Health & Welfare Plans Newsletter

June 11, 2018

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Retirement & Institutional Services Plan Analyst
BB&T
in NC, SC

Mid-Level Employee Benefits Attorney (#75180111)
Holland & Hart LLP
in AK, CO, DC, ID, MT, NV, UT, WY

Rollover Education Specialist
John Hancock Retirement Plan Services
in MA

Actuarial Specialist
RPG Consultants
in NY

Recordkeeping Team Manager, OmniPlus
Aon
in CT, DC, FL, GA, IL, MA, MI, MN, MO, NJ, NY, OH, PA, TX, VA, WI

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[Guidance Overview]

How Beneficial Is the New Paid Leave Tax Credit?

"The paid leave, for tax credit purposes, must be due to taking an FMLA leave. In other words, pay during the leave due to vacation, personal leave, or a medical leave is not considered for credit purposes. For example, if an employer provides a self-funded short-term disability benefit, that wage replacement is disregarded. Similarly, any paid leave required under state or local law is disregarded for purposes of the federal tax credit.... Even employers not subject to FMLA (e.g., have fewer than 50 employees) may still qualify for the tax credit.... The tax credit is calculated as a percentage of the wages paid to an employee while on family or medical leave."
Miller Johnson

[Advert.]

Employee Health, Benefits, & Well-Being Congress | July 30-31

Sponsored by World Congress

Who is moving the needle on employee health care? This event convenes HR, benefits, and wellness executives, TPAs, Brokers, Payers, and Providers to learn and discuss strategies to enhance employee health and improve outcomes while reducing costs.


In Mental Health Parity Dispute, Plan Must Cover Room and Board at Residential Treatment Facility

"On appeal, the Ninth Circuit held that the MHPAEA prevented the plan from: [1] Providing room and board reimbursement at licensed skilled nursing facilities for medical and surgical patients. [2] Not reimbursing room and board charges at residential treatment facilities for mental health patients." [Danny P. v. Catholic Health Initiatives, No. 16-35609 (9th Cir. June 6, 2018)]
Thomson Reuters Practical Law

Insurer's Limited Reimbursements to Air Ambulance Provider Protected by Safe Harbor

"The Eastern District of Arkansas dismissed claims ... alleging that the insurer's practice of limiting reimbursement to an emergency air ambulance service provider constituted violations of the [ACA] and state law and regulations. The court found that the provisions cited by the provider did not create a private cause of action and that the insurer's reimbursement practices, as highly regulated conduct, fell within a state safe harbor provision." [Air Evac EMS Inc. v. Usable Mutual Ins. Co., No. 16-266 (E.D. Ark. May 29, 2018)]
Wolters Kluwer; free registration required

Mental Health Wellness Plan for Your Onsite Program

"Opening up a company-wide dialogue about mental health, training managers to recognize symptoms of mental health issues, and adopting policies that promote mental health care can go a long way toward reducing stigma and empowering employees who need mental health treatment to seek out services in a more timely manner."
Healthstat

Biggest Chunk of the Health Care Dollar Goes to Prescription Drugs

"The greatest percentage of the health care dollar goes to prescription drugs, at 23.2 cents ... 22.2 cents goes to pay for doctors; 20.2 cents goes to pay other costs at doctors' offices and clinics; 16.1 cents goes to pay for hospital stays; 4.7 cents goes to pay federal, state, and local taxes[.]"
Wolters Kluwer Law & Business

[Advert.]

Health Savings Accounts (HSAs): Essential Compliance Updates

Sponsored by Lorman and BenefitsLink

June 13 webinar. Avoid legal missteps under ERISA when administering your company's health savings accounts. Discount for BenefitsLink readers.


