Health & Welfare Plans Newsletter

July 3, 2018

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[Guidance Overview]

OCR Cybersecurity Newsletter: Guidance on Software Vulnerabilities and Patching (PDF)

"Identifying software vulnerabilities and mitigating the associated risks are important activities for [HIPAA covered entities and business associates] to conduct as part of their security management process and technical evaluations.... Mitigation activities could include installing patches ... In situations where patches are not available (e.g., obsolete or unsupported software) or testing or other concerns weigh against patching ... entities should implement reasonable compensating controls to reduce the risk of identified vulnerabilities to a reasonable and appropriate level[.]"
U.S. Department of Health and Human Services [HHS]

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[Guidance Overview]

Association Health Plans: A New Frontier?

"Pros: [1] Exemption from various [ACA] requirements ... [2] Reduced reporting and disclosure requirements ... [3] Economies of scale ... Cons: [1] AHPs are MEWAs ... [2] AHPS are subject to ERISA and other laws that apply to group health plans ... [3] Small employers may become subject to Mental Health Parity, COBRA, and other requirements that apply to large employers ... [4] Taxation of health coverage and benefits ... [5] Liability concerns ... [6] Legal uncertainty."
Snell & Wilmer L.L.P.

Pfizer Raises Prices for Dozens of Drugs

"Pfizer Inc. raised the list prices for more than 40 of its prescription drugs this week, marking a second round of increases this year despite mounting public scrutiny.... Many lift the list prices by 9.4% and by double-digit percentages for the year overall. The moves ... separate Pfizer from several rivals that have pledged to lift list prices only once every 12 months and by less than 10% overall for the year, as they try to blunt criticism and avoid congressional action."
The Wall Street Journal; subscription may be required

Doctors, Hospitals Received $8.4B in Payments from Drug Companies Last Year

"Doctors and teaching hospitals received $8.4 billion in payments from drug companies in 2017 ... The 2017 payments included nearly $4.7 billion in research related payments, $2.82 billion in non-research-related payments and more than $927 million representing ownership or investment interests held by physicians or their immediate family members,"
FierceHealthcare

Healthy Food, Transportation to the Doctor are New Frontiers for Health Insurance Providers

"[WellCare Health Plans has worked] over the last seven years to connect members in need with access to social services including food, medication assistance, and transportation.... [P]roviding this service has led to a 26 percent decrease in emergency spending.... People who live in underserved communities get caught in a cycle where lack of access -- to food, transportation or providers -- leads to poor outcomes.... Closing the transportation gap can reduce the number of missed appointments and help make sure that patients are able to take their medication as directed."
America's Health Insurance Plans [AHIP]

Healthcare Calculators, AI Enhance Employee Benefit Understanding

"There is a disconnect between what employers think they're doing and how employees feel they're being engaged ... 83% of employers believing they do a good job in benefits education, where only 75% of workers would agree.... Decision support during open enrollment ... can help workers feel they're making the right choice.... [D]ecision support can be classified into three buckets: communication, tech tools and using a hands-on approach."
Employee Benefit News

Get the Most out of Inclusive Paternity Leave

"As you're developing or updating your benefits packages for your employees over the next year, here are three benefits of offering more inclusive paternity leave you'll want to consider. [1] You'll attract and retain more millennials ... [2] You'll improve workplace engagement and satisfaction ... [3] You'll contribute to the good of everyone."
HR Daily Advisor

Trends in Subsidized and Unsubsidized Individual Health Insurance Market Enrollment (PDF)

"Average monthly enrollment in individual market plans decreased by 10 percent between 2016 and 2017 at the same time premiums increased by 21 percent. Most of the decrease in enrollment between 2016 and 2017 occurred among people who did not receive APTC subsidies.... 10 states experienced declining individual market enrollment between 2015 and 2016.... The decline in the non-APTC portion of state markets grew larger and more widespread between 2016 and 2017."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Early 2018 Effectuated Enrollment Snapshot (PDF)

12 pages. "As of March 15, 2018, 10.6 million individuals had effectuated coverage through the Federal and State-Based Exchanges for February 2018, meaning that they selected a plan, paid their first month's premium, if applicable, and had coverage in February 2018. The total number of members with February 2018 coverage is about 9 percent lower than the number of individuals (11.8 million) who made plan selections during the 2018 Open Enrollment period."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

The Exchanges Trends Report 2018 (PDF)

12 pages. "Data from the call center shows that the consumer satisfaction rate remained at an all-time high -- averaging 90 percent -- throughout the entire Open Enrollment period. This is up from 85 percent last year. 63 percent of uninsured consumers who have visited Federal platform Exchanges in the past year indicate they didn't purchase a health plan through the Federal platform because the health insurance premium was too expensive, which is up from 52 percent from the end of last year's Open Enrollment Period."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Executive Compensation
and Nonqualified Plans

Unique 162(m) Considerations for Financial Institutions

"One [strategy is] a voluntary or automatic deferral of restricted stock units (RSUs) or the payout of short-term incentive plan payments in the form of deferred RSUs. The deferral would essentially convert the RSUs into a promise to distribute shares of the company's stock in the future, generally after the executive's retirement or other employment termination. After termination, the distribution of the stock could be spread over a period of years, in an effort to create distributions/payouts less than $1 million per year, which should be deductible."
Winston & Strawn LLP

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David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
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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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