Health & Welfare Plans Newsletter

December 27, 2018

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[Guidance Overview]

New York Paid Family Leave Increases Effective January 1

"Effective January 1, 2019, the paid leave period under the NY Paid Family Leave will increase from 8 weeks to 10 weeks per year. Also effective January 1, 2019, employees taking NY Paid Family Leave will receive 55% of their average weekly wage (up from 50% in 2018) ... [T]he maximum weekly benefit for 2019 ... will increase from $652.96 to $746.41.... [T]he employee contribution rate will also increase from 0.126% to 0.153% of an employee's gross wages each pay period ... [An] employee's maximum annual contribution will increase from $85.56 to $107.97."
Hodgson Russ LLP

Hospital Prices Are About to Go Public

"A federal rule requires all hospitals to post online a master list of prices for the services they provide so consumers can review them starting Jan. 1. The health care industry nationally has a reputation for having little price transparency, which can make it difficult for consumers to price compare. But the hospital's master list prices, sometimes called a chargemaster, is also not a complete look, consumer advocates say."
Atlanta Journal-Constitution

Health Tech Predictions for 2019

"Wearables will track blood pressure ... A lot of new tech hits Medicare Advantage ... Amazon gets into health insurance ... Pharma companies flex their buying muscle ... Funding will flow into tech for mental health."
CNBC

District Court Dismisses Wilderness Therapy Lawsuit

"One of the plans covered treatment performed at a 'residential treatment facility' and listed detailed requirements a facility must meet to qualify for coverage. The court found that the complaint did not contain sufficient information to show that the wilderness program met those requirements ... The other plan covered 'residential treatment services,' defined in relevant part as services that are licensed in accordance with the laws of the 'appropriate legally authorized agency.' The court dismissed the claims because the complaint alleged that the wilderness plan was licensed under Utah law as an 'outdoor youth treatment program,' rather than as a 'residential treatment service,' thus failing to meet the plan's requirements." [H.H. v. Aetna Ins. Co., No. 18-80773 (S.D. Fla. Dec. 13, 2018)]
Proskauer's ERISA Practice Center

ACA Defenders Push Again for Expedited Appeal

"On December 21, The Trump Administration and Republican AGs agreed that O'Connor's December 14 decision does not change the status quo of the ACA.... On December 26, the Democratic AGs reiterated their call for clarity in an expedited and certified ruling." [Texas v. U.S., No. 18-167 (N.D. Tex. Dec. 14, 2018)]
HealthLeaders Media

ACA Ruled Unconstitutional -- Now What for Employers?

"From an employer perspective, this case does not require or even provide opportunities for change as the ACA continues to be the law of the land as the case works its way through the system. As such, employers should continue its health coverage strategies per the ACA and comply with all if its requirements."
Findley

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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 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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