Mercer and American Benefits Council Testimony to House Subcommittee Hearing on Consumer-Directed Health Plans (PDF)

25 pages. "Approximately 34% of covered employees working for large employers (those with 500 or more employees) were enrolled in a CDHP in 2017, ... [a] 325% increase since 2009.... HSA-eligible plans save about 20% on plan costs when compared to PPO plans and are 6% less costly than PPO plans with deductibles over $1,000.... [T]he success of HSA-eligible plans in reducing plan costs is one of the few strategies proven to help 'bend the cost curve' and, in turn, help manage premium costs for employees[.]"
American Benefits Council

The Impact of the $0 Individual Mandate Penalty (PDF)

"[T]he morbidity impact was most influenced by: [1] Degree of anti-selective lapse that has already occurred in the individual market; [2] Income distribution and subsidies; [3] Morbidity differential between subsidized and unsubsidized members."
Milliman

DOJ Argues Key ACA Provisions Unconstitutional

"Weighing in on a lawsuit brought by 20 conservative states, the U.S. Department of Justice urged a federal judge ... to find two of the ACA's provisions unconstitutional on the basis that they are inextricably linked to the law's individual mandate." [Texas v. U.S., No. 18-167 (N.D. Tex., response brief filed June 7, 2018)]
HealthLeaders Media

Mom, Dad, and the FMLA: What Co-Worker Spouses May Need to Know

"[F]ederal law allows employers of co-worker spouses to limit to a combined 12 weeks the amount of leave they may take for the birth of a child and to bond with a newborn. Typically, 12 weeks is the amount of time off every individual worker covered by the [FMLA] may use over a 12-month period.... That quirk for co-worker spouses, however, means if mom takes 12 weeks of FMLA leave, dad may get none. Or if dad takes 4 weeks, mom may only get eight."
Bloomberg BNA

Is Pet Insurance Worth It?

"[M]any companies even offer discounted pet insurance for employees.... A common complaint about pet insurance is that the things that it covers are limiting to the point of the policy being relatively useless when the big dollars are due.... [T]he average monthly cost is about $27 for cats and $43 for dogs."
Financial Finesse

[Opinion]

Can Low-Intensity Care Solve High Health Care Costs?

"[T]he cost of the same procedure on the same patient by the same physician can vary by thousands of dollars depending on whether it's performed in a hospital, a hospital's outpatient department, an ambulatory surgical center or a doctor's office. It can also vary by who's paying the bill -- which insurer or public program.... [A]ll other things equal, the shift toward lower-intensity, lower-cost settings is a worthy goal. But in some cases, outcomes may not be equal, and it seems we should make sure we're not cutting quality when we're cutting costs."
The New York Times; subscription may be required

Benefits in General

[Guidance Overview]

What Are Creditable Benefits for New York's Wage Parity Act?

"The Act requires a minimum basic wage (cash) of the applicable New York State minimum wage plus additional wages or supplemental wages (i.e., benefits) equal to another $4.09 per hour in NYC or $3.22 per hour in Nassau, Suffolk and Westchester counties ... The goal for agencies is to deliver the WPA package in a way that is tax advantaged.... [which] requires complying not only with the WPA, but also with many other federal and state laws ... [F]or example, if a cell phone plan reimbursement program meets all the standards to be tax qualified under the Internal Revenue Code, it is not a creditable cost towards the WPA Package."
FordHarrison

Cybersecurity and Employee Benefit Plans

Podcast with transcript. "Data breaches are occurring with increased frequency in today's digital environment. Benefit plans in particular are uniquely susceptible to cyber-risks because they store large amounts of sensitive employee information and share it with multiple third parties. In this [podcast, the writers] discuss the developing legal framework in the area of cybersecurity and outline practical tips that plan sponsors and record-keepers may use to secure plan data."
Proskauer's ERISA Practice Center

Selected Discussions
on the BenefitsLink Message Boards

Using DocuSign to Get Client Signatures on Form 5500?

Is anyone using DocuSign to get clients to "manually" sign the Form 5500? Using DocuSign is MUCH easier then the whole credential process, and clients seem to be getting more familiar with signing documents this way. Is it acceptable to the DOL?
BenefitsLink Message Boards

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61st Annual Survey Questionnaire Open for Participation
PSCA [Plan Sponsor Council of America]

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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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