Health & Welfare Plans Newsletter

September 10, 2018

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Pension Administrator
The Nolan Company
in KS, Telecommute

Underwriting Manager
Transamerica
in AR

Retirement Plan Transition Administrator
Alerus Financial
in MN, ND

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[Official Guidance]

Text of 2019 Instructions for IRS Form 1099-H: Health Coverage Tax Credit (HCTC) Advance Payment (PDF)

Dated Sept. 6, 2018. "Due to the very low volume of paper Forms 1099-H received and processed by the IRS each year, this form has been converted to an online fillable format.... If you are filing this form on paper due to a low volume of recipients, for this form only, you may send in the black-and-white Copy A with a Form 1096 that you print from the IRS website."
Internal Revenue Service [IRS]

[Advert.]

What Employers Need to Know About ACA 'Pay or Play' Mandates

Sponsored by Lorman and BenefitsLink

Sept. 18 webinar will clear up any confusion about the ACA 'Pay or Play' mandates and help employers to avoid penalties. Discount for BenefitsLink readers.


[Guidance Overview]

Medicare Part D Notices to Participants Due October 15

"[All] employers that offer prescription drug benefits [must] provide an annual notice to all Medicare-eligible plan participants and qualified beneficiaries before October 15th of each year, the start of the Medicare open enrollment period.... For most employers, rather than determine which actives, retirees, dependents, and COBRA participants are Medicare-eligible, it's easier to blanket the entire population with this annual notice."
Kushner & Company

[Guidance Overview]

New Enforcement Guidance on 'No-Fault' Attendance Policies and FMLA Leave

"The [DOL's] Wage and Hour Division (WHD) released a new opinion letter concerning [FMLA] and 'no-fault' attendance policies... [T]he concern in this context was the fact that employees on FMLA leave would have attendance points on their records for longer than other employees not on FMLA leave.... The WHD noted that if an employer counted other types of leave as 'active service" and thereby caused employees on FMLA leave to have attendance points for longer periods than employees on equivalent types of leave, the policy may be unlawfully discriminatory."
Ogletree Deakins

[Guidance Overview]

Paid Leave: Coming to a Michigan Workplace Near You

"In addition to FMLA-covered absences, the adopted proposal permits paid leave in cases of domestic violence and/or sexual assault, to attend meetings at a child's school or place of care, and in cases of school or business closures ordered by public officials."
Ogletree Deakins

Ninth Circuit Revives Implied Contract Claims Concerning Retiree Heath Care Benefit

"Contract claims asserted by retirees with regard to a county's reduction in the Grant Benefit paid to retirees to defray the cost of health care premiums were revived by the Ninth Circuit.... [B]ecause employers are not required to provide post-retirement benefits at all, the county did not violate the California Fair Employment and Housing Act (FEHA) by treating retirees as a separate force and making cost calculations accordingly, taking into account the age distribution of the retiree group as a whole." [Harris v. County of Orange, No. 13-56061 (9th Cir. Sept. 5, 2018)]
Wolters Kluwer; free registration required

Sixth Circuit Finds Group Health Policy for Tribal Members Was Not Subject to ERISA

"In fiduciary breach litigation under ERISA, the Sixth Circuit addressed the extent of a third-party administrator's (TPA) liability regarding two policies under an Indian tribe's health benefit program ... The court held that a policy for tribal members and a policy for tribal employees did not together constitute a single ERISA plan." [Saginaw Chippewa Indian Tribe of Mich. v. Blue Cross Blue Shield of Mich., No. 17-1932 (6th Cir. Aug. 30, 2018, unpub.)]
Thomson Reuters Practical Law

Judge Vacates Medicare Advantage 2014 Overpayment Final Rule

"[Insurers] had argued that the 2014 statute requires 'actuarial equivalence' between [CMS] payments for care delivered under traditional Medicare and Medicare Advantage. Instead, the health insurers successfully argued, the 2014 final rule imposed a stricter standard on MA carriers than on CMS itself when paying Medicare benefits." [UnitedHealthcare Ins. Co. v. Azar, No. 16-157 (D.D.C. Sept. 7, 2018)]
HealthLeaders Media

