Health & Welfare Plans Newsletter

March 12, 2018

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Health and Group Benefits Lawyer
Willis Towers Watson
in Toronto, Ontario

Qualified Retirement Plan Investment Advisor
Nadler Financial Group, Inc.
in IL

Retirement Plan Services Senior Associate
Dixon Hughes Goodman
in VA

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[Guidance Overview]

Same Sex Marriages and Welfare Benefit Plans (PDF)
16 pages. Topics include: [1] Federal and State laws; [2] Public sector employers, church plans, and private sector employers (including non-profit); [3] Action steps; [4] Sample list of HR policies and/or benefit plans that may be affected; [5] Administration; [6] Consequences of enrolling ineligible individuals; [7] Cafeteria Plans; [8] Coordination of benefits/subrogation/right of recovery; [9] Children of same-sex couples; [10] HIPAA; [11] Summary of tax treatment; and [12] Confidentiality.
Arthur J. Gallagher & Co.

[Advert.]

Online Learning Course: Family and Medical Leave Act (FMLA)

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Learn how to avoid common administration mistakes, implement best practices and be aware of interactions with other laws.


Self-Insured Health Plans: Recent Trends by Firm Size, 1996-2016 (PDF)
"The percentage of all private-sector establishments offering health plans at least one of which is self-insured has continued an increase that started in 2000.... Between 2013 and 2016, the percentages of small and midsized establishments offering at least one self-insured plan both increased.... Between 2013 and 2016, the self-insurance trend for large establishments continued to decline, falling from 83.9 percent to 78.5 percent.... Between 2015 and 2016, the percentage of enrollees in self-insured plans fell from 60 percent to 57.8 percent."
Employee Benefit Research Institute [EBRI]

Designing Health Plans That Meet Value-Based Standards: Steps for Employers
"[E]mployers need to be self-insured to effectively structure their health-plan design to meet value-based standards.... [A]llow your employees and their dependents to pay only the copay when they access high-value services -- even if they have not met their deductibles.... [P]romote transparency of the costs and quality of healthcare to employees whenever possible.... [C]reate high-value provider networks."
Human Resource Executive

Combating the Substance Abuse Epidemic Through Employee Benefit Programs
"Properly structured and utilized substance abuse management programs and [employee assistance programs (EAPs)] provide an arguably unrivaled level of access to ... the nearly 16 million employees in the United States afflicted by drug and alcohol abuse ... [M]any GHPs don't include a robust, legally compliant substance abuse management program that participants know about. And not only do a significant percentage of employers not sponsor EAPs, many of those that do have witnessed anemic levels of participation."
HR Daily Advisor

Prescription Drug Spending in the U.S. Health Care System (PDF)
28 presentation slides. Topics: [1] Drivers of growth in prescription drug expenses; [2] Impact of drug costs on payers; and [3] Options to address spending.
American Academy of Actuaries

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Comments Indicate Concern that DOL's Small Employer Health Plan Proposal Ripe for Fraud
"The [DOL's] proposed expansion of health plans for employer groups would invite scammers back into the insurance market ... Employment lawyers, former DOL officials, insurers, and advocacy groups are among those to voice concerns about past fraud and insolvency problems with similar multiple employer health plans."
Bloomberg BNA

Tennessee Executive Pleads Guilty to Fraudulent Sales of Association Coverage and Limited Benefit Products
"On March 7, 2018, the Department of Justice (DOJ) announced that the former owner and chief executive officer of a Nashville-based telemarketing company had pled guilty to defrauding consumers to sell limited benefit health plans and association memberships as traditional, major medical health insurance. The announcement came just one day after comments were due on a proposed rule from the [DOL] to expand access to association health plans and appears to confirm some concerns about fraud, abuse, and insolvency raised by a variety of stakeholders in public comments."
Health Affairs

Administration's Plan to Put You in Charge of Your Health Information
"Interoperability is essentially the ability of different computer systems to communicate with each other quickly and effectively. For healthcare specifically, that means being able to share patient data in an instant regardless of what hospital, pharmacy, laboratory, or clinic houses the information -- and being able to do so with complete reliability and privacy protection."
The White House

Tri-Agencies Proposed Rule Alters Short-Term, Limited Duration Insurance Offering
"The consensus among policy makers is that extending the duration of the coverage period that STLDI can be offered is likely to increase the number of consumers who elect to enroll in these plans over health insurance that constitutes Minimum Essential Coverage. The number of people enrolling in STLDI plans is likely to increase further in 2019 when consumers will no longer face a tax penalty for failing to maintain minimum essential coverage."
Health Law Advisor, Epstein Becker Green

No-Go for Idaho: Back to the Drawing Board on State-Based Health Plans
"No, you can't. That's what federal officials told Idaho regulators ... regarding the state's plan to allow insurers to sell health plans that fall short of the [ACA's] requirements. But the letter from [CMS] did offer an alternative: Tweak your plan a bit to make them qualify as 'short-term' policies ... which are exempted from ACA rules, including those barring insurers from rejecting people with preexisting medical conditions[.]"
Kaiser Health News

Benefits in General

Should You Transfer Money from an IRA to an HSA?
"[T]ransferring money from an IRA to an HSA will be of limited value, except in a small handful of cases. Most other IRA owners should leave their IRA assets intact and fund their HSAs with non-IRA dollars, the better to maximize contributions to both account types and take advantage of tax-sheltered savings."
Morningstar Advisor

Executive Compensation
and Nonqualified Plans

New Tax Law Provides Tax Deferral Opportunity for Certain Private Company Equity Grants
"[New] Code Section 83(i) ... will allow certain private company employees to defer federal income tax on eligible stock options and restricted stock units for up to five years following their respective exercise or settlement.... Section 83(i) could be useful for bridging the gap between when an employee is subject to income tax and when the employee's shares can be liquidated."
Morgan Lewis

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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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