Health & Welfare Plans Newsletter

December 6, 2018

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Pension Plan Administrator
American Pension Advisors, Ltd.
in IN

ERISA Attorney
Warner Norcross + Judd LLP
in MI

Retirement Plan Administration Specialist
Kassouf & Co.
in AL

Retirement Services Associate
Alerus Financial
in MI, MN

401(k) Administrator
Hicks Pension Services
in CA, Telecommute

Retirement Plan Administrator
Flexible Benefits Systems Inc.
in OH, Telecommute

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[Guidance Overview]

Review of 2018 Developments for Health and Welfare Plans (PDF)

23 pages. Topics: [1] Tax Reform Act; [2] Appropriations Act; [3] Short-term, limited duration insurance (STLDI) regulations; [4] Proposed legislation impacting account based plans; [5] State based laws; [6] DOL fiduciary update; [7] AHP regulations; [8] Wellness program rule reversal; [9] Proposed HRA regulations; [10] New contraception regulations; [11] Section 1557 update; [12] Adjusted limits for 2019; and [13] Forms and filings.
Alston & Bird

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[Guidance Overview]

CMS Releases Medicare Advantage and Part D Drug Pricing Proposed Rule for Contract Year 2020

"The agency has proposed five changes to amend Medicare Advantage and Medicare Prescription Drug Benefit (Part D) regulations to support health and drug plans' negotiation for lower drug prices and to reduce out-of-pocket costs for MA and Part D enrollees.... [1] Providing plan flexibility to manage protected classes ... [2] E-prescribing and the Part D prescription drug program; updating Part D e-prescribing standards ... [3] Medicare Advantage and step therapy for Part B drugs ... [4] Pharmacy price concessions to drug prices at the point of sale ... [5] Part D explanation of benefits."
Epstein Becker Green

[Guidance Overview]

Can an Employer Withhold a Year-End Bonus or Incentive Payment from the Employee Who Took FMLA Leave?

"[Perhaps] you want to offer a pay incentive to employees to improve attendance or production? Take, for instance, a point-based attendance bonus policy in which employees are assessed points for every tardiness or absence (even for FMLA or ADA-covered leave), which, in turn, disqualifies an employee from receiving the bonus. In these situations, can an employer disqualify an employee from the bonus or incentive? In short, Yes."
FMLA Insights

[Guidance Overview]

Michigan's Senate and House of Representatives Adopt Changes to the Paid Sick Leave Act

"Businesses with fewer than 50 employees are not covered and employees who are exempt from overtime pay under the [FLSA's] 'white collar' exemptions ... are not eligible for paid sick leave.... The bill reduces the maximum amount of paid sick leave to 40 hours in a 12-month period, which accrues at a rate of one hour for every 35 hours worked ... There have also been significant changes to how employees must request and substantiate their need for paid leave."
Ogletree Deakins

IRS Extends Deadline for ALEs to Distribute 2018 ACA Reporting Forms to Individuals

"This extended deadline applies only to distributing the 2018 ACA reporting forms to employees and covered individuals and not to the deadline for filing the forms with the IRS.... ALEs are advised to use the additional time provided by the extended deadline ... to ensure that the forms are accurate and complete.... [F]ilers will have less time between the distribution deadline and the filing deadline to make any required corrections."
The Wagner Law Group

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Magic Words Unnecessary -- But Staying Out of Work Not Enough -- to Request Medical Leave Under the FMLA

"The evidence established that Shoemaker did not make a request for leave due to a medical condition when she called in her absence. Consequently, her employer's knowledge of her recent medical issues ... was not enough to put it on notice that Shoemaker's absence might qualify as FMLA leave." [Shoemaker v. Alcon Laboratories, Inc., No. 17-1738 (4th Cir. Aug. 6, 2018)]
Poyner Spruill LLP

Law Firms Pad Parental Leave to Attract Diverse Attorney Pool

"Paid parental leave has become the shiny new thing for employers in 2018 -- big name brands like Walmart, Starbucks, and Microsoft have all made headlines with updated policies. In the legal field, a handful of firms also have updated their policies to offer more leave, make the time off gender neutral, or add new types of benefits for parents."
Bloomberg BNA

Student Loan Debt Trends and Employer Programs to Help

"[T]he percentage of families with student loan debt grew from 10.5 percent in 1992 to 22.3 percent in 2016. For families with heads younger than age 35, the percentage with student loan debt approaches one half (45 percent), and the percentage is over a third for those with a family head ages 35 to 44.... [E]mployers looking to attract and retain workers can develop creative programs to address one of the more pressing issues facing workers."
Employee Benefit Research Institute [EBRI]

Drug Companies Draw Fire for Not Using Tax Savings to Lower Drug Prices

"Critics of high drug prices are launching a new line of attack against manufacturers of the medicines, faulting the firms for using savings from the tax overhaul to buy back shares rather than lower prices.... The Congressional scrutiny is the latest sign that drug pricing is emerging as a leading issue in Washington, and drug companies could have a big bullseye on their backs as both Republicans and Democrats respond to popular discontent with how much drugs cost."
The Wall Street Journal; subscription may be required

2019 Health Care Predictions

"[1] The new 'healthcare front door' won't be a physical door at all.... [2] As health needs evolve, more non-acute care will go virtual.... [3] Virtual care delivery will integrate behavioral health into the primary care setting.... [4] Virtual care moves beyond the tipping point as regulatory conditions, economic imperatives, and consumer expectations align in its favor.... [5] AI will play a valuable role in healthcare as augmented intelligence.... [6] Virtual care will curb costs by reducing barriers to care."
Teladoc

[Opinion]

ECFC Applauds Report on Reforming the Healthcare System by Increasing Consumer Choice

"[The report prepared by DOL, HHS, and the Treasury Department] outlines several legislative changes that could be made to increase the use of HSAs by: [1] Allowing innovative insurance products (such as those that provide payment for generic drugs below the deductible or fixed fee payments for primary care) to be coupled with HSAs; [2] Allowing individuals enrolled in a health insurance plan with a 70 percent actuarial value (AV), or below, to contribute to an HSA; and [3] Raising the contribution limits to HSAs."
Employers Council on Flexible Compensation [ECFC]

[Opinion]

Could Telehealth Increase the Price of Health Care?

"[T]he effect of telehealth on prices depends on: [1] how responsive suppliers (i.e., physicians and other health care providers) are to this changing dynamic; [2] the price of telehealth technology; ... [3] patients' perceived inconvenience cost of going to the physician; [and] [4] how third party payers (i.e., insurers) interact with the market."
Healthcare Economist

Benefits in General

Trends in Social Security Disability Insurance Enrollment (PDF)

21 pages. "Multiple factors have contributed to the growth in the SSDI enrollment between 1985 and 2014. Some of the main factors are [1] the increased eligibility and rising disability incidence among women, [2] the attainment of peak disability-claiming years (between age 50 and full retirement age) among baby boomers ... [3] the increase in full retirement age (FRA) from 65 to 66, [4] fewer job opportunities during economic recessions, and [5] the legislative reform that expanded the eligibility standard in SSDI. Some factors may have prolonged effect s on SSDI benefit receipt." [Report R45419, Nov. 30, 2018]
Congressional Research Service [CRS]

Press Releases

DecisionPoint Financial is Certified for Fiduciary Excellence
Centre for Fiduciary Excellence [CEFEX]

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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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