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Health & Welfare Plans Newsletter May 29, 2018 |
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Jobs
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Webcasts, Conferences |
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Discussions |
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This Newsletter:
BenefitsLink Retirement Plans Newsletter:
Message Boards Digest:
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Plan Administrator|
The State-by-State Who, What, and Where of Mandated Paid Sick Leave "In most of the 12 states or jurisdictions that require private employers to provide paid sick leave, companies must offer up to 40 hours of sick leave in a year. The laws cover businesses of all sizes, and full-time, part-time, and temporary workers.... Here's a closer look at who is covered, who is exempt, and how much leave is required in each state."
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[Advert.]
Employee Health, Benefits, & Well-Being Congress | July 30-31
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No, Your Insurer Doesn't Care If You Have High Claims. In Fact, They Like It That Way "As a result of the PPACA MLR mandate, carriers have strategically reduced spending on fraud detection, research and development, customer service training and improved systems. Large group insurers now have 15 percent to pay their rent, keep the lights on, and pay brokers and personnel.... If the insurance company has accurately built high costs into the premium, it can make more money."
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Benefit Change Could Raise Costs for Patients Getting Drug Copay Assistance "Under new 'copay accumulator' programs, the monthly copayments drug companies make don't count toward patients' plan deductibles or out-of-pocket maximums.... Once patients hit the annual limit on a drugmaker's copay assistance program, they're on the hook for their entire monthly copayment until they reach their plan deductible and spending limits."
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The 'Right to Try' Bill: Beneath the Surface "The 'Right to Try' bill doesn't specifically require plans to pay for experimental care, but things get a little murky from there. Who pays for hope and who pays for harm? ... Even if your plan excludes coverage for the off-label use of prescription drugs, will it end up paying for the treatment of serious side-effects and complications? Is there really any way to distinguish cause and effect at end of life? What was the result of the natural disease progression, and what was the result of an adverse reaction to the experimental medication?"
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How to Cover the Costs of Employee Health Plans without Getting Sick About It "[1] Take advantage of the small business tax credit ... [2] Understand the 'employer shared responsibility' provision ... [3] Don't leave tax breaks on the table ... [4] Make sure yours is a 'qualified health plan'."
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[Advert.]
For over 20 years, we've helped employers find the best-informed candidates to fill their benefits job openings -- learn more! |
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Insurance Industry Licks Its Chops at Possible Third Delay of Health Insurance Tax "A group of bipartisan lawmakers is seeking to once again delay the health insurance tax, this time until 2021.... The measure (H.R. 5963) ... would be the third such delay of the Obama-era tax. Insurers lost about $8 billion in 2014 under the law, which jumped to $11 billion the following year. The provision was suspended in 2017, in place for 2018, but then delayed again for 2019."
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Urban Institute Enters Post-ACA Coverage Policy Proposal Ring with 'Healthy America' Plan "Healthy America would not change existing employer-sponsored plans, Medicare, or other federal programs like TRICARE or the Indian Health Service. It proposes replacing the non-group insurance market and the Medicaid/Children's Health Insurance Program (CHIP) acute care for the non-elderly with a government-administered public health insurance plan similar to Medicare in conjunction with private coverage similar to Medicare Advantage."
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Origins of an Epidemic: Purdue Pharma Knew Its Opioids Were Widely Abused "Purdue Pharma, the company that planted the seeds of the opioid epidemic through its aggressive marketing of OxyContin, has long claimed it was unaware of the powerful opioid painkiller's growing abuse until years after it went on the market. But a copy of a confidential Justice Department report shows that federal prosecutors investigating the company found that Purdue Pharma knew about 'significant' abuse of OxyContin in the first years after the drug's introduction in 1996 and concealed that information."
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Benefits in General |
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"[T]he court grants in part Plaintiff's motion for attorneys' fees and denies Defendants' request for attorneys' fees, even though Defendants were ultimately successful on the merits of the underlying long-term disability dispute.... In awarding Plaintiff attorneys' fees, the court determined that Plaintiff achieved some degree of success on the merits by obtaining an order of remand. The court rejected Defendant's argument that the hourly rate of $700 was excessive and that a lower rate should be applied to work performed between 2014-2016." [Gorbacheva v. Abbott Laboratories Extended Disability Plan, No. 14-02524 (N.D. Cal. May 25, 2018)]
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Selected Discussions |
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Auditor Report Required for Self-Funded Welfare Plan? Have a welfare benefit plan funded from general assets of sponsor; over 100 employees. We believe no audit is required; all we file are the 3 pages of the 5500, with no Schedule H or Schedule C. Sound OK?
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How Would a 2% Shareholder Be Enrolled in a 125 Plan? I thought it was common knowledge that 2% shareholders cannot enroll in a 125 plan? I read that if a 2% shareholder is enrolled, it can cause issues for the plan. Does anyone have any practical experience how this is handled? How would this have happened?
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Press Releases |
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AIG Expands Presence in Pension Risk Transfer Market
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Connect
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BenefitsLink.com, Inc.
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David Rhett Baker, J.D., Editor and Publisher
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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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