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[Guidance Overview]
Four Items to Consider in Light of IRS Letter 226J
"Each Letter 226J [the author] reviewed in private practice has had egregious errors.... [T]he codes an employer entered on lines 14 and 16 of the Form 1095-C was a determining factor (or at least a theoretically determining factor) whether an employer received a Letter 226J.... While little can be done in 2016 and 2017 it is critical that all employers know when an employee is a full-time employee and needs to be offered coverage in order to avoid the section 4980H penalties.... [A]ll employers should be recording their offers of coverage and retaining signed waivers of coverage."
Accord
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DOL Issues Proposed Regs to Expand Association Health Plans
"[T]he proposed rule would broaden the definition of 'employer' under ERISA and related regulations by: [1] Relaxing the requirement that associations sponsoring AHPs must exist for a reason other than offering health insurance; [2] Relaxing the requirement that association members share a common interest ... [3] Allowing associations whose members are in the same industry but in different areas to sponsor AHPs; [4] Clarifying that 'working owners' (the self-employed) and their dependents may participate in AHPs.... Comments on the proposed regulations are due by March 6, 2018."
Willis Towers Watson
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CMS Releases 2017-2026 Projections of National Health Expenditures
"National health expenditure growth is expected to average 5.5 percent annually over 2017-2026 ... Medicare is projected to experience the most rapid annual growth at 7.4 percent, largely driven by enrollment growth and faster growth in utilization from recent near-historically low rates.... Private health insurance spending is projected to average 4.7 percent over 2017-2026, the slowest of the major payers ... [S]pending growth is projected to be fastest for prescription drugs, averaging 6.3 percent for 2017-2026." [Full report is available on CMS website.]
Office of the Actuary, Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]
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Despite Uncertainty, Fundamentals Are Primary Driver of Projected Spending Growth
"Projected national health spending and enrollment growth over the next decade is largely driven by fundamental economic and demographic factors: changes in projected income growth, increases in prices for medical goods and services, and enrollment shifts from private health insurance to Medicare that are related to the aging of the population. The recent enactment of tax legislation that eliminated the individual mandate is expected to result in only a small reduction to insurance coverage trends."
Health Affairs
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Amazon 'Pouring Gasoline on the Fire': Health Plans Must Respond
"Health plans may be facing the same upheaval that Amazon brought to retailers.... Customer service will become a top priority ... as consumers gravitate toward ... whatever turns out to be the healthcare equivalent of free two-day delivery for your books and other purchases.... That could include everything from leveraging Amazon's Echo technology into the electronic medical record to using the company's delivery expertise to improve the supply chain and its purchasing power to lower the cost of drugs[.]"
HealthLeaders Media
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Receiver for Out-of-Business HIPAA Business Associate Reaches $100,000 Settlement with HHS
"In addition to the $100,000 payment, the receiver agreed, on the company's behalf, to comply with a corrective action plan (CAP). The receiver had already placed the medical records at issue into storage with a third-party information management company. The CAP requires the receiver to properly store and dispose of these remaining medical records."
Thomson Reuters Practical Law
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Benefits in General
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[Guidance Overview]
New DOL Regs Require Changes to Plan Claims Procedures
"One could avoid dealing with the new regulations by referencing a third-party determination of disability, such as a determination by the Social Security Administration. The practical problems with that approach are that the Social Security Administration can take a long time to determine that a disability exists, and the SSA definition may be a more restrictive definition of disability, which could raise employee relations concerns. Also, in the qualified retirement plan area, a more restrictive definition may result in an impermissible cut-back of an accrued benefit, such as where a retirement subsidy attaches to a finding of a disability."
Davis Wright Tremaine LLP
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Executive Compensation
and Nonqualified Plans
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How Compensation Committees Should Treat the CEO Pay Ratio Disclosure
"Typically, compensation committees perform certain activities such as reviewing CEO performance and setting CEO pay which is mandated by their charters with minimum requirements dictated by their listing exchange.... SEC counsel generally likes to keep these charters focused, although [the authors] have seen some with more detail about additional responsibilities, and some that expand the committee's role based on a company's unique circumstances."
Willis Towers Watson
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BenefitsLink.com, Inc.
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Lois Baker, J.D., President
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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