Health & Welfare Plans Newsletter

May 15, 2018

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[Guidance Overview]

IRS Releases 2019 Inflation Adjusted Amounts for HSAs

"IRS Revenue Procedure 2018-30 increases the 2019 calendar year HSA contribution limit for individual coverage to $3,500. The limit for family coverage will be $7,000 ... California AB 1305 requires fully insured California family HDHP policies to have an embedded individual deductible that is no greater than the policy's individual deductible.... [B]ecause the minimum HDHP deductible will remain the same, no change is needed for 2019 to the embedded individual deductible on the family HDHP if it is currently set at $2,700 or higher."
ABD Insurance & Financial Services

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[Guidance Overview]

Proposed Mental Health Parity Guidance Would Impose Significant Disclosure Requirements

"[T]he Agencies' proposed rule [would] require plan administrators to distribute hard copy health care provider lists when the ERISA electronic disclosure standards cannot be met. This proposed requirement deviates from the standard practice of directing plan participants to network administrator websites for provider lists and would be sure to significantly increase administration costs."
Proskauer's ERISA Practice Center

IRS Sending ACA Noncompliance Notices to Some Already Compliant Employers

"The IRS is mailing Employer Shared Responsibility Payment (ESRP) notices to employers that it believes failed to comply with the ACA coverage requirements in 2015. Some employers receiving these notices actually complied with the ACA requirements in 2015, but the IRS received inaccurate or incomplete information and has thus incorrectly identified the employer as failing to satisfy the ACA coverage requirements."
Holland & Hart LLP

Using Wellness to Tackle Disease Management

"Rather than focus attention -- and dollars -- on getting people well and having minimal impact, employers are beginning to zero in on helping employees manage chronic disease.... About 86% of healthcare dollars are spent on chronic and mental health conditions, and 59% of Americans have at least one chronic health condition, according to the CDC. And, there's a lot of evidence that shows chronic disease management programs work."
Corporate Synergies, via Employee Benefit News

HHS to Resurrect Medicare Part B Price Bidding Program

"HHS Secretary Alex Azar announced May 14 that the agency plans to propose a program to merge some Part B drugs with Part D, where their prices could be negotiated, a major goal of Trump's plan to lower drug prices.... Such a program has been used before with poor results."
FierceHealthcare

[Opinion]

Urban Institute Proposes the 'Healthy America Program'

"[This] proposal builds on components of the Medicare program and the ACA Marketplaces.... The large new Medicare-style marketplace, featuring a public plan and private insurer options, would contain costs by fostering competition among many insurers, capping provider payment rates, and addressing prescription drug pricing. This proposal is less ambitious than a single-payer system ... but it would get close to universal coverage with much lower increases in federal spending and less disruption for people currently enrolled in employer coverage or Medicare."
Urban Institute

[Opinion]

Trump's Drug Pricing Speech Breaks Little New Ground, Largely Spares Industry

"The first immediate action calls on the FDA to 'evaluate the inclusion of list prices in direct-to-consumer advertising.' ... The second immediate action calls on [CMS] to update Medicare's drug-pricing dashboard 'to make price increases and generic competition more transparent.' ... The use of confidential rebates has become a central feature of our drug reimbursement system, and restricting or reducing their use would significantly change the ways in which drugs are distributed and reimbursed."
Health Affairs

Benefits in General

[Guidance Overview]

New DOL Claims Procedures for Disability Benefits: Action Items to Stay in Compliance

"Review and identify all company-sponsored employee benefit plans to determine if the plan conditions benefits, including the payment or vesting thereof, on a determination of disability.... Amend claims procedures and update notices, Summary Plan Description and third-party service provider agreements ... Employees involved in making disability claims determinations should be trained on the new requirements imposed under the Final Regulations."
Buchanan Ingersoll & Rooney PC

Employee Benefit Risk Management from a Board's Perspective (PDF)

"This article discusses tactics boards use to gain a thorough understanding of their organizations' risks, how fiduciary risk ranks among other hazards, [and] the effect risk culture has on how directors prioritize risks. [It] includes suggestions on how to strengthen the management of risks associated with employee benefit plans."
Roland|Criss, via Journal of Compensation and Benefits

Many Plan Participants Lack Access and Skills to Fully Engage with Technology (PDF)

"Insurance carriers, 401(k) recordkeepers and plan sponsors continue to push the use of different technologies. And while there are certainly a number of participants who can properly access these options, the fact remains that, whether through lack of geographical access, lack of funds to purchase access or fear of technology, there are millions of Americans who cannot take part in the technological services offered (or required) in their benefit plans."
Benefits Quarterly, published by the International Society of Certified Employee Benefit Specialists [ISCEBS]

DOL and Treasury Update 2017-2018 Regulatory Agendas for Employee Benefits

"There is one new DOL initiative -- an exception for short-term limited duration insurance under the [ACA] -- and no new IRS initiatives.... DOL also discontinued six projects ... relating to the claims procedure regulation, state saving arrangements for non-governmental employees, brokerage windows in retirement plans, the section 408(b)(2) disclosure regulations, target date funds, and health care continuation coverage. DOL retained the Form 5500 modernization project but changed its status to a long-term initiative."
Eversheds Sutherland

Press Releases

NPPG Fiduciary Services Appoints Brian J. Horowitz as ERISA Counsel
Northeast Professional Planning Group [NPPG)]

Chief Investment Officer Ted Eliopoulos to Leave CalPERS
CalPERS [California Public Employees' Retirement System]

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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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