House of Representatives to Consider Bill to Further Delay the Cadillac Tax

"H.R. 3798, the Save American Workers Act of 2017 ... would further delay the implementation of the excise tax on high cost employer health plans (often referred to as the 'Cadillac Tax') by another year, so that it will not become effective until 2023.... [ECFC anticipates] that H.R. 3798 will be passed by the House when it is considered.... The timing of Senate consideration of this bill is unclear[.]"
Employers Council on Flexible Compensation [ECFC]

Employee and Employer Satisfaction with Group Benefit Marketplaces

"94% of employees were satisfied with the variety of choices available.... 90% of employees said they are more aware of their company's contribution toward their benefits.... 87% of employers said the marketplace helped them control benefit costs.... 90% of employers said their benefits administration was simplified."
Willis Towers Watson

Editor's Pick Federal Requirements on Private Health Insurance Plans (PDF)

26 pages. "The first part of this report provides background information about health plans sold in the PHI market and briefly describes state and federal regulation of private plans. The second part summarizes elected federal requirements and indicates each requirement's applicability to one or more of the following types of private health plans: individual, small group, large group, and self-insured.... Many of the federal requirements described in this report were established under the [ACA]; however, some were established under federal laws enacted prior to the ACA." [Report R45146, updated Aug. 28, 2018]
Congressional Research Service [CRS]

The Remedy for Surprise Medical Bills May Lie in Stitching Up Federal Law

"The simplest way to stop surprise bills would be through restrictions imposed by federal legislation that would apply to both state-regulated policies sold by insurers and employer-sponsored self-funded health plans, which are federally regulated.... The [DOL] could ... issue a ruling that clarifies that states can regulate provider payment, or require self-funded plans to participate in state dispute-resolution programs.... There are other possibilities for addressing surprise bills at the state level... While states can't regulate self-funded health plans, they do regulate doctors and hospitals and other providers."
Kaiser Health News

Nondiscrimination Testing of Group Term Life Insurance: An Overview (PDF)

"Group term life insurance is employer-provided if the policy is 'carried directly or indirectly' by the employer.... Although amounts included in a key employee's income are not subject to federal income tax withholding, they are subject to withholding for FICA taxes.... Although amounts included in a key employee's income are not subject to federal income tax withholding, they are subject to withholding for FICA taxes."
Buck

Benefits in General

[Official Guidance]

Revised IRS Form 5558 and Instructions: Application for Extension of Time to File Certain Employee Plan Returns (PDF)

Fillable PDF, rev. Sept. 2018. "An extension of time to file Form 5500 Series ... and/or Form 8955-SSA ... and an extension of time to file Form 5330 ... must be submitted on separate Forms 5558. A signature is not required for an extension of time to file Form 5500 series and Form 8955-SSA. However, a signature is required for an extension of time to file Form 5330."
Internal Revenue Service [IRS]

Sure That Plaintiff You Settled With Won't Sue Again?

"You settle an employment dispute, pay a hefty amount to plaintiff, and get a broad release of claims. You won't have to deal with that plaintiff again, right? Maybe not. If you don't get the right release, that same plaintiff now can bring an ERISA lawsuit on behalf of her employee benefit plan."
Bob Blum Mediation via the Daily Journal

[Opinion]

Stop Making 401(k) Contributions -- Fill Up Your HSA First

"HSAs are triple tax-free ... HSA payroll contributions are truly tax-free ... No use it or lose it ... Paying retiree health care expenses ... No age 70‑1/2 minimum distribution requirements ... Contribution limits ... HSAs and retirement planning ... Investing HSA contributions important."
Robert C. Lawton, via Forbes

Selected Discussions
on the BenefitsLink Message Boards

Form 5500: Input of Multiple Schedule A's

A client has a wrap document. Their carrier has provided me with 9 different Schedule A's due to different policy numbers. Am I able to combine any of the Schedule A's on the plan's Form 5500, or do they have to be input separately?
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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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