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Health & Welfare Plans Newsletter July 17, 2018 |
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Jobs
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Webcasts, Conferences Employee Benefit Plans for Small Employers: Preliminary Issues, Plan Design Options and Administrative Challenges
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Discussions |
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This Newsletter:
BenefitsLink Retirement Plans Newsletter:
Message Boards Digest:
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Defined Contribution Account Manager|
[Official Guidance]
55 pages. "These are the filing instructions for the report to the Secretary required by section 2718 of the Public Health Service Act (PHSA), which includes elements that make up the medical loss ratio (MLR) and the calculation and provision of rebates to enrollees. The data included in the MLR Annual Reporting Form (MLR Form) are the exact data that will be used to calculate an issuer's MLR and rebates, if any ... The MLR Form has been updated to incorporate provisions in 45 CFR Part 158 that are effective for the 2017 MLR reporting year."
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[Advert.]
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![Sponsored by International Foundation of Employee Benefit Plans [IFEBP]](https://benefitslink.com/bnrs/2017/IFEBP_OnsiteEduc_top.jpg "Sponsored by International Foundation of Employee Benefit Plans [IFEBP]")
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[Official Guidance]
System Validations for the 2017 MLR Reporting Year (PDF) "When an issuer uploads the annual MLR reporting form into the Health Insurance Oversight System (HIOS), the submission undergoes several automated validations. Some of the validations result in an error message and the issuer must resolve the problem before they can attest to their submission."
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11 pages. "[E]mployers are increasingly focused on cost control options that don't involve automatically shifting costs to employees. These options include encouraging cost-effective treatment venues, narrow networks, reference-based pricing and centers of excellence.... [This article reviews] ... [1] Issues affecting medical care and costs; [2] Strategies employers use to control health plan costs."
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Health Savings Account Participants Are Healthcare's Savviest Consumers "HSA participants are: ... [1] 38 percent more confident they understand their health insurance coverage and 54 percent more confident in forecasting out-of-pocket healthcare costs.... [2] 23 percent more likely to make cost/value-based decisions than the general population....[3] 46 percent more likely to research and compare costs and 37 percent more likely to seek out alternatives.... [4] 68 percent more likely to have a savings goal and 80 percent more likely to be saving aggressively for future healthcare savings."
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IRS Doubles Down on Employer Mandate Enforcement (PDF) "In addition to assessment notices in connection with an employer's failure to offer minimum essential coverage to at least 70% of its full-time employees and their dependents, the IRS is now sending assessments for 2015 coverage that was 'unaffordable' or failed to provide minimum value. If timing is like last year, IRS will start releasing assessment notices for the 2016 calendar year later this year."
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New Business Credit for Paid Family and Medical Leave "To qualify, employers must have a written policy granting at least two weeks annual paid family and medical leave to employees at 50% or more of the employee's normal salary. The policy must grant leave to all qualifying employees who work full-time and be pro-rated for part-time employees. Vacation leave, personal leave, or other medical or sick leave does not meet the criteria and the credit does not apply if state or local laws mandate paid leave."
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One Sure-Fire Way to Engage Employees in Voluntary Benefits "One way is to understand what employees might need given their life stage, family situation or other variables. To help employees sort this out, here are few scenarios of how voluntary benefits could help employees[.]"
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Tracking Section 1332 State Innovation Waivers "The current statutory language requires that state waiver applications must demonstrate that the innovation plan will provide coverage that is at least as comprehensive in covered benefits; at least as affordable (taking into account premiums and excessive cost sharing); cover at least a comparable number of state residents; and not increase the federal deficit.... Additional details on [specific] state waivers are provided [in this article]."
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Judge Kavanaugh's Health Care Opinions "In two [ACA] cases, Kavanaugh dissented from the majority opinion that had rejected a challenge to the ACA. In both, however, he objected only to the reasoning of the court; he agreed with the majority that the complaint against the ACA should have been rejected.... In none of these cases did Kavanaugh stake out a strong ideological position ... In several of the cases he made a point of following existing precedent and in none would he have radically changed the law."
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[Opinion]
Paid Family Leave Should Not Come at the Expense of Retirement "That there is a commitment from both parties on this issue is certainly a step forward. But the parties have different approaches to providing paid leave to their constituents -- and the GOP's proposal poses serious risks for Americans."
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[Opinion]
National Health Law Program Comments on HHS Plan to Lower Drug Prices "[National Health Law Program (NHeLP)] outlines steps HHS can take to lower consumer out-of-pocket expenses, such as barring the use of co-insurance whereby insurers require consumers to pay a percentage of the costs for prescription drugs ... And [NHeLP's] comments describe a number of measures to curb pharmaceutical company profiteering on the backs of health care consumers and tax payers."
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Benefits in General |
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Cybersecurity Hot Topics for Closely Held Businesses (PDF) "Cyberattacks are not exclusively a threat to companies of a particular size.... [1] Users can be your greatest risk or your best security ... [2] Multifactor authentication and a password management solution can help keep you secure ... [3] Use security software and create access barrier ... [4] Image-based backups with an offsite copy ... [5] Consider cyber liability insurance."
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[Opinion]
How to Keep HSAs From Cannibalizing Retirement Savings "Anytime we can help a participant understand how to prioritize and spend their 'next best dollar' we should jump on that opportunity. It makes sense that the HSA should be integrated with any retirement discussions. Most health brokers are not licensed to talk about investments and retirement savings ... [As] long as the retirement industry leads the discussion and not the health broker, we should be in good shape. This just adds to the need of better communication and education. Which now points back to more resources are needed from adviser teams to provide this type of education."
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Selected Discussions |
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Health Plan Requires Use of 340B Providers as Condition to Covering Certain High-Cost Prescriptions What legal issues are associated with a self-insured health plan requiring use of a 340B provider as a condition to covering certain high-cost prescription drugs? HIPAA non-discrimination? ADA? "Network adequacy"? Other legal issues?
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Press Releases |
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All Firm Lawyers Selected to the 2018 Northern California Super Lawyers and Rising Stars Lists
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Fidelity Launches Advice Solution For Workplace Plan Participants
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Connect
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BenefitsLink.com, Inc.
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Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager
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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