|
Health & Welfare Plans Newsletter December 21, 2018 |
|
|
Jobs
|
|
Webcasts, Conferences More Changes to the Michigan Minimum Wage & Paid Medical Leave Law: What Now?
|
|
Discussions |
|
This Newsletter:
BenefitsLink Retirement Plans Newsletter:
Message Boards Digest:
|
Retirement Plan Administrator|
[Official Guidance]
957 pages. "The policies included in this final rule provide a new direction for the Shared Savings Program by establishing pathways to success through redesigning the participation options available under the program to encourage ACOs to transition to two-sided models (in which they may share in savings and are accountable for repaying shared losses). These policies are designed to increase savings for the Trust Funds and mitigate losses, reduce gaming opportunities, and promote regulatory flexibility and free-market principles. This final rule also provides new tools to support coordination of care across settings and strengthen beneficiary engagement; and ensure rigorous benchmarking."
|
|
[Official Guidance]
"This notice supplements Notice 2014-76, ... as supplemented by Notice 2017-14, ... by identifying additional hardship exemptions from the individual shared responsibility payment under Section 5000A of the Internal Revenue Code that a taxpayer may claim on a Federal income tax return for the 2018 tax year without obtaining a hardship exemption certification from the Health Insurance Marketplace."
|
|
[Guidance Overview]
Pathways to Success: An Overhaul of Medicare's ACO Program "The rule is projected to achieve $2.9 billion in savings over ten years.... One key element of [this final rule] is a reduction in the amount of time that an ACO can remain in the program without taking accountability for healthcare spending.... [The] rule also increases flexibility for certain performance-based risk ACOs to encourage innovation and expand access to high-quality services that are convenient for patients, including telehealth services provided at a patient's place of residence."
|
|
[Guidance Overview]
"Under state law and Tacoma law, employees must be notified at least monthly -- in Seattle, each time wages are paid in Seattle -- in writing or electronically, of their PSST balance.... Beginning on January 1, 2019 (or when a CBA expires, for CBAs in existence on December 31, 2018), none of the Seattle standards that exceed state law requirements may be waived. Accordingly, time is running out to negotiate waivers with unions and file those waivers with Seattle's Office of Labor Standards."
|
|
Employer Health System Networks to Become More Exclusive "These strategies are narrowing medical care provider networks and, in some cases, shutting out some health systems in favor of others for hip, knee, and spine surgeries; transplants; and cancer treatments. The strategies will place a significant hurdle to a worker's ability to choose the hospital or health system that they want but employers say they are guiding them to the higher-quality health systems with the best outcomes."
|
|
Are Medicare Part D Disclosure Notices Required for an HRA or Health FSA? "The answer is probably yes for the HRA, and no for the health FSA. This assumes that your company's health FSA and HRA will offer prescription drug coverage to Part D-eligible individuals -- i.e., individuals covered under Medicare Part A or Part B, including active and disabled employees, COBRA participants, retirees, and their covered spouses and dependents who live in the service area of a Part D prescription drug plan."
|
|
Onsite Dispensaries Help Employees Use Medications Properly "A healthcare delivery model that fosters an open dialogue between patients and their healthcare providers can improve medication adherence.... Having easy access to a trusted provider in a workplace clinic can also help patients access the right team of clinicians to meet their needs in the community, across the care continuum.... Providers in traditional healthcare settings are often constrained by lack of time to communicate effectively with patients -- and their families."
|
|
Cutting Employee Hours to Avoid ACA Requirements Costs Employer $7.4 Million "[T]he employees claimed that Dave & Buster's discriminated against them 'for the purpose of interfering with the attainment' of their right to health coverage under the health plan because they were covered under the restaurant's health insurance plan prior to the enactment of the ACA.... On December 7, the court gave preliminary approval to Dave & Buster's $7.4 million proposed settlement, which also bars Dave & Buster's management from taking adverse employment actions against employees for the purpose of denying them health coverage." [Marin v. Dave & Buster's, Inc., No. 15-3608 (S.D.N.Y. Dec. 7, 2018)]
|
|
States Renew Push to Block Contraception Coverage Rules "The request by California and 13 other state attorneys general for a nationwide preliminary injunction halting the final exemption rules comes after the Ninth Circuit scaled back a previous nationwide block of interim rules to just the five states prosecuting the case at the time." [Calif. v. Azar, No. 17-5783 (N.D. Cal. motion for preliminary injunction filed Dec. 19, 2018)]
|
|
Men Just Dipping Toes in Expanding Sea of Paid Parental Leave "66 percent of women take all available paid maternity leave, while only 36 percent of men use all of their paternity leave. Moreover, 40 percent of male employees used less than half of the paid parental or family leave they had available, compared with 13 percent of female employees[.]"
|
|
Benefits in General |
|
ERISA Attacks Move From Church Plans to Government Plans "Having settled many of its attacks on pension plans sponsored by several large church-affiliated healthcare organizations, the plaintiff's bar appears to be shifting focus ... One of the same firms that previously challenged the application of ERISA's 'church plan' exclusion several years ago represents the plaintiffs ... Notably, the 'church plan' cases have thus far been limited to pension plans. [This] case opens up a new front in the larger war being waged by the plaintiffs' law firm by challenging the status of Atrium's health plan as well."
|
|
Press Releases |
|
Most Popular Items in the Previous Issue |
Connect
|
BenefitsLink.com, Inc.
1298 Minnesota Avenue, Suite H
Winter Park, Florida 32789
(407) 644-4146
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.
Links to web sites other than BenefitsLink.com and EmployeeBenefitsJobs.com are offered as a service to our readers; we were not involved in their production and are not responsible for their content.