Health & Welfare Plans Newsletter

February 1, 2019

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Managers Guide to FMLA
February 7, 2019 WEBCAST
Lorman Education Services

Employee Benefits Spring Update 2019
April 3, 2019 in DC
American Bar Association Joint Committee on Employee Benefits [JCEB]

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[Official Guidance]

Text of HHS Proposed Regs: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain PBM Fees

123 pages. "The amendment would revise the discount safe harbor to explicitly exclude from the definition of a discount eligible for safe harbor protection certain reductions in price or other remuneration from a manufacturer of prescription pharmaceutical products to plan sponsors under Medicare Part D, Medicaid managed care organizations ... or pharmacy benefit managers (PBMs) under contract with them. In addition, the Department is proposing two new safe harbors. The first would protect certain point-of-sale reductions in price on prescription pharmaceutical products, and the second would protect certain PBM service fees."
Office of Inspector General, U.S. Department of Health and Human Services [HHS]

[Advert.]

The Must-Attend Event for Those Working with Multiemployer Plans

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Still time to register - Attend the Trustees and Administrators Institutes to receive timely and relevant education on the issues that face the benefits industry including the opioid crisis, cybersecurity, pharmacy benefits and mental health.


[Guidance Overview]

Administration Proposes to Lower Drug Costs by Targeting Backdoor Rebates and Encouraging Direct Discounts to Patients

"The HHS proposal would expressly exclude from safe harbor protection under the Anti-Kickback Statute rebates on prescription drugs paid by manufacturers to pharmacy benefit managers (PBMs), Part D plans and Medicaid managed care organizations. It would create a new safe harbor for prescription drug discounts offered directly to patients, as well as fixed fee service arrangements between drug manufacturers and PBMs. The proposal would also provide a historic new level of transparency to a system that has been shrouded in secrecy for decades."
U.S. Department of Health and Human Services [HHS]

HHS Proposal Could Kill PBM Rebates

"The idea is to pass savings along to patients by increasing transparency, encouraging discounts given directly to consumers rather than middlemen, and prohibiting a compensation system that incentivizes annual price hikes, according to [HHS]."
HealthLeaders Media

IRS Releases 2018 Form 8941 for Claiming Small Business Health Care Tax Credit

"In previous years, the instructions have specified the counties with transition relief; however, for 2018 and beyond, employers are instructed to go to Healthcare.gov/small-business, select 'Plans and Prices,' and enter a zip code to see whether a particular county has coverage available through a SHOP Exchange." [See 2018 Form 8941 and Instructions.]
Thomson Reuters / EBIA

Five Simple Ways to Improve Employee Health and Productivity

"[1] General well-checks, including blood work and immunizations.... [2] Screenings based on age, gender and family history.... [3] Renew & refill prescriptions.... [4] Dental cleaning & checkup.... [5] Vision exam."
Benefitfocus

[Advert.]

Managers Guide to FMLA

Sponsored by Lorman and BenefitsLink

Feb. 7 webinar. Discuss in depth what kinds of leave employees may take and how to best manage that leave, how to track down paperwork and control intermittent leave. BenefitsLink discount.


See Health as a Resource, Not as a Problem

"The next frontier of health investment will require shifting from a predominant focus on health as a state of illness to health as a state of high capacity and overall well-being.... Despite our long-term fixations on these externals, staggering financial expenditures, and unending calls for change in the medical industry, our current approach to health will never lead to high health and high well-being.... High health and high well-being arise when people engage in practices that optimize their physical, mental, emotional, purpose and life direction dimensions."
High Health Network

How CBO and JCT Analyzed Coverage Effects of New Rules for Association Health Plans and Short-Term Plans (PDF)

20 pages. "To estimate the effects of the new rules for AHPs and short-term plans, CBO and JCT analyzed the incremental increase in coverage in both types of plans that will result from the rules ... The agencies followed several steps in completing their analysis, beginning with a comparison of estimated premiums for the new plans with those for the lowest-cost insurance otherwise available to individuals and small employers."
Congressional Budget Office [CBO]

Benefits in General

DOL Issues 2019 Adjusted Penalty Amounts

"The maximum penalty for failing to file Form 5500 (which must be filed annually for most ERISA plans) increases from $2,140 to $2,194 per day that the filing is late.... The maximum penalty for failing to provide the summary of benefits and coverage (SBC) required under the [ACA] increases from $1,128 to $1,156 per failure.... For plans with automatic contribution arrangements, penalties for failure to provide the required ERISA Section 514(e)preemption notice to participants increase from $1,693 to $1,736 per day."
Thomson Reuters / EBIA

Press Releases

CUNA Retirement Adds to Sales Team
CUNA Mutual Retirement Solutions

Most Popular Items in the Previous Issue

Long-Term Trends in Employer-Based Coverage
The Peterson-Kaiser Health System Tracker

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Lois Baker, J.D., President  loisbaker@benefitslink.com
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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