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Health Reform: From the Midterms to 2020
November 16, 2018 in DC
Health Affairs

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[Guidance Overview]

Expanded Usability of HRAs Under the Proposed Rule

"Integrated HRAs may be particularly attractive to small employers who are not required to offer coverage under the employer mandate but who wish to provide workers with health care coverage as a means of attracting talent and retaining employees.... Under the Proposed Rule, an employer would not be permitted to offer both an Integrated HRA and an Excepted Benefit HRA to the same employee, but an employer could offer one of these HRA arrangements to one class of employees and the other HRA arrangement to a different class of employees."
Drinker Biddle


Now is the time to become a member of ECFC

Sponsored by ECFC [Employers Council on Flexible Compensation]

ECFC is dedicated to maintaining and expanding employee benefit programs on a tax-advantaged basis. Members include employers, TPAs, health plan providers, brokers, payers, providers, payment networks, processors, and financial institutions.

Managing Pharmacy Costs Through Focused Analytics (PDF)

"This article discusses the importance of focused analytics that include retrospective and prospective reviews of internal and external forces. Plan sponsors can optimize their pharmacy management by evaluating past experience, benchmarking experience against the industry, aligning program goals, and responding to industry changes." [Article starts at page 5.]

Tips to Avoid Compliance Missteps During Open Enrollment

"Accuracy and clear communication are key to foreclose future benefit claims and litigation.... [P]ay close attention to how ... voluntary benefits are described and endorsed and what administrative tasks you are performing for these benefits. A misstep risks tripping the voluntary plan safe harbor and subjecting these plans to one or more of ERISA, COBRA, HIPAA, and other compliance mandates.... [E]nsure your enrollment vendor is able to provide records of employees that waived and enrolled in group medical benefits.... Carefully review all language in open enrollment materials, which are rife with potential problems."

Massachusetts Employers Must Complete New Health Insurance Responsibility Disclosure Form by November 30

"Massachusetts employers with six or more employees are required to annually submit the new Health Insurance Responsibility Disclosure (HIRD) form, regardless of whether they offer health insurance to their employees or not.... The new HIRD form only consists of a single employer form, which only needs to be completed once annually."
Epstein Becker Green

Data Analytics in Health Care and Benefits: Key Trends to Track in 2019

"[1] Expanding use of wearable technology to drive wellness ... [2] Enabling consumers to make better-informed health care decisions ... [3] Deeper data analytics to match benefit options to employee needs."


Health Savings Accounts (HSAs): Compliance Obligations Under the Internal Revenue Code and ERISA

Sponsored by Lorman and BenefitsLink

Nov. 28 webinar. Although HSAs have numerous tax advantages, it is easy to inadvertently fail to satisfy the requirements. This webinar will help health plan administrators navigate this sometimes treacherous terrain. BenefitsLink discount.

Finding the Payoff from Happier, Healthier Employees

"[A]reas where companies can leverage their investment in self-funding to improve employee well-being: [1] Using data to design your wellness program.... [2] Taking advantage of flexibility in plan design.... [3] Creating a culture that reinforces well-being."
The Alliance

Automobile Insurer Not Required to Reimburse Group Health Insurance Plan Under Automobile Liability Policy's Medical Expense Coverage

"[To] invoke the 'right to recovery' provisions, the coverage provided by both Security Health and American Family has to be a 'plan' as defined under [Wisconsin statutes]. The court ... ruled that American Family's [automobile liability] coverage was not a 'plan' for two ... reasons: [1] the medical expense coverage in the American Family policies was not 'required by law' because Wis. Stat. Section 632.32(4)(bc) specifically states that a named insured may reject medical expense coverage; and [2] the American Family medical expense coverage was not a 'no-fault' contract because 'no-fault' did not refer to medical expense coverage in an automobile insurance policy issued in Wisconsin." [Security Health Plan of Wisconsin, Inc. v. American Standard Ins. Co. of Wisconsin, No. 2017AP1914 (Wis. App. Ct. Oct. 25, 2018; unpub.)]
von Briesen & Roper, s.c.

Healthcare Data Breach Enforcements and Fines

"[1] While enforcement activities and fines are projecting upward, they appear stable between 2014‑2015. [2] Only a minority of investigations lead to fines and penalties. [3] Cooperation in government-initiated compliance reviews is key to reducing the risk of a penalty. [4] Having multiple incidents, even if minor on their own, tends to trigger an investigation and lead to fines and [Resolution Agreements]. [5] All entities, regardless of size, are at risk of being found non-compliant and facing large fines in an investigation."
Bryan Cave Leighton Paisner


Trends in Health Premiums: Stairway to Hell (With Apologies to Led Zeppelin)

"[H]ealth spending under employer-sponsored insurance has increased faster than inflation.... [T]here are many reasons for employers' reluctance to embrace ... value-based strategies, including a lack of resources, the complexity of developing and implementing creative benefit designs, concerns about employee complaints (especially in a tight labor market), and a sense of futility based on past experience. But we should recognize and encourage those employers that are taking up the challenge."
Bill Kramer, in Health Affairs

Benefits in General

[Official Guidance]

Text of IRS Disaster Relief Notice AL-2018-06, for Victims of Hurricane Michael in Alabama

"Victims of Hurricane Michael that took place beginning on Oct. 10, 2018 in Alabama may qualify for tax relief ... Individuals who reside or have a business in Geneva, Henry, Houston, and Mobile counties may qualify ... certain deadlines falling on or after Oct. 10, 2018 and before Feb. 28, 2019, are granted additional time to file through Feb. 28, 2019."
Internal Revenue Service [IRS]

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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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