Health & Welfare Plans Newsletter

January 2, 2019

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Defined Benefit Client Coordinator
The Retirement Plan Company (TRPC)
Telecommute

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Bates & Company
in FL

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Dart Container
in MI

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Webcasts, Conferences

Leave Policy Coordination - A Panel Discussion
January 10, 2019 in OH
Worldwide Employee Benefits Network [WEB] - Northeast Ohio Chapter

Open Enrollment - Local Companies Share Their Experiences
January 16, 2019 in MO
Worldwide Employee Benefits Network [WEB] - St. Louis Chapter

Keeping Work Places Safe from Violence, Including Domestic Violence and Active Shooters
January 17, 2019 in GA
Worldwide Employee Benefits Network [WEB] - Atlanta Chapter

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►See 1461 Recorded Webcasts


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[Guidance Overview]

Duluth Becomes Third City in Minnesota to Pass Safe and Sick Time Ordinance

"The ordinance goes into effect on January 1, 2020. It requires employers to provide employees up to 40 hours of covered sick and safe leave per year, and it also ensures that employees have a private civil cause of action against their employers for violations of the ordinance."
Ogletree Deakins

Employers Face Challenges in Developing a Universal Paid Sick and Safe Time Policy

"[The authors] reviewed the basic aspects of [paid sick and safe time (PSST)] laws ... across jurisdictions to identify particular pain points.... [This article highlights] one provision from each jurisdiction with a generally-applicable PSST law (and some industry-specific and federal government contractor laws) that demonstrates why developing a multi-city, -state, or nationwide PSST policy may be a hard new year's resolution for employers to keep[.]"
Littler

Employee Benefits Trends to Watch in 2019

"Customization of employee benefits ... Location of service delivery ... Creative funding of health plans and their risk ... Digitization of benefits ... Student loan assistance ... Parental perks."
OneDigital Health and Benefits

Medicare Part D Disclosure to CMS (PDF)

"Employers with group health plans that provide prescription drug coverage to individuals who are eligible for Medicare Part D must disclose to [CMS] certain information about the coverage.... The disclosure to CMS is due within 60 days after the start of each plan year (March 1, for calendar year plans)."
EPIC

Court Grants Stay in ACA Case: Clears Way For Appeal, Keeps ACA In Place

"On December 30, 2018, Judge Reed O'Connor of the Northern District of Texas issued a stay and partial final judgment ... This will allow the parties to immediately appeal his recent decision to invalidate the entire [ACA] to the Fifth Circuit Court of Appeals. [The] ruling ensures that the provisions of the ACA remain fully in effect in all 50 states and DC." [Texas v. U.S., No. 18-167 (N.D. Tex. Dec. 14, 2018; order granting stay and partial final judgment filed Dec. 30, 2018)]
Katie Keith, in Health Affairs

The Torturous Path of the ACA's Contraceptive Mandate Takes Another Sharp Turn (But Only in Five States)

"Most employers, particularly for-profit employers, comply with the contraceptive mandate without objection. But for-profit employers in California, New York, Virginia, Maryland and Delaware that do have a religious or moral objection to contraception must now comply with the ACA's mandate unless [1] their group health plan is grandfathered, or [2] they are privately held, hold a sincere religious objection to the mandate, and notify either their insurance carrier, third-party administrator or HHS of that objection."
Lockton

CMS Announces Reinsurance Funding for NJ, WI

"Combined, these two states will be receiving about $308 million in federal pass-through funding for state-based reinsurance programs.... [The total] estimated 2019 pass-through funding for all eight states is about $942 million ... Nearly 40 percent of this total funding will go to Maryland, which has the largest state-based reinsurance program."
Katie Keith, in Health Affairs

Judge OKs CVS Plan to Keep Aetna Separate Pending Review

"CVS said it is currently operating Aetna's health insurance business separately from CVS's retail pharmacy and PBM business units, with Aetna maintaining control over pricing and product offerings. Aetna personnel will also retain their current compensation and benefits, and CVS will maintain a firewall to prevent the exchange of competitively sensitive information between the two companies."
AISHealth

Dozens of Pharmaceutical Makers Raise Prices on Hundreds of Drugs to Ring in the New Year

"Many companies' increases are relatively modest this year, amid growing public and political pressure on the industry over prices. Yet a few are particularly high, including on some generics, the cheaper alternative to branded accounting for nine out of 10 prescriptions filled in the U.S. Overall, price increases, including recently restored price increases from Pfizer Inc. continue to exceed inflation."
MarketWatch

[Opinion]

ECFC Comment Letter to HHS, IRS and DOL on Health Reimbursement Arrangements and Other Account-Based Group Health Plans (PDF)

"We request clarification that substantiation need not occur upon initial ICHRA enrollment; rather substantiation prior to first reimbursement would be adequate.... We would ask that an additional class of employees be considered: exempt and non-exempt employees.... We request confirmation in the final regulations that classes are determined on an employer-by-employer basis not on a controlled group basis."
Employers Council on Flexible Compensation [ECFC]

Benefits in General

Court Awards Plaintiff's Attorney the Highest Rate Awarded in a Disability Case to Date: $900 per Hour

"[T]he court found that hourly rates of $450 for the associate on the case and $900 for the partner to be reasonable and within the prevailing rates in the market of ERISA attorneys. The court rejected Defendants' argument that [the plaintiff] should not get full fees because a few claims were dismissed early in the case. The court found that the claims arose from the same core of facts such that the work done on the dismissed claims was likely to have aided and overlapped with the successful abuse of discretion claim." [Dimry v. Bert Bell/Pete Rozelle NFL Player Ret. Plan, No. 16-01413 (N.D. Cal. Dec. 22, 2018)]
Kantor & Kantor

Press Releases

Most Popular Items in the Previous Issue

ERISA Implications for Firing a Whistleblower
Proskauer's ERISA Practice Center

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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 2019 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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