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Health & Welfare Plans Newsletter July 25, 2018 |
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Jobs
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Webcasts, Conferences Health Benefits Laws Compliance Assistance Seminar
Fiduciary Institute 2018
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Discussions |
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This Newsletter:
BenefitsLink Retirement Plans Newsletter:
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Defined Contribution Account Manager|
[Guidance Overview]
Massachusetts Enacts New Paid Leave Law "All Massachusetts employees will be immediately eligible for paid family or medical leave at the outset of the program. Self-employed individuals will be able to opt into the program, and former employees will remain eligible for paid leave within 26 weeks of their separation from employment."
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Forcing Continuous Leave When Employee Sought Intermittent Leave May Violate Both FMLA, ADA "[The court] found a triable issue on whether the employer retaliated by placing the employee on continuous FMLA leave after he requested intermittent leave. The 'sudden about-face in 2016' regarding his ability to work suggested the employer's excuse of medical for continuous leave was pretext for retaliation. Also, while the employer asserted that the decisionmaker didn't know about his prior intermittent leave, the fact that she didn't bother to look at his history was also suspicious." [Brown v. Gestamp of Alabama, Nos. 16-1862 and 17-1411 (N.D. Ala. July 18, 2018]
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Recent Observations on ACA Employer Mandate Enforcement "The IRS initial letters were for 2015 and focused on the 'A' penalty, which applies to Applicable Large Employers (ALEs) that did not offer coverage ... However, rather than going through the 'A'-'B' two-step, the latest Letters 226J address both the 'A' penalty and the 'B' penalty of the Employer Mandate.... Many Letters 226J are the result of mistakes in filling out the Forms 1094/1095-C.... The IRS has also made some apparent mistakes in generating its Letters 226J."
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About 90% of Large, Mid-Size Employers Offer Medical Benefits "In March 2018, eighty-eight percent of employers with 500 or more employees and 83 percent of employers with 100 to 500 employees offered medical benefits. In contrast, only 55 percent of small employers with less than 100 employees offered medical benefits to employees. Overall, 69 percent of private employees and 89 percent of state and local government workers in the US are offered health plan benefits[.]"
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"Promote vaccines and the benefits your company offers to cover the cost of vaccines as part of a broader health & wellbeing strategy promoting prevention and self-care. Educate employees and eliminate [these] barriers: [1] ACA plans cover preventive immunizations at 100%; [2] Most network retail pharmacies offer immunizations; [3] Offer on-site immunization clinics or offer immunization through health fairs."
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[Advert.]
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Reference-based Pricing: A Cure for Rising Healthcare Costs? "Typically, a preferred provider organization (PPO) network achieves a 50-60% discount on billable charges.... The same hospitalization for chest pain can range anywhere from $3,000 to $25,000. Reference-based pricing allows employers to pay for medical services based on a percentage of [CMS] reimbursements (i.e. Medicare + 30%), rather than a percentage discount of billable charges. This model ensures that the [example hospitalization for chest pain] costs an employer $3,000 rather than $25,000."
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Substance Abuse and Opioids Are Not an Issue with My Employees ... or Are They? "The most important thing an employer can do is to have a proactive plan in place to help your employees live a healthy lifestyle.... Train your staff.... Show employees you care.... Be transparent.... Share the savings."
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Pharma's Promises to Curb Drug Prices Have Been Heard Before "Promises by the pharmaceutical industry to contain prices are a familiar -- and fleeting -- phenomenon, say analysts who have watched the unstoppable rise in drug costs over the years. History's lesson, they say, is that price-restraint vows last only as long as it is politically necessary for companies to make them. Recent pharma pledges are unlikely to be any different, they predict."
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HIPAA Case Study Shows How to Get it Right "Employers that are, or that have plans, subject to HIPAA should: [1] Ensure you have HIPAA and disciplinary policies that are well written, clear, and understandable. [2] Provide examples of prohibited conduct. [3] Enforce your policies consistently and across the board -- don't make exceptions or vary your response to similar violations and misconduct. [4] Ensure that employees are trained and tested on a regular basis ... [5] Monitor employee conduct and behavior for compliance ... [6] Be sure that if you are a medical provider that provides care to your employees that they are included in the protections offered by your policies."
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"Last year's amendments increased the basic EMAC annual fee to $77 per employee from $51 per employee and added a new, supplemental penalty of up to $750 for each non-disabled worker who receives health insurance coverage through MassHealth or who opts out of employer-provided coverage and instead receives subsidized coverage from the Massachusetts Health Connector ... [T]he Massachusetts Legislature has proposed an amendment to the EMAC rules providing for hardship waivers."
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Press Releases |
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Alliance Benefit Group Partners with an Industry Veteran
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Susan Hoffman and Marc Machiz Join Together to Form Justican Mediation LLC
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National Business Group on Health Appoints Tracy Kofski, General Mills HR Executive, as Board Chair
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NAGDCA Announces 2018 Leadership Recognition Award Recipients
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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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