Health & Welfare Plans Newsletter

February 19, 2018

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Severance Pay Plans & ERISA
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Proskauer Rose LLP

New DOL Disability Claims Regulations: Effects on Employee Benefits and Nonqualified Compensation Plans
March 27, 2018 WEBCAST
Strafford

Annual Clients and Friends Seminar
May 10, 2018 in MD
Smith & Downey, P.A.

Advanced ERISA Benefit Claims Litigation
May 17, 2018 in IL
American Bar Association Joint Committee on Employee Benefits [JCEB]

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[Official Guidance]

Text of Official FAQs on Maryland Health Working Families Act (PDF)
10 pages. "These FAQs are preliminary responses ... and may be subject to change ... [1] Applicability and eligibility ... [2] Calculation of the 15-employee threshold ... [3] Sick Leave accrual and tracking requirements ... [4] Permissible uses of earned Sick and Save Leave ... [5] Employer verification of Sick and Safe Leave use ... [6] Rehire requirements ... [7] Specific categories of employees."
State of Maryland Department of Labor, Licensing and Regulation

[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.


[Guidance Overview]

New 2018 Federal Poverty Guidelines Affect ACA Safe Harbor
"[If] the cost of self-only coverage under an employer's lowest-cost minimum value plan is no more than 9.56% (for 2018) of the single Federal Poverty Guideline applicable to that individual for that year, then it will be treated as affordable. For 2018, the mainland Federal Poverty Guideline is $12,140 ... [To] satisfy the safe harbor ... the monthly premium amount cannot exceed $96.71[.]"
HUB International

[Guidance Overview]

Does Anything Good Happen After Midnight? Austin, Texas Adopts Paid Sick Leave
"At approximately 1:00 a.m. CST on February 16, 2018, the Austin, Texas City Council approved an ordinance establishing a paid sick leave requirement that will apply to all private employers located within the City.... Employees are covered by the ordinance if they perform at least 80 hours of work for pay annually within the City of Austin.... [E]mployees are entitled to earn 1 hour of sick time for every 30 hours worked in the City. Sick time will begin accruing when employment commences or when the ordinance takes effect, whichever is later."
Littler

[Guidance Overview]

Austin's Earned Sick Time Ordinance: Things You Need to Know
"When does the ordinance take effect? ... Whom does the ordinance affect? ... What does the ordinance require? ... What qualifies as sick time? ... How much sick time can employees accrue and use? ... Which records must employers maintain, provide, or display? ... Are there other requirements? ... How will the ordinance be enforced?"
Ogletree Deakins

Does a Change to a Group Health Plan's Employee Contribution Create a Change in Status Opportunity?
"[An] employee's ability to adjust his or her election depends: [1] on whether the applicable plan documents include language permitting cost-related election changes; and [2] whether the group health plan's cost change would be considered 'significant' or 'insignificant.' "
HUB International

[Advert.]

Now is a great time to join Worldwide Employee Benefits Network (WEB)

Sponsored by WEB - Worldwide Employee Benefits Network

WEB members represent more than 25 professions and 30 areas of expertise within the pension and benefits industry -- administrators, consultants, attorneys, accountants, investment managers, communications experts and benefits managers. Join today.


HHS Provides a Glimpse of Mental Health Parity Enforcement
"[HHS] released its report of enforcement actions under the Mental Health Parity and Addiction Equity Act ... primarily [for] governmental plans and, in certain states, health insurance issuers.... The key takeaways are: ... [1] If you get wind of a requirement that seems to be imposed more restrictively on mental health/substance use disorder benefits, raise it with your insurer or third party administrator. [2] Make sure your plan documents reflect reality. If you are imposing rules on participants, the plan documents should reflect that."
HUB International

Anthem Alters Controversial Emergency Room Coverage Policies
"Anthem's program was meant to deter members from using the emergency room for illnesses or injuries that aren't life-threatening. But critics say patients shouldn't be forced to self-diagnose, warning that the new policies will encourage people to avoid seeking care for serious medical conditions out of fear that their claim will be denied."
FierceHealthcare

HHS Sidesteps Idaho Dispute on Health Insurance
"Health and Human Services Secretary Alex Azar told the Senate Finance Committee he doesn't yet know if Idaho's insurance regulator will approve a plan by Blue Cross of Idaho to sell insurance that doesn't follow ACA requirements. Democrats have been pressing the agency to block the move as a violation of existing law."
The Wall Street Journal; subscription may be required

Benefits in General

Corrections and Substantive Fixes Needed with Respect to Employee Benefit Changes Made by the 2017 Tax Act
"[T]he 2017 Act limits the personal casualty loss itemized deduction for property losses (not used in connection with a trade or business or transaction entered into for profit) to apply only to losses incurred as a result of federally-declared disasters.... Another possible error in drafting involves distributions from retirement plans that are used to pay for expenses for qualified higher education.... As the rules are currently written, it is unclear whether public universities are included in the definition [of an applicable tax-exempt organization], and therefore subject to the excise tax on excess executive compensation under Section 4960."
Bloomberg BNA

Seventh Circuit to Plan Participants: File Suit Immediately or Lose De Novo Review
"[T]he Seventh Circuit held that [the employee] waived the argument that Reliance Standard's failure to render a timely decision on her claim compelled de novo review simply because she pursued administrative review through an appeal rather than pursued available remedies when the issue arose (i.e. immediately file a lawsuit).... The unintended consequence ... is that in the Seventh Circuit claimants are now incentivized, rather than discouraged, to immediately file a lawsuit in order to obtain a favorable standard of review[.]" [Dragus v. Reliance Standard Life Inc. Co., No. 17-1752 (7th Cir. Feb. 14, 2018)]
Roberts Bartolic

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Disclosure of 5% Contributors
Is there any legal (or other) significance behind the 5% contributor disclosure (for employers contributing to multiemployer plans)? Or is that just what's required by FASB?
BenefitsLink Message Boards

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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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