Health & Welfare Plans Newsletter

July 11, 2018

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Jobs

DC Retirement Plan Consultant
Intac Actuarial Services
in NJ, NY

Senior Pension Consultant
The Ryding Company
in CA

Assoc. General Counsel - ERISA & Wealth Management
CUNA Mutual Group
in WI

401(k) Consultant
Creative Retirement Systems
in OH, Telecommute

Retirement Account Administrator
Stalker and Associates
in NJ, PA

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Webcasts, Conferences

FMLA Overview for Employers
RECORDED
Cowden Associates, Inc.

Health Savings Accounts: Tips and Traps
July 19, 2018 WEBCAST
Cowden Associates, Inc.

SALGBA Regional Conference
August 20, 2018 in AL
State and Local Government Benefits Association [SALGBA]

►See 132 Upcoming Webcasts and Conferences

►See 1400 Recorded Webcasts


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[Official Guidance]

Text of OPM Final Regs: Federal Employees Health Benefits Program and Federal Employees Dental and Vision Insurance Program: Expiration of Coverage of Children of Same-Sex Domestic Partners

"Understanding that we have provided agencies with additional time for compliance given that overseas federal employees may not have been able to marry immediately following the Supreme Court decision, OPM is issuing a final rule removing references to domestic partners and domestic partnerships from the regulations. Based on the Supreme Court decision and the two additional year's lead time for domestic partners overseas to marry, the current language in the CFR is not needed and may be somewhat confusing. There is no change in coverage for children whose same-sex partners are married."
U.S. Office of Personnel Management [OPM]

[Advert.]

Certificate in Global Benefits Management

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

From understanding the power of world views to defining your company strategies, the Certificate in Global Benefits Management provides the comprehensive knowledge needed to administer and manage a global benefits program.


[Guidance Overview]

Sections 4980H(a) and 4980H(b) Penalty Amounts Set for Historic Increase in 2019

"The Code explains that the original $2,000 amount associated with the section 4980H(a) penalty and the original $3,000 amount associated with the section 4980H(b) penalty would be adjusted for calendar years beginning after 2014 ... [T]he correct numbers to use when calculating the potential section 4980H penalties for 2019 are: Section 4980H(a) penalty amount = $2,500; Section 4980H(b) penalty amount = $3,750. The penalty amounts have increased significantly compared to 2018."
Accord

[Guidance Overview]

Association Health Plans: The Final Rule Is Issued

"[V]irtually any type of existing trade association should be able to meet the necessary associational and control requirements.... [H]ospitals and hospital based systems should be able to create an AHP to offer health benefits to their aligned medical staffs.... [A] franchisor should be able to offer an AHP to its franchisees to enable those franchisees to offer health benefits to their employees.... [T]he role of the States remains pivotal."
Foley & Lardner LLP

[Guidance Overview]

CMS Issues New Funding Opportunity Announcement for the Federally-Facilitated Exchange Navigator Program

"[CMS issued] the Funding Opportunity Announcement (FOA) for the Federally-facilitated Exchange (FFE) Navigator Program for plan year 2019... CMS expects to award up to $10 million for a 1-year period of performance. A minimum of $100,000 will be awarded in each of the 34 FFE states to provide assistance to Exchange consumers, starting in the fall of 2018. Awards will go to eligible grantees, such as chambers of commerce, small businesses, trade associations, and faith-based organizations."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

Sick and Safe Time Leave Reaches Northern Minnesota

"The City of Duluth, Minnesota recently became the third major Minnesota city to enact a local law providing eligible employees with paid leave for sick or safe time absences.... The Ordinance is written to apply to employers with five or more employees nationwide -- regardless of where those employees are located. Employee eligibility, however, is written to tie to how much time an employee spends working in Duluth.... [The] employee eligibility standard differs from the standards set by the Minneapolis and St. Paul sick and safe time ordinances."
Gray Plant Mooty

[Advert.]

Develop a Strong Parental Leave Policy

Sponsored by Lorman and BenefitsLink

July 25 webinar will address the changes taking place in parental leave policies and how to develop a policy which is legally compliant, and which is best suited to help employers recruit and retain employees. Discount for BenefitsLink readers.


