Health & Welfare Plans Newsletter

March 14, 2019

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Jobs

Pension Plan Administrator
American Pension Advisors, Ltd.
in Indianapolis IN

Defined Benefit Operations Specialist
Charles Schwab
in Richfield OH / Austin TX

Defined Benefit Plan Administrator
MGKS
in Phoenix AZ

Associate Plan Administrator
America's 401K LLC
in Dallas TX

Retirement Plan Compliance Processor
The Paragon Alliance Group
in Souderton PA

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[Official Guidance]

Text of DOL Opinion Letter FMLA2019-1-A: Employer May Not Delay Designating Paid Leave as FMLA Leave Nor Permit Employees to Expand Their FMLA Leave Beyond the Statutory 12-Week Entitlement (PDF)

"An employer may not delay the designation of FMLA-qualifying leave or designate more than 12 weeks of leave (or 26 weeks of military caregiver leave) as FMLA leave.... Once the employer has enough information to make this determination, the employer must, absent extenuating circumstances, provide notice of the designation within five business days.... [T]he employer may not delay designating leave as FMLA-qualifying, even if the employee would prefer that the employer delay the designation.... [If] an employee substitutes paid leave for unpaid FMLA leave, the employee's paid leave counts toward his or her 12-week (or 26-week) FMLA entitlement and does not expand that entitlement."
Wage and Hour Division, U.S. Department of Labor [DOL]

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[Guidance Overview]

Editor's Pick Completing Form 1094-C: How to Unlock the Section 4980H Affordability Safe Harbors for a Month

"By far the most prevalent error that leads to an employer receiving a Letter 226J is the employer checking the 'No' box or forgetting to check the 'Yes' or 'No' box on line 23 (or, alternatively, on some of the lines from line 24 through line 35). This article explains why making this mistake leaves employers exposed to the section 4980H penalty even for employees whom the employer has coded with a seemingly protective offer code (1A, 1C, 1E, etc.) and an affordability safe harbor (2F, 2G, or 2H)."
Accord

[Guidance Overview]

Nonprofits Seeking to Avoid New Parking Tax Must Make Changes Soon

"Even nonprofit employers obligated by state law or city ordinance to provide mass transit options to employees must pay tax on expenses for this type of employee perk.... These new rules will require tax returns from many exempt organizations that have never before filed with the IRS -- including organizations that do not engage in any actual unrelated trade or business activity and organizations, such as churches, that are exempt from filing information returns."
McGuireWoods

How Employers Are Fixing Health Care

"Working closely with providers such as Geisinger, the Mayo Clinic, Johns Hopkins, and Virginia Mason ... [some employers] are crafting bundled payment arrangements that cover the cost of an employee's care for certain episodes from start to finish -- all the procedures, devices, tests, drugs, and services needed for, say, a knee replacement or a back surgery. They're also, in most instances, picking up the tab for any necessary travel, lodging, and meals for the employee and a caregiver, thus democratizing destination care programs that have historically been reserved as an executive perk."
Harvard Business Review

The State of Employer-Sponsored Healthcare

"[K]ey areas of employer frustration: ... [1] Consolidated medical and pharmacy benefit manager vendor markets means less competition, resulting in higher prices for employers.... [2] Providers are incented to perform more services rather than improving the quality of care ... [3] Most large employers self-insure their health benefits programs, thereby bearing all of the cost escalation risk.... [4] The current prescription drug supply chain model lacks transparency ... [5] Employers perceive that market players (i.e., doctors, hospitals, pharmaceutical companies, insurers, and even brokers) are mostly vested in the status quo, making change slow and difficult."
Managed Healthcare

CMS Updates Drug Dashboards with Prescription Drug Pricing and Spending Data

"This Administration's version of the drug dashboards ... adds information on the manufacturers that are responsible for price increases and includes pricing and spending data for thousands more drugs across Medicare Parts B and D and Medicaid.The dashboards focus on average spending per dosage unit for prescription drugs paid under Medicare Parts B and D and Medicaid, and track the change in average spending per dosage unit over time."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Benefits in General

[Guidance Overview]

Editor's Pick JCT Overview of Deduction for Qualified Business Income: Section 199A

32 presentation slides. "An individual taxpayer, estate, or trust generally may deduct 20% of qualified business income, and 20% of qualified REIT dividends and qualified PTP income The deduction is limited above a threshold amount of taxable income ($157,500, or $315,000 for joint returns, indexed).... Taxable income means without regard to the section 199A deduction, for this purpose ... Effective for taxable years beginning after 2017 and before 2026."
Joint Committee on Taxation [JCT], U.S. Congress

Selected Discussions
on the BenefitsLink Message Boards

Final Form 5500 Needed for Health & Welfare Plan? Small Plan Exemption Satisfied Years Ago

A company filed their first (and only) Form 5500 return for their H&W plan in 2013. The BOY count that year was > 100, with the EOY count dipping below 100 participants. Thus, they stopped filing because they satisfied the small plan exemption. They also did not use the 4R code. In 2018 the company was purchased by another company, and will now be under that new company's H&W plan. Question: Because that single Form 5500 was previously filed, should a final Form 5500 be filed to inform the DOL/IRS the plan no longer exists? There is a 5 year gap because they only had to file in 2013.
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David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager

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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