Health & Welfare Plans Newsletter

January 30, 2018

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Jobs

Plan Document & Compliance Specialist
Northeast Professional Planning Group, Inc.
in NJ

Employee Benefits Associate
Thompson Hine LLP
in OH

Education Director
Retirement Industry Trust Association [RITA]
Telecommute

Client Service Manager, Retirement Plan Services
Charles Schwab
in OH

►See 110 Jobs

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Webcasts, Conferences

Workplace Compliance Spotlight: Tax Reform Is Here -- Understanding the Impact, Part 1
February 8, 2018 WEBCAST
ADP

Upcoming Changes with HIPAA - 2018
February 15, 2018 WEBCAST
MentorHealth

Workplace Sexual Harassment: How Much Do You Know?
February 15, 2018 in GA
Worldwide Employee Benefits Network [WEB] - Atlanta Chapter

EBIA Employee Benefits Seminar
May 8, 2018 in MA
Thomson Reuters / EBIA

►See 137 Upcoming Webcasts and Conferences

►See 1377 Recorded Webcasts


Discussions

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New Comments and Topics

All Topics, Grouped by Forum


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[Guidance Overview]

IRS Q&As on 2017 Moratorium for Health Insurance Provider Fee
"[1] Under the 2019 moratorium, is there a health insurance provider fee in 2019? ... No.... [2] Must Form 8963 be filed in the 2019 fee year? ... No.... [3] Do the 2017 or 2019 moratoriums affect the 2018 fee year? ... No.... [4] Does the 2019 moratorium apply to fee year 2019 or data year 2019? ... The 2019 moratorium applies to fee year 2019.... [5] How do the 2017 and 2019 moratoriums affect the filing obligation or fee amount for the 2018 fee year? ... The 2017 and the 2019 moratoriums have no effect on the filing obligation or fee amount for the 2018 fee year."
Internal Revenue Service [IRS]

[Advert.]

Employer Health Care Cost & Quality Congress | Washington DC

Sponsored by World Congress

4/29-5/2/2018 in Washington DC. This event brings together Employers, Brokers, and TPAs. Qualified HR & Benefits Professionals may attend as our guest – See website for details/restrictions & to apply.


ERISA Doesn't Preempt Montana's Mental Health Parity Law
"A federal district court ... determined that ERISA did not preempt Montana's mental health parity law and that the state law was therefore applicable against [a] long-term disability insurer. The court reached this conclusion because the state law regulated health insurance policies and was directed at entities that engage in insurance." [Sand-Smith v. Liberty Life Assurance Co. of Boston, No. 17-0004 (D. Mont. Sept. 20, 2017)]
The Wagner Law Group

Massachusetts Issues Employer Assessment Regs
"These employer assessments are intended to curb the growing cost of the state's public health programs and are offset by lower state unemployment insurance rates. Both the higher assessments and lower unemployment rates are scheduled to sunset in two years. Massachusetts employers with six or more employees in the state must also submit employer health care coverage forms annually."
Willis Towers Watson

Idaho 'Pushing Envelope' With Health Insurance Plan: How Far Can It Go?
"Idaho's approach has national implications because of a key underlying question: Will the administration compel Idaho to follow the ACA or offer a green light that could prompt other states to take even more sweeping action?"
National Public Radio

Amazon, Berkshire and JPMorgan Chase to Partner on Health Care
"Amazon, Berkshire Hathaway and JPMorgan announce a partnership to cut health costs and improve services for employees. The idea is to create a company that would be "free from profit-making incentives." News of the deal slammed suppliers in the industry including Express Scripts, Cigna, CVS, United Health and Aetna."
CNBC

[Advert.]

Defined Contribution Health Plan Update

Sponsored by Lorman and BenefitsLink

February 1 webinar. What is the future of a defined contribution health benefit plan? BenefitsLink discount.


An ER Visit, a $12,000 Bill, and a Health Insurer That Wouldn't Pay
"In recent years, Anthem has begun denying coverage for emergency room visits that it deems 'inappropriate' because they aren't, in the insurance plan's view, true emergencies. The problem: These denials are made after patients visit the ER, sometimes based on the diagnosis after seeing a doctor, not on the symptoms that sent them ... The policy has so far rolled out in four states: Georgia, Indiana, Missouri, and Kentucky."
Vox

Family Crisis or New Joy? Get Paid Time Off for It
"Starting this month, [California's Paid Family Leave] program addresses some of the obstacles: Now you can receive up to 70 percent of your pay, depending on your income, up from 55 percent. And the previously required seven-day waiting period is going away, which means your benefits can kick in on the first day you need them.... You may qualify for the program if you work for an employer of any size, in the public or private sector, or even for yourself, so long as you have recently contributed to the program."
Kaiser Health News