PCORI Fee: Long Story for Short Plan Years

"The PCORI fee applies to short plan years. The fee due for a short plan year is based on the average number of plan participants during the short plan year. There are three methods for self-insured plans to choose from when calculating the average number of participants."
International Foundation of Employee Benefit Plans [IFEBP]

Pfizer Backs Down from Drug Price Hike After Pummeling by Trump Administration

"In a surprising reversal, pharmaceutical giant Pfizer said [July 10] it would back down from planned price hikes for several dozen of its drugs amid heavy criticism from the White House. After weathering a one-two punch Monday from the president and his [HHS] secretary, who took turns publicly lambasting the company, Pfizer appeared to have escaped unscathed, at least in terms of its performance on Wall Street."
HealthLeaders Media

Dealing with Reluctance: How to Boost Wellness Program Participation Rates

"Invite employees to help plan a wellness program or come up with new challenges.... [A] mix of group and solo activities will greatly appeal to those who prefer to manage their own health.... [Be] crystal-clear about what data is collected, whether their names are attached to it, and how the data is used.... [M]ake healthy snacks prominently available, offer on-site lunch-and-learns, or provide an app so it's easier to track progress on wellness challenges."
WellRight

Supporting a 'Careforce' (PDF)

"More than one in six U.S. employees are engaged in informal caregiving for a family member ... Caregiving impacts employee absence, work performance and employee health care costs.... Supporting a careforce is about much more than paid leave. This article discusses approaches employers are taking now and might take in the future as they assume the role of caretaker."
Benefits Quarterly, published by the International Society of Certified Employee Benefit Specialists [ISCEBS]

More Trouble for AD&D and Life Insurance Plan Administrators in Drunk Driving Cases

"[T]he Fifth Circuit joined the other circuits in reading these exclusions to require an insurer to conclude that the insured was intoxicated at the time of the accident, which in turn requires some form of scientific proof. It is not sufficient, for example, for a toxicology report to reveal drugs in an insured's system. It also may not be it sufficient, depending on the jurisdiction, that a toxicology report reveal alcohol intoxication at some point after the accident." [White v. LINA, No. 17-30356 (5th Cir. June 13, 2018)]
Seyfarth Shaw LLP

Republican Attorneys General Ask That a Partial Injunction Against ACA Apply Only in Their States

"On July 5, 2018, the plaintiffs in Texas v. United States -- ongoing litigation over the constitutionality of the [ACA's] individual mandate and, with it, the entire ACA -- filed a brief in support of their request for a preliminary injunction.... The plaintiffs continue to ask Judge O'Connor to enjoin the entire ACA on a nationwide basis and request an injunction in advance of January 1, 2019, when the mandate penalty is zeroed out. If, however, the court only grants a limited injunction (for the mandate, guaranteed issue, and community rating), the plaintiffs now ask the court to apply that injunction to only the 20 plaintiff states."
Katie Keith, in Health Affairs

Insurer: ACA Risk Payments Use 'Flawed' Methodology

"Health Connections' CEO Marlene Baca said the [CMS suspension of risk-adjustment payments] was a positive development for both the company and the industry, particularly for small insurers who had been penalized by the program.... A CMS report released Monday showed New Mexico Health Connections would have had to pay a net sum of about $5.6 million[.]"
InsuranceNewsNet.com

The Effect of Eliminating the Individual Mandate Penalty and the Role of Behavioral Factors

"Under a range of scenarios that reflect alternative assumptions about responses to these factors, we find that enrollment falls by 2.8 million to 13 million people and premiums for bronze plans increase by 3 percent to 13 percent when the mandate penalty is removed. The impact on the federal budget deficit is more uncertain, with effects ranging from a reduction of $8 billion to an increase of $3.6 billion in 2020."
The Commonwealth Fund

[Opinion]

Paid Family Leave Is an Investment in America's Families -- It Deserves Bipartisan Support

"Social conservatives underscore paid leave as a way to forge more tightly bonded families and protect infants and parents at their most vulnerable. Fiscal hawks recognize the efficiency of increasing workforce attachment and minimizing government dependence. And everyone shares the concern for our country's plummeting fertility rates, now the lowest in history, and the effect that will have on our society and economy at large. If executed responsibly, paid family leave is targeted government action with the right incentives -- designed to increase the independence, health and dignity of our citizens."
The White House

[Opinion]

Thoughts On Risk Adjustment

"[T]he Trump Administration has temporarily suspended all payments and collections of RA until the lawsuit is resolved.... [T]his is something that could have been avoided and fixed by the prior administration.... They could have issued interim rules to circumvent the problem. They could have adjusted the 2017 Notice of Benefit and Payment Parameters that were rushed through in late 2016 to mitigate the problem too. But they didn't."
InsureBlog

Executive Compensation
and Nonqualified Plans

SEC Sanctions Dow Chemical for Undisclosed Perquisites

"The SEC issued a cease-and-desist order against The Dow Chemical Company for failing to disclose approximately $3 million in executive perquisites in the company's proxy statements. The SEC imposed the sanctions agreed to in Dow's settlement offer, which include extensive undertakings to ensure future compliance and a $1,750,000 civil monetary penalty."
Thomson Reuters Practical Law

Selected Discussions
on the BenefitsLink Message Boards

Can I Check Both 'Trust' and 'General Assets' on Form 5500 Line 9?

A health & welfare plan with a trust (VEBA) pays for some expenses out of the trust, but pays others out of general company assets. Can I check both the 'trust' and 'general assets' boxes on line 9?
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Lois Baker, J.D., President  loisbaker@benefitslink.com
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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