Health & Welfare Plans Newsletter

April 24, 2018

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Retirement Plan Administrator
Northeast Professional Planning Group, Inc.
in NJ, NY

ERISA / Employee Benefits Attorney
Reid and Riege, P.C.
in CT

Sr. Pension Administrator
PACETPA
in CA, NV

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[Guidance Overview]

Massachusetts Begins Assessing New Employer Healthcare Penalties
"According to the current guidance ... an employer appears to have a limited basis on which to appeal a penalty determination. For example, an employer may argue that the individual triggering the penalty is an independent contractor and not an employee or that the wages on which the penalty was based were incorrect. Notably, the Department's guidance does not address what appears to be the most obvious grounds for appeal -- that the employee was not actually eligible for the state program triggering the penalty."
Mazursky Constantine LLC

[Advert.]

Evaluating Your Third-Party Administrator: Are You Getting What You're Paying For?

Sponsored by Lorman and BenefitsLink

May 2 webinar will enable entities responsible for identifying, selecting, and monitoring their TPA to track performance and assess results, as well as identify opportunities to create additional value. Discount for BenefitsLink readers.


[Guidance Overview]

New Jersey Passes Paid Sick Leave Law
"Over the past few years, New Jersey local governments have been active on the issue of earned paid sick leave, leading to 13 municipalities to enacting their own laws. These municipalities are: [1] Bloomfield; [2] East Orange; [3] Elizabeth; [4] Irvington; [5] Jersey City; [6] Montclair; [7] Morristown; [8] Newark; [9] New Brunswick; [10] Passaic; [11] Paterson; [12] Plainfield; and [13] Trenton. The good news for employers is that the state law preempts all of these local ordinances so employers will need to comply only with the state law."
Fox Rothschild LLP

Sixth Circuit Reverses Summary Judgment on ERISA Section 510 Claims Because of Management Comments That Healthcare Costs Are Rising
"[W]hile the supervisor who fired plaintiff did not know about the son's medical expenses, the Sixth Circuit found significant that the Vice President and director who commented about medical expenses played a role in the decision. Also, plaintiff contended that Atlas had tried to contact other employees before firing them under the no-call/no-show policy, but did not do the same for him." [Stein v. Atlas Industries, Inc., No. 17-3737 (6th Cir. Apr. 9, 2018)]
Seyfarth Shaw LLP

Health Care and Benefits Stats Every Employer Should Know
"[T]he average cost of new cancer therapy is $171,000 and spend for specialty drugs used in cancer treatment is expected to increase by 20% every year.... There are 86 million pre-diabetic adults in the U.S. and 90% don't even know it.... More than two-thirds of adults with depression don't get treatment.... Specialty prescription costs are expected to double in three years."
Willis Towers Watson

The State of Employee Benefits: Findings from EBRI's 2017 Health and Workplace Benefits Survey
"Benefit offerings generally remain similar between years, with the most frequently offered benefits being health insurance (67 percent), dental insurance (59 percent) and retirement savings plans (57 percent).... Just over one-half (52 percent) of employees say they understand their health benefits and 43 percent indicate they understand their non-health benefits very/extremely well. Both statistics are down from 2016[.]"
Employee Benefit Research Institute [EBRI]

[Advert.]

Online Learning Course: COBRA

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Even with ACA coverage easier for individuals to obtain, group health plans must continue to offer COBRA coverage. This course explains technicalities of COBRA, including who is entitled and how to administer.


Your Employee Surgery Roadmap
Infographic. "When your employees need surgery, the way to safe, effective care is fraught with obstacles. Surgeons push for care that patients don't need; it's extremely difficult to find high-quality providers; and hospital systems charge rates far out of proportion with their value.... [1] Avoid inappropriate procedures ... [2] Avoid ineffective surgeons ... [3] Avoid overcharging."
mpirica

Bridging the Wellness Generation Gap
"For the first time in history, five generations are rubbing shoulders in the workplace; and each generation is associated with distinct stereotypes. A one-size-fits-all approach to your wellness program activities probably won't cut it (unless it only involves free food and chair massages!)."
Frenkel Benefits

Changes to the Essential Health Benefits Standards in the 2019 Notice of Benefit and Payment Parameters
"The Final Rule eliminates the ten benchmark options ... and establishes new benchmarking options for states that wish to redefine their EHBs. For all benchmarking options, the Final Rule imposes a 'generosity cap' which enables states to weaken EHB minimum standards, but penalizes states seeking to improve and strengthen EHB."
National Health Law Program [NHeLP]

New Hardship Exemptions Let Consumers Avoid ACA Penalty for Not Having Health Insurance
"Under the new rules, people can apply for a hardship exemption that excuses them from having to have health insurance if they: [1] Live in an area where there are no marketplace plans. [2] Live in an area where there is just one insurer selling marketplace plans. [3] Can't find an affordable marketplace plan that doesn't cover abortion. [4] Experience 'personal circumstances' that make it difficult for them to buy a marketplace plan, including not being able to find a plan in their area that gives them access to specialty care they need."
Kaiser Health News

Benefits in General

Eye-Opening Facts About Benefits and Employee Retention
"47% of your employees will look for another position in the next 12 months.... [H]ow many people would have stayed in their current role if they understood their current benefits and what their total compensation truly was? ... 51% of employers say that using benefits to retain employees will become even more important in the next 3 to 5 years.... 75% of employees reported to be more likely to stay with an employer based on their benefit program[.]"
Hodges-Mace

Executive Compensation
and Nonqualified Plans

Executive Compensation as Corporate Waste? Delaware Court Allows a Lawsuit to Continue
"Two full pages of the opinion are devoted to listing facts and information 'demonstrating that it should have been abundantly clear to the members of the Board ... that far from being 'actively engaged' in CBS's affairs, Redstone was providing no meaningful services to the Company beginning at some point in the latter part of 2014 or in 2015. During and after that period, CBS paid Mr. Redstone more than $13 million, most of it in performance bonuses." [Feuer v. Redstone, No. 12575-CB (Del. Ch. Apr. 19, 2018)]
Winston & Strawn LLP

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Lois Baker, J.D., President  loisbaker@benefitslink.com
David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
Holly Horton, Business Manager  hollyhorton@benefitslink.com

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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