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Health & Welfare Plans Newsletter October 25, 2018 |
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Jobs
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Webcasts, Conferences HSAs and High-Deductible Health Plans: A Refresher Course
Legislative Update: Year-End Review of Legal Changes Affecting Benefit Plans
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Discussions |
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This Newsletter:
BenefitsLink Retirement Plans Newsletter:
Message Boards Digest:
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Retirement Plan Administrator|
[Official Guidance]
Text of CMS HIOS Portal User Manual (PDF) 107 pages. Version 29.00.00, Oct. 2018. "Enhancements have been added including new organization search functionality and user role removal functionality for administrative users.... These technical instructions explain how the [Health Insurance Oversight System (HIOS)] application works within any compatible Internet browser applications ... HIOS is one of the systems that can be accessed through the CMS Portal using EIDM authentication and authorization. Only users who are authenticated with the EIDM procedures will be allowed to access the HIOS system."
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[Guidance Overview]
"Comply with large employer shared responsibility rules if applicable, or pay penalties ... Consider amendments to align plan with Code Section 4980H full-time employee determinations ... Association Health Plans ... Health Reimbursement Arrangements ... FMLA tax credit ... Consider impact of new disability claims regulations ... Consider impact of nondiscrimination rules ... Reconsider offering domestic partner benefits ... Review grandfathered status ... Be ready for HIPAA Phase 2 audits ... Review wellness programs ... Consider proper treatment of telemedicine benefits ... Distribute revised Summaries of Benefits and Coverage ... Distribute Summary Annual Report ... Gear up for the Cadillac Tax ... Consider offering alternatives to opioids and easy access to addiction support services ... Reflect cost-of-living increases."
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[Guidance Overview]
"The proposal will not to apply to group health plans or health insurance issuers until January 1, 2020. This proposal will require new processes, notices, plan documents and careful consideration by employers to implement it effectively.... The purpose of this alert is to provide some quick answers for common questions this proposal may raise as leaders think about long term options."
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[Guidance Overview]
New Guidance Creates a New Playing Field for HRAs "The new rules provide that HRAs may be integrated with individual health coverage -- whether purchased through a Health Insurance Exchange or otherwise -- by meeting specified requirements ... Small employers, in particular, may make widespread use of HRAs once the new rules take effect. Many of the rules are aimed at creating an environment that will further stabilization of the individual insurance market by bringing in a broad segment of employed individuals."
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[Guidance Overview]
New Jersey Paid Sick Leave Law Update: NJDOL Issues New Guidance "[T]he New Jersey Department of Labor and Workforce Development (NJDOL) issued a detailed list of answers to frequently asked questions (FAQs) on October 24, 2018. Many of the answers to the FAQs simply restate the provisions of the proposed regulations, but others clarify open questions."
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The Health Plan's Role in Preventing Pharmacist 'Gag' Clauses "[The Patient Right to Know Drug Prices Act] requires is that an insurer or health plan 'ensure' that the pharmacy benefits manager (PBM) 'does not' impose a gag clause on pharmacists.... How can a self-funded health plan ensure that a PBM does not do this? ... One avenue is to amend the plan's contract with the PBM to prohibit the PBM from using gag clauses. That would at least give the plan a contractual right to sue if the plan discovered the PBM was still using gag clauses."
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Impact of Employee Health on Business Success (PDF) 16 pages. "This paper ... [describes] proactive measures business owners can implement to resolve the enormous challenges employee health expenditures create.... Beyond reducing expenditures, the effective application of comprehensive wellness strategies may generate dual rewards: moderation of total healthcare costs while significantly boosting productivity, employee satisfaction, and business profitability -- regardless of the size of the workforce."
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Managing Paid Sick and Safe Time for Seasonal Employees "Virtually all PSST laws include coverage for seasonal workers.... [D]epending on their length of service, seasonal workers may not meet a law's covered employee threshold.... Employers may be able to institute a waiting period during which PSST cannot be used.... Most, but not all, laws require that previously accrued but unused PSST be reinstated if employees are rehired within a specific timeframe."
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Employers Combat Healthcare Costs Through HSAs, Wellbeing and Pharmacy Benefit Measures "Though companies expect a slight upswing in healthcare cost increases over the next two years or so, cost trends remain at or below 5 percent after plan changes ... This is due, in part, to the maturing of account-based health plans, a strategy that combines a group health insurance plan with an employee flexible spending account or health savings account.... [E]mployer confidence in offering health benefits in 10 years remains strong, and in fact that confidence is close to its highest level in 15 years."
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Some Couples Could Need as Much as $400,000 to Cover Medicare Expenses (PDF) "In 2018, a 65-year-old man needs $75,000 in savings and a 65-year-old woman needs $99,000 for a 50 percent chance of having enough to cover premiums and median prescription drug expenses in retirement.... For a 50 percent chance of having enough to cover health care expenses in retirement, a couple with median prescription drug expenses needs $174,000 in savings. For a 90 percent chance of having enough, the couple need s $296,000 in savings. At the extreme -- a couple with drug expenses at the 90th percentile throughout retirement who want a 90 percent chance of having enough money for health care expenses in retirement by age 65 -- targeted savings are $399,000 in 2018."
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Benefits in General |
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Severance Planning During an Economic Boom "While many employers think they do not have an ERISA-covered plan -- because it is not written or is not distributed to employees -- they may in fact have a de facto plan if they have a routine policy for providing severance benefits that requires ongoing administrative discretion.... ERISA coverage is generally a good thing."
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"To make it easier to figure out which source is right for your needs, [BLS now has] an interactive guide to all BLS data on pay, benefits, wages, earnings, and all the other terms we use to describe compensation.... The guide lists 12 sources of compensation data and 32 key details about those data sources. 12 x 32 = a LOT of information!"
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Selected Discussions |
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Payment of Premiums by Employer after COBRA If an employer wants to pay a former employee's health premiums, first COBRA, and then after COBRA ends, whatever it costs for the employee to get health coverage, how are payments of those premiums treated for tax purposes? I know premiums paid for COBRA are nontaxable if the Company pays directly or pays to former employee upon proof of payment to insurance company, but if the Company continues to pay the former employee's premiums after COBRA ended, how is that treated? Is that income, subject to a 1099 or something like that?
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Press Releases |
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Couple Indicted For Embezzling $14.5 Million from Retirement Funds
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Most Popular Items in the Previous Issue |
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Departments Propose Regs Permitting HRAs for Individual Policies
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Federal Government Releases Proposed Regs That Will Expand the Use of HRAs
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An Employer's Guide to Navigating the ACA Reporting Requirements (PDF)
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Connect
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BenefitsLink.com, Inc.
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Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager
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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