Health & Welfare Plans Newsletter

March 7, 2019

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[Official Guidance]

Text of CMS Request for Information: Sale of Individual Health Insurance Coverage Across State Lines Through Health Care Choice Compacts

15 pages. "This request for information (RFI) solicits comment from interested parties on how to eliminate barriers to and enhance health insurance issuers' ability to sell individual health insurance coverage across state lines, primarily pursuant to Health Care Choice Compacts....Comments are requested in response to [22 specific questions] with respect to individual health insurance coverage.... Providing states with flexibility to address the unique needs of their health insurance markets is a key component of achieving the goals stated in the Executive Order. This RFI is not intended to inform policy which will preempt state law or otherwise impede the role states play as the primary regulators of insurance."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

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[Guidance Overview]

CMS Seeks Recommendations That Allow Americans to Purchase Health Insurance Across State Lines

"CMS is interested in feedback on how states can take advantage of Section 1333 of the [ACA], which provides for the establishment of a regulatory framework that allows two or more states to enter into a Health Care Choice Compact to facilitate the sale of health insurance coverage across state lines. CMS is primarily looking for input on how the agency can expand access to health insurance coverage across state lines, effectively operationalize the sale of health insurance coverage across state lines, and understand the financial impacts of selling health insurance coverage across state lines."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

Are You Ready for the Michigan Paid Medical Leave Act?

"Are you covered? ... Do you already give enough leave? ... How does paid leave work? ... Do you allow leave for the right reasons? ... Which employees must receive leave? ... When do employees become entitled to leave? ... Employee notification requirements ... Documentation of leave for domestic violence or sexual assault ... Records retention ... Penalties for violating the Act."
Masuda Funai

Editor's Pick ABA Publishes Summary of 2018 FMLA Court Decisions

"[T]he ABA's annual report includes all FMLA decisions from this past year. This year's report is as comprehensive as always -- it summarizes 2018 FMLA decisions in a user-friendly manner and is a great reference for me throughout the year."
FMLA Insights

The Use of Self-Insured Plans as 'Bona Fide' Fringe Benefits Under the Service Contract Act

"[T]he DOL looks at a number of factors in determining whether an unfunded self-insured plan should be considered 'bona fide' for SCA compliance purposes. The primary factors it considers are: [1] Can the plan be reasonably anticipated to provide the prescribed benefits? [2] Is it a legally enforceable commitment on the part of the employer? [3] Is it carried out under a financially responsible program? [4] Has it been communicated to the employees in writing?"
CBIZ

Insurers Ask for More Than $2 Billion in Unpaid CSRs

"Following continued success in suing the federal government over unpaid cost-sharing reduction payments (CSRs) ... the insurers in a class action lawsuit estimate damages of $2.36 billion for both 2017 and 2018. A second case includes a request for about $71 million for 2017 and 2018. The amount for 2018 in a third case will be determined through the CSR reconciliation process this spring. No funds will be paid out any time soon; any payments would not be made until after the appeals process is completed."
Katie Keith, in Health Affairs

Amazon-Backed Healthcare Venture Gets Much-Needed Name

"A new website launched to coincide with the new name outlines in broad terms some of the areas where Haven could make improvements on the current healthcare system.... The name Haven was chosen to reflect the venture's goal of partnering with patients and clinicians alike in pursuit of systemic improvements."
HealthLeaders Media

IRS Attempts to Tighten Rules for Business Meal Exclusions

"An employer who is claiming exclusion from income and wages for meals furnished to employees for the convenience of the employer must provide substantiation if requested concerning the business reasons.... [IRS Technical Advice Memorandum 201903017] underlines how difficult it can be to prove to the IRS administratively a substantial non-compensatory business reason and provides guidance for employers looking to claim the exclusion."
Holland & Hart LLP

Benefits in General

[Official Guidance]

Text of IRS Disaster Relief Notice AL-2019-01, for Alabama Victims of Severe Storms, Tornadoes and Straight-Line Winds

"Victims of the severe storms, tornadoes, and straight-line winds that took place on March 3, 2019 in Alabama may qualify for tax relief ... [A]ffected taxpayers in certain areas will receive tax relief. Individuals who reside or have a business in Lee County may qualify for tax relief.... [C]ertain deadlines falling on or after March 3, 2019 and before July 31, 2019, are granted additional time to file through July 31, 2019"
Internal Revenue Service [IRS]

Press Releases

Most Popular Items in the Previous Issue

United Loses in Court on Behavioral Health Coverage Guidelines
Modern Healthcare Online; free registration required

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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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