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Health & Welfare Plans Newsletter July 20, 2018 |
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Jobs
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Webcasts, Conferences Northern California Compliance Roundtable: Afternoon Session
2019 Onsite Employee Health Clinics Summit
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Discussions |
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This Newsletter:
BenefitsLink Retirement Plans Newsletter:
Message Boards Digest:
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Pension Administrator - Retirement Plans|
[Guidance Overview]
"While the information letter does not break any new ground, it may be of interest to certain employers in understanding the interaction between an ALE's responsibilities under employer shared responsibility and under prevailing wage laws. In addition, it serves as a reminder that the IRS is continuing to enforce the requirements of employer shared responsibility -- including penalty assessments under Code Section 4980H[.]"
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[Advert.]
Develop a Strong Parental Leave Policy
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. |
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[Guidance Overview]
State Legislature Expands the New York Paid Family Leave Program "[T]he Living Donor Protection Act of 2018, expands the definition of the term 'serious health condition' ... [so that] an employee would be able to take NYPFL to care for a family member who undergoes transplantation preparation and/or donation-related surgery.... [T]he change in the definition of serious health condition under this bill does not create a right for an employee to take NYPFL to prepare or recover for his or her own transplantation preparation or donation-related surgery."
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Forming an Association Health Plan: Legal and Governance Structure "The formation of an AHP starts with the sponsoring association, which will typically serve the role of 'plan sponsor' within the meaning of ERISA Section 3(16)(B). A common first step is for the sponsoring association to form a trust.... The next step -- and most challenging -- is to contract with skilled and experienced service providers who will be crucial to the smooth day-to-day operation of the AHP.... Assuming that the AHP is successful in engaging an insurance carrier, the carrier will issue a group insurance policy to the AHP."
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Supreme Court Antitrust Ruling May Have Big Impact on Health Insurance "The U.S. Supreme Court has decided its first antitrust case in almost three years, establishing a new rule that in the two-sided credit card network market, a plaintiff must analyze both the merchant services side and the consumer cardholder side for anti-competitive effects ... The parallels between two-sided credit card markets and two-sided insurance markets are clear ... Given the recent appeal of vertical transactions, and several ongoing antitrust cases involving health insurance networks, the applicability of a two-sided market analysis in the health insurance space will inevitably be in front of courts in due course." [Ohio v. American Express Co., No. 16-1454 (U.S. June 25, 2018)]
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Administration Considering Overhaul to Drug Rebate Safe Harbor Protections "Details on how exactly HHS wants to rethink safe harbors are scant, as the rule will not be released publicly until OMB signs off on it. But the rule's title -- 'Removal of Safe Harbor Protection for Rebates to Plans or PBMs Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection' -- signals that the changes could be significant."
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[Advert.]
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Now available on Google Play and in the App Store, the free BenefitsLink mobile app includes all the same great content as the daily newsletter -- news, jobs, events, message boards -- at your fingertips when you're on the go. Download today! |
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CBO Follow-Up About the Budgetary Treatment of Cost-Sharing Reductions "CBO and the staff of the Joint Committee on Taxation project that, under current law, the entitlement for subsidies for CSRs will continue to be funded [through higher premiums and larger tax credits based on those premiums]. So in its baseline, CBO no longer projects direct payments for CSRs and, instead, reflects the current form of funding. This letter responds to questions from Congressman Mark Meadows about that change in the baseline and the consequences for estimating the budgetary impact of legislation that would restore and fund direct payments."
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CMS May Be Restarting ACA Risk-Adjustment Payments "[An] interim final rule CMS sent [July 19 to OMB] for review suggests one of those options could be to restart the program.... The title of the potential regulatory item, 'Ratification and Reissuance of the Methodology for the HHS-operated Permanent Risk Adjustment Program under the [ACA],' indicates that CMS is looking to recalibrate the way it calculates payments. Doing so could accomplish what critics said CMS should have done in the first place, instead of halting the payments."
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California's ACA Rates to Rise 8.7% Next Year "Premiums in California's health insurance exchange will rise by an average of 8.7 percent next year, marking a return to more modest increases despite ongoing threats to the [ACA]. The state marketplace, Covered California, said the rate increase for 2019 would have been closer to 5 percent if the federal penalty for going without health coverage had not been repealed[.]"
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How Would State-Based Individual Mandates Affect Health Insurance Coverage and Premium Costs? "If all states implemented individual mandates, the number of uninsured would be lower by 3.9 million in 2019 and 7.5 million in 2022. On average, marketplace premiums would be 11.8 percent lower in 2019. State mandate penalty revenues would amount to $7.4 billion and demand for uncompensated care would be $11.4 billion lower. The impact on coverage and on premiums varies in significant ways across states."
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Fighting FMLA Abuse in the Summertime: Top 10 Employer Tools to Keep Employees Honest "Require that employees complete a written leave request form for all absences.... Prepare a list of probative questions you ask all employees when they request time off.... Enforce call-in procedures.... Certify ... and recertify! ... Use the 'cure' process to your advantage when following up on certification.... Have employee complete a personal certification.... Check in on your employee and/or make them stay put.... Follow up on patterns of absences.... Scheduling medical treatment around your operations.... Conduct a comprehensive audit of your FMLA practices."
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[Opinion]
Will Regulation About Association Health Plans Satisfy the Intent? "Commenters about the [DOL's] regulation say it could result in state restrictions, ratings that will make costs unequal and may provide no inclusion for all small businesses that could benefit from it."
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[Opinion]
We Are Not Doing Anything to Control Healthcare Costs "[H]ere are some low-hanging fruit solutions: ... [1] Multiple price increases for established drugs are unconscionable.... Innovation should be rewarded but prices should be regulated to avoid the price gouging that exists today. [2] Reduce hospital bed oversupply and increase efficiency of providing this care. [3] Promote wellness and wellbeing. Create disincentives for unhealthy lifestyles. [4] Align incentives to encourage appropriate settings for care."
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Executive Compensation |
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[Official Guidance]
"Since Rule 701 and Form S-8 were last amended, forms of equity compensation have continued to evolve and new types of contractual relationships between companies and the individuals who work for them have emerged. In light of these developments ... we believe this is an appropriate time to revisit the Commission's regulatory regime for compensatory securities transactions. We therefore solicit comment on possible ways to update the requirements of Rule 701 and Form S-8, consistent with investor protection. We also solicit comment on what effects any revised rule or form may have on a company's decision to become a reporting company."
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[Guidance Overview]
SEC Solicits Comment on Modernizing Rules Related to Compensatory Securities Offerings and Sales "The Concept Release solicits comments on questions relating to: [1] 'Gig economy' relationships, or new types of contractual relationships between companies and individuals involving alternative work arrangements, to better understand how they work and determine what attributes of these relationships potentially may provide a basis for extending eligibility for the Rule 701 exemption. [2] Whether the SEC should further revise the disclosure content and timing requirements of Rule 701(e). [3] Whether the use of Form S-8 to register the offering of securities pursuant to employee benefit plans should be further streamlined."
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Executive Retirement Vehicle Seen as a Potential Gamble for Employers (PDF) Qualifed supplemental executive retirement plans (Q-SERPs) can help some public companies looking to mitigate their losses following the changes to section 162(m) in the Tax Cuts and Jobs Act... However, [some] have criticized Q-SERPs ... by indicating that the vehicles exploit loopholes in the nondiscrimination regulations and have been targeted by the IRS in the past."
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Press Releases |
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WindRose Health Investors, LLC Announces Recapitalization of basys, LLC
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Connect
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BenefitsLink.com, Inc.
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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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