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October 11, 2018 logo logo
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Webcasts, Conferences

Navigating DOL Investigations - Strategies from the Trenches in a Changing World
American Bar Association Joint Committee on Employee Benefits [JCEB]

Insurance Carrier Forum: Panel Discussion on Market Innovation
November 1, 2018 in MD
Worldwide Employee Benefits Network [WEB] - Baltimore Chapter

Financing Health: Trends, Challenges and Opportunities
November 14, 2018 WEBCAST
Western Pension & Benefits Council

Avoiding Employee and Fringe Benefit Landmines
December 13, 2018 in VA

►See 85 Upcoming Webcasts and Conferences

►See 1406 Recorded Webcasts


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[Guidance Overview]

Editor's Pick Frequently Asked Questions About the New Jersey Paid Sick Leave Law, Part 3

"What happens to unused sick leave at termination? ... How does the law apply to employees who are transferred to another division or employed by a successor employer?.... Can an employer designate leave taken as PSL under the law even if an employee does not request use of PSL? ... Are employers still required to comply with local paid sick leave laws? ... Are employers required to post and distribute any notices?.... What are the penalties for violating the law? ... Can employees sue their employers for violations of the law?"
Ogletree Deakins


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When Can an Employer Reimburse Individual Health Insurance Premiums? (PDF)

"[1] Qualified Small Employer Health Reimbursement Arrangement (QSEHRA).... [2] Spousal health reimbursement arrangement.... [3] Medicare reimbursement arrangement.... [4] Retiree reimbursement arrangement.... [5] Opt-out/waiver payment."
OneDigital Health and Benefits

Bakery Says Employee's FMLA Claims Don't 'Rise' to the Occasion

"Gold Medal is not moving for judgment on Thompson's claims that it violated the Americans with Disabilities Act (ADA) by terminating him after twelve weeks of leave.... [B]ecause of the ADA, an employer can't just rely on a policy that when FMLA leave is exhausted, it can terminate a potentially disabled employee with impunity -- no matter how justified that policy may be under the FMLA." [Thompson v. Gold Medal Bakery, Inc., No. 18-10410 (D. Mass. motion for judgment filed Oct. 4, 2018)]
Zuckerman Spaeder LLP

Survey Results: Best Practices in Employer-Provided Health Care (PDF)

"[E]mployers are focusing on a short list of top priorities: [1] Concentrating on clinical conditions to reduce high-cost claims ... [2] Improving management of pharmacy costs particularly related to specialty pharmacy cost and utilization. [3] Encouraging greater use of high-performance networks, centers of excellence and telemedicine ... [4] Considering the addition of low-point-of-care cost plans as an option rather than an all account-based health plan (ABHP) lineup. [5] Improving employee total wellbeing -- including physical, social, emotional and financial[.]"
Willis Towers Watson

Editor's Pick Worksite Medical Clinics: 2018 Survey Results (PDF)

30 pages. "One-third of all organizations with 5,000 or more employees provide a general medical clinic at or near the worksite.... Two-thirds (67%) of survey respondents with general medical clinics allow members to select the clinic as their primary care provider ... Among respondents that have invested the time and resources to measure ROI ... over half ... reported a return of 1.5 or higher ... Only 28% of respondents manage their clinic with in-house resources."


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Association Health Plans: A New Twist on Private Exchanges

"Because it's now easier for a group of smaller employers to band together to form a single sponsor of a health plan, it allows the participants to reach a scale of buying power they could not achieve separately. Plus, the plan can be set up to get around the requirement to offer 'essential health benefits', which are required for small group plans that are subject to related [ACA] provisions. While this may skinny down coverage, it may also result in significantly lower premiums."

How Self-Funding Is Helping Businesses Adapt to a Changing Health Care Marketplace

"The benefits to self-funding can be significant. First, there is no premium tax on self-insured benefit plans.... Second, since most self-funded plans fall under the control of [ERISA], which supersedes state law, they are exempt from state insurance requirements. This allows employers to have more flexibility in plan design ... Finally, since claims can vary from year to year, some years are going to be cheaper in terms of claim payouts than others."
Symetra Life Insurance Company, via CNBC

Workers Rank Health Care as the Most Critical Issue in the United States

"73 percent of workers report that health insurance is one of the top three most important benefits when considering whether to stay in or choose a new job, whereas only 57 percent report that a retirement savings plan is in the top three.... One-half of workers with health insurance coverage are extremely or very satisfied with their current health plan.... Just 22 percent are extremely or very satisfied with the cost of their health insurance plan, and only 21 percent are satisfied with the costs of health care services not covered by insurance."
Employee Benefit Research Institute [EBRI]

CVS Health and Aetna Merger Is Approved with Conditions

"The Justice Department's approval of the $69 billion merger between CVS Health and Aetna on [October 10] caps a wave of consolidation among giant health care players that could leave American consumers with less control over their medical care and prescription drugs.... CVS Health had revenues of about $185 billion last year, and provided prescription plans to roughly 94 million customers. Aetna, one of the nation's largest insurers with about $60 billion in revenue last year, covers 22 million people in its health plans."
The New York Times; subscription may be required

Health Apps and Health Policy: What's Needed?

"Four major policy issues need to be addressed with respect to medical apps. First, the safety of apps must be established so the public is adequately protected. Second, a directory of evidence is needed to allow patients and clinicians to assess which apps make a difference. Third, apps must be able to connect with electronic health records (EHRs) to allow seamless and secure transfer of information. Fourth, policies should encourage the market to develop apps that will improve care and value. Throughout this process, the tension between innovation and regulation will need to be managed."
The JAMA Network

Benefits in General

Form 5500s and the Proposal to Publicly Disclose Operational Noncompliance

"The [AICPA's] Proposed SAS would require auditors to disclose findings of noncompliance in the Report on Specific Plan Provisions Relating to the Financial Statements unless the findings are clearly inconsequential. This Report would form part of the official audit report that is attached to the Form 5500 and publicly available on the DOL's EFAST2 website. Public disclosure of operational noncompliance would present many issues for employers."
Winston & Strawn LLP

Selected Discussions
on the BenefitsLink Message Boards

'Change in Status' Event under a Cafeteria Plan

If a legitimate "change in status" takes place during the plan year, is there a specific timeframe by which the employee must make a change in election? I'm looking at a document that was done in 2008, and it doesn't specifically address this question. I presume it must be prospective only, and can't be retroactive. As an aside, does a new union contract effective during the plan year constitute a "change in status"?
BenefitsLink Message Boards

Pre-Tax Arrearages Collected During Following Year

Our company allows medical (actually, all) deductions to go into arrearage when an employee is on an unpaid Leave of Absence. I always recover the deductions in the same year, but now am being asked if we can spread these out over a longer period, which would move us into the new calendar year. Somewhere in my brain is the belief that pre-tax deductions recovered in the next calendar year become taxable. Can someone please confirm (or refute) this for me?
BenefitsLink Message Boards

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David Rhett Baker, J.D., Editor and Publisher
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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2018, 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, 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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