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COBRA Basics for Employer-Sponsored Health Plans: Complying with Continuing Coverage Requirements
RECORDED
HRWebAdvisor

Severance Plans and ERISA Compliance: Limiting Liability in Design and Implementation of Severance Arrangements
June 12, 2018 WEBCAST
Strafford

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[Guidance Overview]

Agencies Provide Additional Guidance for Health Plan Provisions Under Mental Health Parity and Addiction Equity Act

"The complete exclusion of coverage for a particular condition does not violate the MHPAEA, although it could raise issues under other laws ... [D]isparities in the adequacy of networks (and the standards for establishing adequacy) may result in violations of the MHPAEA. The non-quantitative treatment limitations under the MHPAEA apply to the availability of out-of-network coverage as well as in-network coverage.... An eating disorder is specifically treated as a mental health condition, but the guidance sidesteps the issue with regard to autism[.]"
Ballard Spahr LLP

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Certificate in Benefit Plan Administration

Finish Your Certificate in June! The Certificate in Benefit Plan Administration program provides a survey of the core operational areas and issues involved in administering benefit plans.

[Guidance Overview]

Agencies Bolster Reasoning for Out-of-Network Emergency Services Payment Method

"For the moment, at least, ... plans and insurers should continue to apply the [greatest-of-three (GOT)] regulation under the November 2015 final rules in calculating minimum payment rates for out-of-network emergency services. As a reminder, [HHS, DOL and Treasury] also take the view that plans or insurers must disclose how they calculate amounts under the minimum payment standards. This includes the method the plan or insurer uses to determine payments for out-of-network services."
Thomson Reuters Practical Law

Personalized Digital Coaching Program Leads to Savings on Claims, Clinically Significant Outcomes

"Participants engaged with the coach and program through the first year, and with more than 1,300 people enrolled, the outcomes include: ... 95% program completion; an average of 3.8 meaningful participant interactions per day during the high intensity intervention; and an 80% monthly active user base through 12 months.... Of those with metabolic syndrome risk factors, 73% of participants reversed at least one."
Restore Health, via PRNewswire

Case Study: The Dangers of Silent Pharmacy Contract Terms (PDF)

"Transparency is critical when it comes to pharmacy contracting. Not only is it important to have robust discount, dispensing fee and rebate guarantees, but the contract terms and definitions must be clear and precise. A high generic discount might not be such a good deal if the contract language isn't strong. Generic drug definitions that lack clarity or are absent from the pharmacy contract altogether can be a costly mistake."
Lockton

Risk Analyses vs. Gap Analyses -- What Is the Difference? (PDF)

"Conducting a risk analysis is the first step in identifying and implementing safeguards that ensure the confidentiality, integrity, and availability of [electronic protected health information]. A gap analysis, while not required by the HIPAA Rules, is a useful tool to identify whether certain standards and implementation specifications of the Security Rule have been met."
Office for Civil Rights [OCR], U.S. Department of Health and Human Services [HHS]

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

Worldwide Employee Benefits Network helps me connect with thought leaders in the Benefits Industry. Join WEB today at www.webnetwork.org.

CVS 'Moving Forward' with Aetna Deal, Profit Tops Estimates

"CVS's proposed takeover of Aetna would bring together around 10,000 CVS stores and the health insurer's 22 million customers. A central plank of the deal is transforming the stores into health hubs where consumers can get care, pick up their drugs, buy some cosmetics, and stay out of the hospital."
Bloomberg

Making Health Insurance Enrollment as Automatic as Possible

"[This aritcle] discusses previous uses of auto-enrollment with health insurance and other benefits as well as recent efforts in Maryland to deploy auto-enrollment to improve the individual market's risk pool and reduce the number of uninsured."
Health Affairs

[Official Guidance]

Text of IRS Disaster Relief AL-2018-03, for Victims of Severe Storms and Tornadoes in Alabama

"Individuals who reside or have a business in Calhoun, Cullman, and Etowah counties may qualify for tax relief.... [C]ertain deadlines falling on or after March 19, 2018 and before July 31, 2018, are granted additional time to file through July 31, 2018. In addition, penalties on payroll and excise tax deposits due on or after March 19, 2018 and before April 3, 2018, will be abated as long as the deposits were made before April 3, 2018."
Internal Revenue Service [IRS]

California Supreme Court Holds Worker Classifications Easy as A-B-C

"The California Supreme Court's decision to eschew the traditional multifactor case-by-case worker classification analysis in favor of this 'simpler, more structured test' will undoubtedly raise concerns among many industries, including from companies operating in the gig economy space with large independent contractor workforces."
ReedSmith

California Supreme Court Applies 'ABC' Test When Assessing Independent Contractor Status

"For Wage Order claims, the 'engage, suffer or permit' standard determines if a worker is an employee or an independent contractor. The Supreme Court also held that, to evaluate whether a worker is an employee under this language, courts should use the so-called ABC test that other jurisdictions have used."
Seyfarth Shaw LLP

The Next Critical Action Item After Filing Your Proxy Statement

"Compensation Committees and the appropriate members of the Company's legal, executive compensation, tax, and/or HR functions should quickly prepare to shift their focus to action items relating to new world of Code Section 162(m) -- without a performance-based compensation exception.... [F]or many companies, the impact of losing the ability to deduct compensation amounts over $1 million per year per executive will be significant."
Winston & Strawn LLP

Press Releases

Group Benefits Insurers Automate Document Creation with Global IQX Update
Global IQX, Inc.

PSCA Presents Volunteer Service Awards at the 71st Annual National Conference
PSCA [Plan Sponsor Council of America]

Nyhart Appoints New CEO Lisa Hague
Nyhart

NTSA Releases Best Practices Guide for 403(b) & 457 Plans
American Retirement Association

For the First Time, Wisconsin Private Colleges Unite Retirement Plans to Reduce Costs, Streamline Providers, and Simplify Administrative Burdens
Transamerica

Lockton Named by Forbes as a Best Employer in America for Third Straight Year
Lockton

Ed Emerson Heads MMM's Employment and Benefits Group; Four Attorneys Hired
Morris, Manning & Martin, LLP

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