Health & Welfare Plans Newsletter

September 11, 2018

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[Official Guidance]

Draft 2018 Instructions for IRS Forms 1094-B Transmittal of Health Coverage Information Returns, and 1095-B, Health Coverage (PDF)

"Health insurance issuers and carriers are encouraged (but not required) to report coverage in catastrophic health plans enrolled in through the Marketplace for months in 2018.... Every person that provides minimum essential coverage to an individual during a calendar year must file an information return reporting the coverage. Filers will use Form 1094-B (transmittal) to submit Forms 1095-B (returns)."
Internal Revenue Service [IRS]

[Guidance Overview]

Editor's Pick Massachusetts and New Jersey Enact State-Level Health Coverage Mandates

"In Massachusetts, new legislation temporarily increases the existing Employer Medical Assistance Contribution (EMAC) and imposes an additional EMAC supplement on employers whose employees receive Medicaid or subsidized coverage through Massachusetts' ConnectorCare program.... In New Jersey, the state legislature established an individual health care mandate that requires New Jersey residents to obtain health coverage or pay a penalty."
Groom Law Group

Judge Hears Oral Arguments in Texas v. United States

"Much of the hearing focused on arguments about congressional intent ... and severability.... Judge O'Connor seemed to be unconvinced that the mandate, with a zeroed-out penalty, remained constitutional.... Judge O'Connor's questions on severability, in particular, suggest he may be considering striking down some or all of the ACA. This is, however, only at the stage of a preliminary injunction, and all parties expect any ruling, regardless of the outcome, to be appealed immediately." [Texas v. U.S., No. 18-167 (N.D. Tex. hearing on motion for preliminary injunction, Sept. 5, 2018)]
Katie Keith, in Health Affairs

Does Your Health & Welfare Plan Need a Trust? (PDF)

"A health and welfare plan does not need a trust to hold plan assets if the plan does not have assets, or if its assets fall within a non-enforcement policy. Health and welfare plans generally are funded by employer contributions, participant contributions, or a combination of both. A careful structuring of funding methods may allow the plan to operate without a trust and still meet the trust requirements."
Kathleen Salas Bass and Sherrie Boutwell, via Journal of Pension Benefits

Strategies for Open Enrollment Communication

"Collect everything that was shared with your employees ... PowerPoints, emails, text messages, posters, benefit guides, websites/technology -- and put together an internal team to help review their effectiveness.... [C]raft a communications campaign that goes beyond the basic formula of a few emails with PDF attachments. You need to aspire to reach your employees in more surprising ways."
Grooms Benefit Solutions

Editor's Pick Taking the Temperature of Sick Leave Laws Around the Country: Accrual Caps

"[A chart provides] paid sick leave law accrual cap information, including accrual amounts and types of caps. Each listed location contains a paid sick leave law or ordinance that either is currently in effect or scheduled to go into effect in the coming months."
Seyfarth Shaw LLP

Unwitting Patients, Copycat Comments Play Hidden Role In Federal Rule-Making

"Of the 1,406 comments that specifically mentioned 340B -- part of several thousand comments submitted on a broad proposal to revise medical payment systems -- about half included the same or similar wording and were submitted anonymously ... Those comments lamented 'abuse' of the drug discounts, faulted hospitals for being 'greedy' and used phrasing such as 'quality, affordable, and accessible.' Two that were duplicated hundreds of times made the very same grammatical mistake."
Kaiser Health News

[Opinion]

Employer-Sponsored Health Insurance Isn't Going Away: Why That's a Good Thing

"[E]mployers have kept our health insurance coverage and costs from spiraling out of control by leveraging their buying power. Today, 65 percent of employers self-insure, eliminating insurer profits and maintaining coverage stability for individuals.... Employers ... have an incentive to achieve sustainable cost control since they pay directly for most health care costs. They aim to keep their employees for years, so they take a longer-term view than private insurers.... Technology and new approaches to care are giving employers greater control over their health care investments than ever before."
STAT

[Opinion]

Medicare Shared Savings Program Produces Substantial Savings, New Policies Should Promote ACO Growth

"One of the assumptions of the administration's proposal to accelerate risk is that the [Medicare Shared Savings Program (MSSP)] has not saved money for Medicare, while other [CMS] initiatives that require downside financial risk have generated savings.... According to CMS, MSSP ACOs saved $1.1 billion in 2017, with net savings of $314 million after accounting for shared savings payments earned by ACOs. The ACOs that joined the program in 2012 through 2014 accounted for the majority of savings. This illustrates that ACO performance improves over time and that ACOs need time before clinical restructuring can generate program savings."
Robert Mechanic and Clifton Gaus, in Health Affairs

Benefits in General

[Guidance Overview]

Changes in Defined Benefit and OPEB Disclosure Requirements (PDF)

"[FASB] has issued a final Accounting Standards Update that affects pension and postretirement benefit accounting. The update adds, removes, and clarifies some current footnote disclosures. The final provisions vary somewhat from the proposed ASU issued in 2016 and take into account comments received on the utility of the information to financial statement users relative to the burden imposed on reporting entities. While some disclosure items were removed, some have been added, and the net effect could be an increase in the time required to complete disclosure information."
Buck

Leveraging Healthcare Costs to Drive 401(k) Contributions and Improve Health (PDF)

14 pages. "A 50-year-old man diagnosed with high blood pressure could save an average of $2,234 per year in out-of-pocket healthcare costs, and add three years to his life expectancy by properly managing his health.... By improving health and investing the savings, a 45-year-old woman with type 2 diabetes and high cholesterol could add more than $100,000 to her 401(k) retirement savings and eight years to her life expectancy through simple changes such as moderating alcohol intake and continuing to take medication as prescribed.... A self-insured company with 5,000 employees could save more than $2.5 million in healthcare costs."
Healthy Capital

Press Releases

Evolution Revolution 2018
National Regulatory Services [NRS]

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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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