Health & Welfare Plans Newsletter

September 13, 2018

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Plan Documents, Required Notices and Document Retention Requirements
RECORDED
OneDigital Health and Benefits

Trends in the Availability of Employment-Based Health Coverage
September 27, 2018 WEBCAST
EBRI [Employee Benefit Research Institute]

Today's Voluntary Benefits: An Essential Employer Strategy
October 10, 2018 in TX
Worldwide Employee Benefits Network [WEB] - Houston Chapter

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[Official Guidance]

Text of CMS Guidance on Claiming a Hardship Exemption Through the IRS (PDF)

"[C]onsumers may claim all hardship exemptions available under Section 155.605(d)(1) either by obtaining an [exemption certificate number (ECN)] through the [federally-facilitated exchange (FFE)] using the existing application process, or on a federal income tax return without presenting the documentary evidence or written explanation generally required for hardship exemptions. Consumers should keep with their other tax records any documentation that demonstrates qualification for the hardship exemption."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

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

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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]

CMS Details Additional Process for Providing Relief for Consumers from Individual Mandate

"Of the $3 billion the [IRS] collected from taxpayers in individual mandate penalties in 2015, over 5 million households, or nearly 80 percent, earned $50,000 a year or less.... This new option to claim a hardship exemption through the federal tax filing process responds to President Trump's first Executive Order, where he directed agencies to minimize the unwarranted economic and regulatory burdens of the PPACA."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Some Employers Receiving IRS Letters to Request Information on ACA Reporting

"The IRS is now sending Letter 5699 to employers it believes were ALEs that may have failed to submit the required Forms. In particular, Letter 5699 requests that the employer confirm the name and Employer Identification Number it used when filing the Forms along with the date such filing was made. Letter 5699 also reminds employers that there are penalties for failing to file the Forms.... Employers must respond to Letter 5699 within 30 days of receipt."
The Wagner Law Group

Cost of Employer Health Coverage to Rise in 2019

"This would be the sixth consecutive year with a 5% increase, with premiums and out-of-pocket costs for employees and their dependents averaging $14,800 next year. Fortunately, employers continue to cover 70% of that tab, on average, with workers picking up the rest. Employers said that high-cost claimants, specialty pharmacy and the treatment of specific diseases or conditions (such as cancer or musculoskeletal conditions) were key drivers of the cost increases for 2019."
Kiplinger

Pharma CEO Jacks Drug Price 400%, Citing 'Moral Requirement to Make Money'

"Nirmal Mulye, CEO of the small Missouri-based drug company Nostrum Laboratories, raised the price of bottle of nitrofurantoin from $474.75 to $2,392 last month. The drug is a decades-old antibiotic used to treat urinary-tract infections caused by Escherichia coli and certain other Gram-negative bacteria. The World Health Organization lists nitrofurantoin as an essential medicine."
Ars Technica

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Insurer: We Won't Pay For OxyContin Anymore

"Health insurance giant Blue Cross Blue Shield of Tennessee will stop covering OxyContin prescriptions next year. Instead, they'll promote the prescribing of two 'abuse deterrent' alternatives."
National Public Radio

Benefits in General

Senate Confirms Charles Rettig as IRS Commissioner

"The Senate voted Wednesday to approve the nomination of Beverly Hills tax attorney Charles 'Chuck' Rettig as commissioner of the [IRS]. Rettig, who has been with the firm of Hochman, Salkin, Rettig, Toscher & Perez for 35 years, will be expected to help the IRS deal with the impact of the Tax Cuts and Jobs Act, including a large number of new tax forms and schedules and demand for guidance on various aspects of the hastily drafted tax law, even as the IRS struggles with flat budgets and diminished staffing."
Accounting Today

Selected Discussions
on the BenefitsLink Message Boards

Benefit Neutrality and Integrated HRA Plans

I've been tying myself in knots on the math trying to compare the cost-sharing implications of switching from a Cadillac health plan to a higher deductible plan with an integrated HRA. The former is a family plan with a standard deductible of $0, no coinsurance, and a max out-of-pocket of $3k/$6k (per person/per family). The latter has a standard deductible of $3k/$9k, no coinsurance, and a max out-of-pocket of $5k/$10k. Copays are naturally a bit higher, and the plan is obviously more restrictive all around. If one of the goals is to minimize cost-shifting to employees, how would you go about determining the appropriate HRA contribution amount?
BenefitsLink Message Boards

Press Releases

NPPG Appoints Natale Coraci to Senior Pension Administrator
Northeast Professional Planning Group [NPPG)]

NPPG Appoints Matthew Donnachie to Retirement Plan Administrator
Northeast Professional Planning Group [NPPG)]

Most Popular Items in the Previous Issue

AICPA Working Draft of Chapter on Multiemployer Benefit Plans (PDF)
American Institute of Certified Public Accountants [AICPA]

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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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