Health & Welfare Plans Newsletter

August 9, 2018

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[Guidance Overview]

Massachusetts Enacts Expansive Paid Family and Medical Leave Legislation

"Though the implementation of this paid family and medical leave program will be gradual, employers with employees in Massachusetts should start taking proactive steps toward compliance, as the first set of deadlines is less than one year away.... The definition of a family member under the Massachusetts program is much broader than that of the federal [FMLA] and includes an employee's spouse, domestic partner, child, parent, parent-in-law, grandchild, grandparent, or sibling."
Thompson Hine

CMS Updates Marketplace Notice

"The update to the model notice expires May 31, 2020. Employers are required to provide this notice to all new-hires at the time of hire. The DOL considers a notice to be provided 'at the time of hiring' if the notice was provided within 14 days of an employee's start date. Employers must distribute this notice to each employee, regardless of whether the employee enrolls in the employer's health plan, or whether the employee is part- or full-time."
Winston & Strawn LLP

Are Employers Ready to Shake Up Health Care?

"Of eight forms of alternative provider payment methods, the one used most commonly by respondents' health plans (47%) is shared savings, in which there is an upside-only financial incentive for providers to reduce unnecessary health care spending for a population of patients or episode of care.... Over half of Scorecard participants (55%) are members in a local or regional business health group that has the goal of improving health care affordability and quality -- and 23% say they are highly engaged in the organization.... The most common way these employers encourage plan members to refer to quality information before selecting a provider is by listing the highest-quality providers and facilities first in directories (45%)."
Mercer

GM Salaried Employees Get 'Direct-To-Employer' Health Care

"The plan, called GM ConnectedCare, would cost employees $300 to $900 less in annual payroll contributions than the automaker's current cheapest plan and would require them to get all their health care, including surgeries, through Henry Ford Health System, or pay expensive out-of-network rates. ConnectedCare will be offered to salaried GM employees who live in the seven counties where the health system has a concentration of clinics, hospitals and more than 3,000 doctors: Wayne, Macomb, Oakland, Washtenaw, Livingston, Lapeer and St. Clair."
Detroit Free Press

Editor's Pick What Dental Expenses Can a Limited-Purpose Health FSA Cover Without Preventing HSA Eligibility?

"While a limited-purpose health FSA plan document may limit dental coverage by reference to the statutory language, you may want to consider identifying specific procedures that will not be covered. Also, be sure your plan document includes language that preserves the plan administrator's discretionary authority to interpret the plan's coverage limitations."
Thomson Reuters / EBIA

Defending the ACA Versus Enforcing the ACA in Texas v. United States

"[T]he plaintiffs continue to request a preliminary injunction.... The intervenor states oppose the idea of proceeding with summary judgment.... They particularly raise issues such as standing, the constitutionality of the mandate under the Commerce Clause, and whether an injunction in only the 20 plaintiff states is permissible.... [T]he DOJ ... decided not to defend the constitutionality of the individual mandate. Beyond this, the DOJ noted its belief that additional provisions of the ACA are inseverable from the mandate."
Katie Keith, in Health Affairs

Benefits in General

Recent Litigation Surrounding Fiduciary Disclosure Obligations

"In a recent case, the provisions of a conflicting SPD may prevail. The case was sent back to the lower court because the error in the SPD was so significant that it could be found to be constructive fraud.... [Two other cases demonstrate there] are two primary situations for which plan fiduciaries can be liable for not disclosing information to plan participants.... Not telling a participant about a future benefit that is under serious consideration, knowledge of which would be material to the participant; and Leaving out information about a current benefit when the fiduciary knows that silence might be harmful."
CAPTRUST Financial Advisors

Executive Compensation
and Nonqualified Plans

[Guidance Overview]

SEC Amends Rule 701 to Increase Enhanced Disclosure Threshold to $10 Million

"The amendment became effective on July 23, 2018. If a company commenced an offering during the current 12-month period that was continuing on the effective date of the rule amendment, it can apply the $10 million disclosure threshold to the offering."
Morgan Lewis

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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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