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January 25, 2019 logo logo
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Implementation Specialist
Nova 401(k) Associates
in AZ, TX, Telecommute

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Summit Financial Corporation
in MA

Recordkeeping Team Manager - OmniPlus
in FL, GA, IL, TX

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[Guidance Overview]

HHS Outlines Limited Changes in Proposed 2020 Benefit and Payment Parameters Notice

"HHS has proposed to increase the maximum annual limitation on cost-sharing for 2020 ... The proposal would ... [permit] insurers to adopt specified midyear prescription-drug formulary changes when generic equivalents to brand-name drugs become available.... [S]ignificant changes are now proposed to streamline and consolidate the [direct enrollment] requirements applicable to insurers and web brokers.... The preamble requests comments on how HHS (in the absence of Congressional action) could address its concerns about silver loading in future rulemaking[.]"
Thomson Reuters / EBIA


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]

Updated Guidance on Determining Nondeductible Amount of Parking Fringe Expenses and Unrelated Business Taxable Income

"The method of determining the nondeductible amount depends on whether the taxpayer pays a third party to provide parking for its employees or the taxpayer owns or leases a parking facility where its employees park ... Notice 2018-99 provides a four-step methodology for determining these expenses that is deemed to be a reasonable method[.]"

[Guidance Overview]

New York Proposes Expanded Telehealth in the Mental Health Setting

"[The] draft regulations would: [1] expand individuals eligible to deliver telehealth mental health services ... [2] expand eligible settings ... [3] eliminate the requirement that the individual delivering services be physically located at the distant/hub site that participates in Medicaid; and [4] permit the time-limited use of telemental health in PROS (Personalized Recovery Oriented Services) and ACT (Assertive Community Treatment) programs when there is a demonstrated shortage of psychiatrists or nurse practitioners."
Hodgson Russ LLP

[Guidance Overview]

Massachusetts Releases Early Draft of Paid Family and Medical Leave Regs

"Although the draft regulations are a work-in-progress, they answer a number of open questions employers have had since the PFML Law was signed last June. In particular, they shed new light on the contributions (i.e. payroll tax) employers will start paying on July 1, 2019, as well as the benefits claim process for workers, beginning January 1, 2021."
Seyfarth Shaw LLP

Eighth Circuit Decision on 'Cross-Plan Offsetting' Illustrates Importance of Careful Plan Drafting

"The third-party administrator argued that its use of cross-plan offsetting was authorized [by] general language that gave the plan administrator discretion to interpret and implement the plan's terms. The Eighth Circuit held that this language was not specific enough to authorize cross-plan offsetting, reasoning that such an interpretation would be 'akin to adopting a rule that anything not forbidden by the plan is permissible.' ... The immediate lesson is that if a plan sponsor wants cross-plan offsetting to be available as a remedy for overpayments... the plan must expressly authorize the practice." [Peterson v. UnitedHealth Group Inc., No. 17-1744 (8th Cir. Jan. 15, 2019)]
Proskauer's ERISA Practice Center


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Nationwide Injunction Halts Exemptions and Accommodations to the ACA Contraceptive Coverage Mandate

"The court granted the injunction the day the final regulations were scheduled to take effect. Thus, as a practical matter, the ruling maintains the status quo for now. A notice of appeal has been filed, which means that this litigation will continue for the foreseeable future."
Proskauer's ERISA Practice Center

Wellness Program Compliance -- Where Are We Now?

"The EEOC might reissue the same regulations but provide more robust justification for why a 30 percent incentive is reasonable and voluntary. Or it might issue completely new regulations with different requirements for wellness incentives. In any event, guidance is not likely forthcoming -- two EEOC commissioner slots, and the EEOC general counsel position, are currently vacant, with nominees stalled in a contentious Senate confirmation process."

HIPAA Settlements Highlight Importance of Business Associate Contracts

"To date, at least seven resolution agreements have resulted from a covered entity's failure to enter into, or update, business associate contracts. Recognizing when a service provider is a business associate is crucial. Once business associates are identified, covered entities should keep a detailed inventory of business associate contracts and make sure they are accessible and updated. Failure to terminate access has also caught OCR's attention -- leading, for example, to a $5.5 million settlement in February 2017[.]"
Thomson Reuters / EBIA

Benefits in General

Editor's Pick Ethical Considerations for Employee Benefits Counselors (PDF)

69 pages. Topics: [1] The glory and peril of written advice; [2] Minutes: how much detail to include? [3] Attorney's retention of consultant: privilege for client's communications with consultant; [4] Preserving client confidentiality on listservs and online chat rooms; [5] Attorney-client privilege; [6] Work product doctrine.
Utz & Lattan, LLC

Is the Partial Government Shutdown Affecting Your Benefit Plans?

"While on leave, employees are not in pay status and, therefore, elective contributions to 401(k) plans and cafeteria plans cannot be made.... A temporary or permanent layoff or a cutback in hours affecting a number of employees can have an impact on nondiscrimination testing.... Employees who are laid off or experience a reduction in hours resulting in loss of health plan coverage must be offered COBRA continuation coverage.... IRS is not publishing the monthly 'applicable interest rate' used in calculating lump sum payments from certain pension plans."
The Wagner Law Group

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2019, 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, 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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