Health & Welfare Plans Newsletter

January 8, 2019

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Jobs

Pension Administrator
Duncan Financial Group
in PA, Telecommute

Financial Operations Settlement Analyst
Willis Towers Watson
in FL

Quality Assurance Automation Specialist
Willis Towers Watson
in UT

Senior Retirement Actuarial Analyst
Willis Towers Watson
in MO

Pension System Implementation Manager
Willis Towers Watson
in IL

Health and Benefits Analyst
Willis Towers Watson
in GA

Conversions Consultant
Newport Group
in CA

Qualified Plan Consultant
Newport Group
in FL

Internal Sales Consultant
Newport Group
in CA, NC

►See All Jobs

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Webcasts, Conferences

2018 Year in Review: Plus What Lies Ahead in 2019!
January 17, 2019 WEBCAST
ABD Insurance & Financial Services

National Health Policy Conference
March 13, 2019 in DC
America's Health Insurance Plans [AHIP]

National Conference on the Individual and Small Group Markets
March 14, 2019 in DC
America's Health Insurance Plans [AHIP]

►See 135 Upcoming Webcasts and Conferences

►See 1464 Recorded Webcasts


Discussions

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[Official Guidance]

Text of Draft IRS Publication 502: Medical and Dental Expenses (Including the Health Coverage Tax Credit) for Use in Preparing 2018 Returns (PDF)

28 pages; Jan. 4, 2019. "This publication explains the itemized deduction for medical and dental expenses that you claim on Schedule A (Form 1040). It discusses what expenses, and whose expenses, you can and can't include in figuring the deduction.... This publication also explains how to treat impairment-related work expenses, health insurance premiums if you are self-employed, and the health coverage tax credit that is available to certain individuals."
Internal Revenue Service [IRS]

[Advert.]

Utilizing Opt-Out Incentives to Cut Health Care Costs

Sponsored by Lorman and BenefitsLink

Jan. 29 webinar. Although these programs may seem simple enough, they are rife with multiple 'compliance landmines' that can trip up unwary employers. Learn how to spot problem spots and develop compliant and effective programs. BenefitsLink discount.


[Guidance Overview]

'Pathways to Success' Update: CMS Issues Final Rule on Changes to the ACO Program

"On December 21, 2018, CMS issued the final rule for the redesign of the [Medicare Shared Savings Program (MSSP) which] includes the following: [1] Greater savings for one-sided risk models.... [2] Qualification as a low revenue ACO.... [3] Additional year of one-sided risk for new low revenue ACOs.... [4] High revenue ACO participation in BASIC Track Level E.... [5] Repayment mechanism for two-sided risk.... [6] Benchmarking methodology."
Sheppard Mullin

[Guidance Overview]

CMS Finalizes Proposed Redesign to Medicare Shared Savings Program

"Low-revenue ACOs are permitted to stay in one-sided risk-sharing models for a longer period ... Any ACO determined to be experienced with Risk Models however, is required to take on risk immediately.... CMS is also cutting the shared savings rate that will be available for ACOs until they enter a Risk Model.... CMS finalized modifications to its calculation of the regional adjustment to an ACO's performance benchmark[.]"
K&L Gates

Drug Costs Driven Largely By Price Increases, Not Innovation

"[T]he cost of brand-name oral prescription drugs rose more than 9 percent a year from 2008 and 2016, while the annual cost of injectable drugs rose more than 15 percent.... [I]ncreases in prices of brand-name drugs were largely driven by year-over-year price increases of drugs that were already in the market[.]"
National Public Radio [NPR]

Health Care Industry Spends $30 Billion Each Year Pushing Its Wares, From Drugs to Stem Cell Treatment

"Spending on health care marketing doubled from 1997 to 2016.... The biggest increase in medical marketing over the past 20 years was in 'direct-to-consumer' advertising, including the TV commercials that exhort viewers to 'ask your doctor' about a particular drug. Spending on such ads jumped from $2.1 billion in 1997 to nearly $10 billion in 2016[.]"
Kaiser Health News

New State Laws Require More Preventive Services From Insurers

"A bevy of new state laws pertaining to health insurers took effect Jan. 1. It all adds up to a year of potentially higher costs for plans, with some states entering 2019 by protecting various [ACA] provisions by statute -- and even more of them eying how to take advantage of the ACA's state innovation waivers as the year progresses."
AISHealth

Digital Health Promises Remain Unfulfilled for High-Need, High-Cost Populations

"[Of] the studies conducted on digital health products and services, most enrolled healthy volunteers. Few enrolled high-burden, high-cost patients ... Healthy volunteers made up 32% of the studies, followed by patients with amyotrophic lateral sclerosis (14%) and those with multiple sclerosis 12%. Mental health was the most common high-burden condition category studied ... There were no studies for lung cancer or smoking."
American Journal of Managed Care

Democrat States, DOJ Appeal Texas ACA Case to Fifth Circuit

"[T]he case is expected to live or die based on what the Fifth Circuit, and ultimately the Supreme Court, decide on the constitutionality of the mandate and severability. This likely makes the House's motion to intervene in the district court case largely symbolic ... In any event, this part of the lawsuit is stayed until after the appeal on the first claim and will not be at issue until at least 2020."
Katie Keith, in Health Affairs

Selected Discussions
on the BenefitsLink Message Boards

HRA, FSA, and HSA at the Same Time?

If you follow the guidelines, you clearly can have any two out of the three at the same time. If your FSA is limited purpose, and your HRA is set up to only pay after reaching the deductible of $1,350/$2,700, is there any reason you can't have all three?
BenefitsLink Message Boards

5500 Newbie Has Question About Question 8a

Am doing a 5500-SF filing for a "one-participant" plan -- 2 sibling partners in a general partnership with 2 self-employed 401(k)s that use the EIN of the partnership. For question 8a on 5500-SF, is the employee contribution of up to $18,500 per person (in 2018) to 401k go to 8a(2) participants and the 20-25% go to employee amount go to 8a(1) employers.... or does IRS want "one-participant" plans to lump all 401k (employer and employee) contributions to 8a(2) participants because it is not a "single employer plan"?
BenefitsLink Message Boards

Press Releases

Most Popular Items in the Previous Issue

Workers with High Deductibles Curb Health Care Spending
Society for Human Resource Management [SHRM]

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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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