Fact Sheet: State Contraceptive Equity Laws
"[State] Contraceptive Equity bills improve upon the federal provisions to: [1] Require coverage of all FDA-approved contraceptive drugs, devices, and products, beyond the ACA requirement of one covered contraceptive method in each of 18 categories.... [2] Strictly limit the ability of insurers to impose restrictions and delays ... [3] Require coverage of over-the-counter (OTC) contraceptives without a prescription. [4] [Eliminate] cost-sharing for contraception, voluntary sterilization, and contraceptive counseling for men."
National Health Law Program [NHeLP]

Oscar Health's Telemedicine Consultations Up 32% in 2017 as More Members Access Virtual Touchpoints
"Oscar Health saw a 32% increase in telemedicine consultations among its members last year amid an overall increase in virtual services. Telemedicine consults are less utilized than the other digital services offered by the company: 25% of members used the service in 2017, up from 17% in 2016. But those figures outpace other telemedicine leaders."
FierceHealthcare

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[Opinion]

Medicare Advantage Versus ACA Marketplaces: Which Is Better?
"Based on MA's success relative to the ACA marketplaces in terms of marketplace strength and long-term stability, there are five policies that could be useful for the ACA marketplaces: [1] Raise enrollment in marketplace plans by increasing premium and cost-sharing subsidies and eliminating short-term plans; [2] Cap provider payment rates at Medicare rates or a fixed percentage above them; [3] Standardize cost-sharing within metal tiers, or limit the number of plan designs available; [4] Lift the budget neutrality requirement for risk adjustment in the marketplaces; and [5] Use a higher benchmark than the second-lowest-cost silver plan for calculating premium tax credits."
Robert Wood Johnson Foundation

Benefits in General

[Official Guidance]

Text of IRS Publication 15 (Circular E): Employer's Tax Guide, for Use in 2018 (PDF)
70 pages. "What's New -- 2018 federal income tax withholding.... Employers should implement the 2018 withholding tables as soon as possible, but not later than February 15, 2018.... P.L. 115-97 suspends the exclusion for qualified moving expense reimbursements from your employee's income beginning after December 31, 2017, and before January 1, 2026.... Reminders: ... Severance payments are subject to social security and Medicare taxes, income tax withholding, and FUTA tax."
Internal Revenue Service [IRS]

Executive Compensation
and Nonqualified Plans

[Guidance Overview]

New Tax Law Strengthens Limits on Excessive Compensation
"Companies should be careful in determining which arrangements are grandfathered. It is not enough that a compensation arrangement was set forth in a valid writing on November 2, 2017; it must meet other requirements to qualify for grandfathering. While the exact scope of this grandfathering rule will need to be clarified by the IRS, it appears to mean payments that would have been tax deductible under the old rule as performance-based compensation or commissions will continue to be deductible if they are made pursuant to a contract that satisfies the grandfathering rule."
Poyner Spruill LLP

District Court: No ERISA Preemption Where Determination of Benefits Was Non-Discretionary
"Under a recent decision from the Central District of California, employers may not be able to invoke ERISA preemption and remove cases to federal courts where the benefits claims at issue are not 'complex' and do not implicate administrative discretion." [Amlani v. Baker's Burgers, Inc., No. 17-2278 (C.D. Cal. Jan. 10, 2018)]
Seyfarth Shaw LLP

Selected Discussions
on the BenefitsLink Message Boards

Are Health Advocacy Benefits Reported on Schedule A of Form 5500?
The health advocacy type of benefit seem to be in a gray area as to whether Schedule A must be included. Such a benefit helps locate providers, addresses errors on bills/claims, answers questions on coverage, and assists with denials and appeals. Would you include it a Schedule A?
BenefitsLink Message Boards

Post-Employment Consulting and Separation from Service
An executive retires with a nonqualified plan benefit, but has an ongoing part-time consulting agreement that will continue for at least one year, under which services will be provided at approximately 25% to 35% of the time put in during the several years leading to retirement. He is considered an independent contractor during the consulting period. My understanding is that this is in the gray area between more than 20% and less than 50%, where there is no presumption as to whether the executive separated or not. My question is about language in regulation section 1.409A-1(h)(2)(ii), which states that, in the case of an independent contractor, "No amount will be paid to the service provider before a date at least 12 months after the day on which the contract expires under which the service provider performs services for the service recipient (or, in the case of more than one contract, all such contracts expire)." Assuming that the employer has treated executive as not separating from service, would that "12 months after expiration until you make payment" rule also apply in the situation where an employee transitions to an independent contractor?
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Press Releases

TRA Acquires Actuarial Consulting Services
The Retirement Advantage [TRA]

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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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