Health & Welfare Plans Newsletter

January 22, 2018

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Jobs

ESOP Administrator
Blue Ridge ESOP Associates
in VA, Telecommute

Senior Defined Contribution (DC) Analyst
Retirement Horizons, Inc.
in TX

DC Plan Administrator
The Benefit Advantage, Inc.
in MI, Telecommute

Business Relationship Consultant
Aspire Financial Services LLC
in FL

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[Guidance Overview]

Avoiding the Accidental MEWA
"To become a MEWA, a plan needs only to cover employees of two or more employers. Because intent is irrelevant, an employer can find itself inadvertently creating a MEWA if it allows employees of other employers or nonemployees to participate in its welfare plan.... Once a MEWA, a plan can face penalties of more than $1,500/day for failing to timely file the DOL's Form M-1, regardless of whether the plan administrator was aware of the requirement."
Fox Rothschild LLP

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[Guidance Overview]

Maryland Becomes Ninth State to Require Paid Sick Leave
"The Act is scheduled to take effect on February 11, 2018, and allows employees to accrue leave as of January 1, 2018.... [T]he General Assembly may delay the Act's implementation in order to provide the state time to draft regulations and employers additional time to comply with the Act's requirements."
Morgan Lewis

[Guidance Overview]

New York Paid Family Leave Is Now in Effect
"[If] you haven't done so already, [you must] obtain PFL coverage from your insurer, similar to the way in which you've secured disability coverage under New York's Disability Benefits Law (DBL).... While you were permitted to start making deductions last summer, as of January 1, 2018, you are required to make these deductions.... You should educate your employees about the new law in several ways ... This law differs from FMLA and requires employers and employees to complete forms and provide information that is distinct from what is required by the FMLA."
Mintz Levin

Despite Letter Referencing FMLA Leave, Employee Was Not Eligible
"An administrative assistant who was not allowed to return to work after taking multiple leaves of absence ... did not dispute that the defendants employed fewer than 50 employees within 75 miles of her worksite and, even though the employer referenced the exhaustion of her 'FMLA' leave by letter, she did not show that she detrimentally relied on the misrepresentation[.]" [Schuler v. The Dow Chemical Co., No. 14-1043 (W.D.N.Y. Jan. 2, 2018)]
Wolters Kluwer Law & Business

HIPAA Breach Reporting: 2017 Trends and Mends
"OCR data shows that HIPAA privacy breach reports affecting 500 or more individuals remained relatively stable when compared to 2016, increasing slightly from 327 to 345. Hacking and IT incidents, however, rose by 25%, with 142 in 2017 compared to 113 in 2016."
McGuireWoods, LLP

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EEOC Wins Some Freedom for Any Wellness Plan Rule Redo
"[T]he [EEOC] told Judge John D. Bates it believed he overstepped his authority in December when Bates said the agency must notify the public by Aug. 31, 2018, if it plans to amend the rules. [T]he EEOC said that whether it chooses to rework the rules -- and on what time schedule it does so -- should be within the agency's policy-making discretion. The U.S. District Court for the District of Columbia on Jan. 18 agreed. It issued a two-page order freeing the EEOC from that requirement." [ AARP v. EEOC, No. 16-2113 (D.D.C., motion for reconsideration partly granted Jan. 18, 2018)]
Bloomberg BNA

What Do Workplace Wellness Programs Do? Evidence from the Illinois Workplace Wellness Study
"[D]uring the year prior to the intervention, program participants had lower medical expenditures and healthier behaviors than non-participants. However, we do not find significant causal effects of treatment on total medical expenditures, health behaviors, employee productivity, or self-reported health status in the first year.... [R]esults suggest these programs may act as a screening mechanism: even in the absence of any direct savings, differential recruitment or retention of lower-cost participants could result in net savings for employers."
National Bureau of Economic Research [NBER]

Association Health Plans to the Rescue?
"This [article] discusses: [1] existing law and how it limits the formation of AHPs; [2] the changes in the proposed rule; and [3] the potential benefits and drawbacks of the administration's approach to AHPs."
Greensfelder

The Association Health Plan Regs: Who Wins, Who Loses?
"[T]he proposed regulation applies only to fully-insured AHPs, which are already subject to state laws governing solvency. In contrast, it is self-funded MEWAs that are more prone to fraud.... The impact of the proposal on state risk pools goes to the heart of the debate over AHPs.... Despite the proposed regulation's non-discrimination rules, ... concerns over AHPs operating across state lines remain valid.... AHPs could ... offer less comprehensive and more affordable coverage, which the Department touts as an advantage of AHPs.... The Department assumes that widespread access to, and adoption of, AHPs by small employers will result in a net savings of administrative expenses ... There is no guarantee, however, that these savings will be passed along to members."
Mintz Levin

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Actions States Can Take to Protect Their Health Insurance Markets
"[These] are in addition to steps many states have already taken (e.g., directing insurers to reflect the cessation of cost-sharing reduction payments solely in premiums for silver plans and working with insurers to ensure coverage is available in all areas).... [1] Restore the individual mandate ... [2] Improve affordability ... [3] Limit substandard plans ... [4] Protect health benefits ... [5] Get people covered."
Health Affairs

Removal of Actuarial Value Requirements for ACA-Compliant Pediatric Standalone Dental Plans
"ACA-compliant pediatric standalone dental plans no longer have to meet any particular [actuarial value (AV)] range. There was no change to the out-of-pocket maximum requirement. This change in policy provides new flexibility for dental issuers and closer alignment of pediatric dental benefits between standalone dental plans and pediatric coverage embedded within an ACA medical plan."
Milliman

Executive Compensation
and Nonqualified Plans

[Guidance Overview]

2018 Deadlines Approach to Furnish ISO and ESPP Information Statements and Returns
"[A] corporation [must] furnish a written statement to any employee or former employee who either [1] exercised an incentive stock option (ISO) ... during 2017 or [2] during 2017 first transferred legal title to shares acquired under the corporation's employee stock purchase plan (ESPP).... The corporation must furnish these statements on Forms 3921 and 3922 no later than January 31, 2018.... [C]orporations [also] must file returns with the [IRS] on Forms 3921 and 3922 no later than February 28, 2018, if filed on paper, or April 2, 2018, if filed electronically."
DLA Piper

Selected Discussions
on the BenefitsLink Message Boards

1095-C When Both Spouses Work for Same ALE?
Both spouses work full-time for the same ALE. Husband enrolls in family coverage and covers his spouse and children. The instructions for Form 1095-C provide that in such as case "the enrollment information should be reflected only on Form 1095-C for the employee who enrolled in the coverage. (However, it would report the other employee family members as covered individuals)." This makes sense. My question is whether a Form 1095-C needs to be completed and delivered separately for the spouse. (The Instructions also state that one Form 1095-C needs to be completed for each full-time employee.) If one does need to be completed, what codes should be used for the spouse? There's probably no requirement that a form be completed for the spouse but I have not found any guidance specifically saying so.
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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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