Health & Welfare Plans Newsletter

February 5, 2019

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Jobs

Relationship Manager - Retirement Plan Services
Trust Point Inc.
in MN

Internal Consultant
Unified Trust Company
in KY

Director of Plan Administration
Liden, Nestle, Soled & Associates
in CA

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Webcasts, Conferences

Terminating Employees: How to Minimize Liabilities
February 8, 2019 WEBCAST
McDermott Will & Emery LLP

Unique Employer Cost Containment Strategies
February 26, 2019 in TX
Worldwide Employee Benefits Network [WEB] - Dallas Chapter

►See 173 Upcoming Webcasts and Conferences

►See 1483 Recorded Webcasts


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[Guidance Overview]

Editor's Pick Is the Proposed Expansion of HRAs a Game Changer for Employers? (PDF)

"The proposed regulations may especially be useful for small and medium-sized companies that want to be able to define the costs that they are willing to pay towards employee health insurance coverage by using HRAs with a fixed annual employer contribution and that have a small enough workforce to satisfy some of the consistency requirements of the proposed regulations."
Epstein Becker Green, via Bloomberg Tax Management Compensation Planning Journal

[Advert.]

Managers Guide to FMLA

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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.


[Guidance Overview]

HHS Proposes Rule Challenging Drug Manufacturer Rebates to PBMs and Payors

"The Proposed Rule would make explicit that the AKS discount safe harbor does not protect manufacturer rebates on prescription drugs paid to Medicare Part D plan sponsors, Medicaid managed care organizations (MCOs), or pharmacy benefit managers (PBMs) in the context of these government programs. The Proposed Rule would create new safe harbors for certain point-of-sale price reductions on prescription drugs and for certain PBM service fees paid by manufacturers."
King & Spalding

[Guidance Overview]

Sweeping Changes Proposed to Safe Harbors for Drug Discounts to Health Plans

"Because the proposed exclusion is limited to Part D plans and Medicaid MCOs, it would not alter current safe harbor protection for price reductions offered to other entities such as wholesalers, pharmacies, physicians and other third-party payers. In lieu of the exclusion it proposes to eliminate, HHS proposes to create new discount safe harbor protections for (1) discounts offered to plans and organizations that are provided to beneficiaries at the point of sale, and (2) fixed-amount service fees to PBMs that do not take into account the volume or value of the business between the manufacturer and the PBM."
Skadden

[Guidance Overview]

Wellness Programs: An Update in Evolving Compliance

"The guidance we have under [HIPAA] remains unchanged.... The EEOC's ADA (and GINA) regulations are still largely in force.... [E]mployers sponsoring wellness programs subject to the ADA have three choices, based on risk tolerance: [1] Run incentives for ADA plans up to the 30% cap that existed before.... [2] Keep the incentives below the previous 30% cap but incentivize the program.... [3] Not incentivize the program at all."
Poyner Spruill LLP

[Guidance Overview]

2019 Brings Mini-COBRA to Arizona

"The Arizona mini-COBRA law ... extends to Arizona employers with 20 or fewer employees the kinds of notification and continuation of health plan benefits requirements previously reserved only for larger employers under [COBRA].... [T]he Arizona Department of Insurance recently prepared a sample notice of coverage continuation form.... [S]mall employers that use, properly complete, and timely issue this form are presumed to satisfy the mini-COBRA law's notification requirements."
Ogletree Deakins

[Advert.]

Now is a great time to join Worldwide Employee Benefits Network (WEB)

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Michigan Issues Paid Medical Leave Act and Workforce Opportunity Wage Act Posters and FAQs

"Effective March 29, 2019, the PMLA requires Michigan employers with a minimum of 50 employees to provide paid medical leave to their eligible employees.... This poster summarizes the PMLA's eligibility criteria, accrual rate, permitted uses, rates of pay and other general requirements.... [The Michigan Department of Licensing and Regulatory Affairs (LARA)] also released FAQs about the PMLA."
Warner Norcross & Judd LLP

Employer Allowed to Deny Employee Pay Differential Due to FMLA-Related Absences

"The court highlighted that the applicable FMLA regulations explicitly allow employers to withhold a bonus or other payment that is based on the achievement of a goal related to hours worked or perfect attendance. Accordingly, even where an employee does not meet the goal due to FMLA leave, the employer may withhold the payment as long as the employer would do the same for non-FMLA absences." [Flowers v. McCartney, No. 17-604 (E.D. Ark. Jan. 8, 2019)]
The Wagner Law Group

Court Finds Email to Claims Administrator Was a First-Level Appeal

"In the Fifth Circuit's view, it was reasonable for the claims administrator to believe that the email was an appeal, because the husband expressly stated he would like to file an appeal.... [T]he claimant's argument was not that the plan lacked procedures for submitting claims -- it did, and the claimant even characterized those procedures as elaborate. Rather, the claimant faulted the claims administrator for failing to follow the plan's procedures for determining what types of inquiries constitute formal appeals." [Rittinger v. Healthy Alliance Life Ins. Co., No. 17-20646 (5th Cir. Jan. 31, 2019)]
Thomson Reuters Practical Law

The Regionality of Employee Benefits: Four Factors for Equal Healthcare

"Before signing a contract with a large insurer, analyze the carrier networks in each location in which your employees live.... The nuances in laws from state to state warrant additional employee education and communications.... Make sure your plan is underwritten in the state with the best rates.... [D]on't overlook educating employees on how to access the best care."
Corporate Synergies

Now Is an Opportune Time to Revisit Your Employee Assistance Program

"[T]ake an inventory of current behavioral health, EAP, work/life resources and other related programs that the EAP would integrate with, including disability and medical, and identify any emotional wellbeing gaps in the holistic wellbeing program. Next, review ... claims and specific provider utilization rates, and analyze absenteeism rates and productivity metrics to provide context for selecting the right mix of EAP components to cater toward the population's needs."
Willis Towers Watson

Benefits in General

[Official Guidance]

Text of IRS Final Regs: Qualified Business Income Deduction

247 pages. "This document contains final regulations concerning the deduction for qualified business income under section 199A of the Internal Revenue Code.... This document also requests additional comments on certain aspects of the deduction." [Editor's note: These final regs were originally released in draft form on January 20; IRS has also provided a redlined version which identifies changes from the draft.]
Internal Revenue Service [IRS]

[Official Guidance]

Text of IRS Proposed Regs: Qualified Business Income Deduction

37 pages. "These proposed regulations ... contain amendments to two substantive sections of the August Proposed Regulations, Sections 1.199A-3 and 1.199A-6, each of which provides rules relevant to the calculation of the section 199A deduction. These additional proposed rules respond to comments received on the August Proposed Regulations as well as address certain issues identified after additional study."
Internal Revenue Service [IRS]

Public Employees Living Longer, Deepening State Pension Crisis

"In the private sector, defined-benefit pensions must follow mortality tables issued by the federal government. No such strictures bind public pensions.... Longer lives for public employees will mean higher costs, and not just for pension plans. Many state and local governments promise to pay for the health care of their retired workers, but few have enough money set aside to do so."
City Journal

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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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