see how permitting self-funded AHPs on the federal level would accomplish much, given that many states would continue to require such AHPs to be regulated as insurers."
Drinker Biddle
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Walmart Adds Adoption Benefit, Expands Parental Leave
"Walmart will expand its U.S. leave policy to 10 weeks of paid maternity leave and six weeks of paid parental leave. Salaried associates also will receive six weeks of paid parental leave. Previously, full-time hourly workers were eligible for up to eight weeks of paid maternity leave and two weeks of paid parental leave, while hourly workers received half pay during family leave. The benefit also applies to parents who adopt, Walmart said."
Employee Benefit News
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Transforming the Federal Individual Mandate Into State Health Insurance Down Payments
"[Under the proposal, when] uninsured Marylanders ... file state income tax returns, they will receive notice that, unless they would rather pay a penalty and get nothing back, their money will instead be used as a down payment to help them buy insurance.... [T]he Maryland health insurance exchange will see whether the consumer is offered a plan that costs no more than the down payment plus any federal premium tax credit (PTC) for which the consumer qualifies. If such a plan is available, the consumer is enrolled, at zero additional cost.... If no zero-cost plan is available, the down payment is saved in an interest-bearing account that the consumer can use to buy insurance during the next open enrollment period."
Families USA
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Multiple Security Failures Lead to $2.3 Million HIPAA Settlement
"This is the first resolution agreement publicly announced in several months, but the size of the settlement payment and the strict terms of the CAP indicate that OCR continues to take HIPAA privacy and security compliance seriously. More robust audit controls might have enabled this provider to discover the unauthorized disclosures before the FBI did -- potentially avoiding OCR's investigation and the attendant ramifications."
Thomson Reuters / EBIA
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Whither Private Health Insurance Now?
"Congress has been busy enacting and proposing changes to the [ACA's] regulation of private health insurance, from repealing the tax on individuals without minimum essential coverage to the Alexander-Murray bill intended to shore up the private market. These changes do not play well together. Three reasons are explored here: the great wall, which divides advocates with different goals; whipsawed insurance markets, in which insurers are simultaneously pulled in different directions; and, of course, the cost of care, which each reform shifts onto different entities."
Health Affairs
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Centene Sued Over Provider Networks in ACA Exchange Plans
"Centene, an insurer that has thrived on the [ACA] exchanges, is facing a federal lawsuit alleging its plans fail to provide adequate access to in-network providers.... The lawsuit accuses Centene of 'selling junk plans on state exchanges and misleading enrollees about the plan benefits,' which violates the ACA's requirements that plans provide adequate coverage[.]"
FierceHealthcare
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[Opinion]
The Individual Insurance Market in 2018: Business as Usual?
"Claims that the exchange market is unstable are greatly exaggerated.... A stable market does not necessarily yield optimal social or fiscal outcomes. Instead of achieving the ACA's goal of (near-) universal coverage, middle-class families who do not have access to employer coverage will continue to be squeezed out of the market. Those who have coverage will continue to see their costs rise as a result of an inefficient delivery system."
Health Affairs
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Benefits in General
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Employee Benefits Resolutions for 2018
"January is a great time ... to tidy up your employee benefit plan documents! ... Re-evaluation of your benefits advisers (third party administrators, investment advisers, auditors and even us attorneys) is not only good common sense, it's required under ERISA.... [C]arefully review cybersecurity protections offered (or perhaps not offered) by service providers.... Review electronic distribution of benefit plans.... [W]hy not try out some new benefits?"
Mintz Levin
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No Further Delay for Disability Claim Procedure Rules, DOL Says
"The Final Rule adds several new requirements for the processing of claims and appeals for disability benefits, including the following: Explanation of reasons for denial ... Statements regarding claim file and internal protocols ... Limitations on denials based on new information ... Avoidance of conflicts of interest ... Deemed exhaustion of claims procedures ... Coverage rescissions ... Communication requirements in non-English languages."
Winston & Strawn LLP
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Executive Compensation
and Nonqualified Plans
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[Guidance Overview]
Nonprofits and Governments Face Compensation and Benefits Issues Under the New Tax Law
"What employers are covered? What employees are covered? What compensation is covered? What is excess compensation? What are excess severance benefits? How do these rules differ from the comparable rules for taxable employers? How does the tax on excess compensation differ from the 'reasonable compensation' rules? How do the excise taxes affect the ability to promote medical employees to other positions? How do the excise taxes affect deferred compensation? How does the excise tax affect fringe benefits?"
Venable LLP
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[Guidance Overview]
New Code Section 83(i): Qualified Equity Grant Programs Permit Employees to Elect to Defer Income Taxes on Stock Options or RSUs (PDF)
"[W]hen an employee vests in a qualified equity grant, the employee can elect to defer for up to five years the income taxes that otherwise would be due on the date the stock vests or is transferred to the employee.... [W]hen an employee makes a Code section 83(i) deferral election, the 'deferral stock' begins its holding period for long-term capital gain tax treatment on the date the qualified stock is transferred to the employee, even though the employee will not pay taxes on the value of the qualified stock for up to five years."
Trucker Huss
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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 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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Sr. Benefits Analyst
