Health & Welfare Plans Newsletter

March 20, 2019

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Jobs

Retirement Plan Analyst
Bates & Company, Inc.
in Winter Park FL

Portfolio Analyst - Target Date
T. Rowe Price
in Baltimore MD

Associate Portfolio Analyst - Target Date
T. Rowe Price
in Baltimore MD

Senior Pension Administrator
Aldrich Retirement Solutions
in Salem OR / Portland OR / San Diego CA / Carlsbad CA

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Webcasts, Conferences

Practical Privacy - Is Employee Information Secure and Private?
March 26, 2019 in CA
Western Pension & Benefits Council - San Diego Chapter

Section 125 Cafeteria Plans: The Top Five Issues for Employers
April 4, 2019 WEBCAST
ABD Insurance & Financial Services

Annual Conference
April 16, 2019 in TX
Houston Business Coalition on Health

Annual Conference
May 8, 2019 in IL
Midwest Business Group on Health

Special Enrollment Questions: Help for Employer-Sponsored Health Plans
May 21, 2019 WEBCAST
HRWebAdvisor

Leadership Summits
June 24, 2019 in PA
National Alliance of Healthcare Purchaser Coalitions

►See 167 Upcoming Webcasts and Conferences

►See 1509 Recorded Webcasts


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[Official Guidance]

Text of CMS Final 2020 Actuarial Value Calculator Methodology (PDF)

25 pages. "The AV Calculator [XLSM] represents an empirical estimate of the AV calculated in a manner that provides a close approximation to the actual average spending by a wide range of consumers in a standard population. This document is meant to detail the specific methodologies used in the AV calculation."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

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[Guidance Overview]

Employers Risk FMLA Violation by Delaying FMLA Notification, Designation While Employees Use Other Leave

"While acknowledging that the FMLA permits an employer to require, or to permit an employee to elect, to 'substitute' accrued paid leave ... to cover any part of the unpaid FMLA entitlement period, [DOL Opinion Letter FMLA2019-1-A] states that '[t]he term substitute means that the paid leave provided by the employer ... will run concurrently with the unpaid FMLA leave.' ... While acknowledging that the FMLA allows employers to adopt leave policies more generous than those required by the FMLA ... the Opinion also says an employer may not designate more than 12 weeks of leave -- or more than 26 weeks of military caregiver leave -- as FMLA-protected."
Solutions Law Press

[Guidance Overview]

Tax Consequences of Reserved Employee Parking: Recharacterization Opportunity Expires Soon

"[Notice 2018-99] contains an important election until March 31 of this year for an employer to change the characterization of some or all employee parking spots from reserved exclusively for employees to not so reserved and to treat those spots as not reserved retroactively to January 1, 2018. This could save significant taxes for the 2018 tax year, but time is running out."
Murphy Austin

[Guidance Overview]

Transportation Fringe Benefits: March 31 Deadline Approaching

"Until the regulations are issued, taxpayers who own or lease employee parking facilities may use any reasonable method to determine the amount of nondeductible parking expense and may rely on guidance provided in the Notice. However, for taxable years beginning on or after January 1, 2019, a method that fails to allocate expenses to reserved employee parking spots can't be a reasonable method. Taxpayers have until March 31, 2019, to modify existing parking arrangements for employees, which will be effective for the tax year beginning on or after January 1, 2018."
Moss Adams LLP

[Guidance Overview]

Will Grandfathered Plans be Rescued?

"[T]he Departments reiterate that there is no authority for non-grandfathered plans to become grandfathered; put another way, if a plan lost grandfathering status (or never had it), it's unlikely that the Departments will issue rules which allow grandfathered status to be conferred or restored. What is clear, however, is that the Departments are looking for ways to relax the grandfathering requirements and breathe new life into existing grandfathered plans."
Mintz

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[Guidance Overview]

Editor's Pick Text of IRS Publication 5187 for Tax Year 2018: The Affordable Care Act -- What You and Your Family Need to Know (PDF)

22 pages. "This publication covers some of the tax provisions of the [ACA]. It provides information that explains how taxpayers satisfy the individual shared responsibility provision by enrolling in minimum essential coverage, qualifying for a coverage exemption, or making a shared responsibility payment for any month without coverage or an exemption. It also provides information about the premium tax credit. A glossary is included to help taxpayers understand some terms related to the health care law."
Internal Revenue Service [IRS]

Key Takeaways from Recent ERISA Fiduciary Breach Decision on Behavioral Standards of Care

"The court found that an emphasis on cost-cutting tainted the development of the relevant internal guidelines.... Employers usually would not be closely involved in the development or application of this sort of clinical criteria, and claims administrators may be reluctant to turn over copies of their internal guidelines. Employers, though, may find that [this decision] will prompt them to renew requests for such guidelines and to ask some timely questions of their behavioral health claims administrators." [Wit v. United Behavioral Health, Nos. 14-2346, 14-5337 (N.D. Cal. Mar. 5, 2019)]
Ogletree Deakins

DC Paid Family Leave Effective Dates Approaching

"[E]mployers with at least one employee working in Washington DC are subject to the new Paid Family Leave (PFL) benefit, under the Universal Paid Leave Act (UPLA). Effective July 1, 2019, DC will begin collecting the payroll tax from employers to fund the benefits. Employees working in DC can apply for benefits starting July 1, 2020.... [T]he DC Office of Paid Family Leave (OPFL) has created a new website which includes employee notices, FAQs, and other written resources."
Keller Benefit Services

HHS Proposes Changes to Rebates for Part D Plans Under the Anti-Kickback Statute

"HHS has requested feedback on many aspects of the proposals such as ... the impact upon beneficiary access to prescription pharmaceutical products either due to cost or formulary placement.... If enacted, the proposals will likely lead to an increase in the Part D premiums as it will substantially alter the relationship between pharmaceutical manufacturers, Medicare Part D plans, PBMs, and participants. The new relationship could also extend to or impact those in the non-Medicare, i.e., commercial, marketplace."
Cheiron

Medicare Won't Pay For Your Annual Physical, Just A 'Wellness Visit'

"An annual physical typically involves an exam by a doctor along with bloodwork or other tests. The annual wellness visit generally doesn't include a physical exam, except to check routine measurements such as height, weight and blood pressure. The focus of the Medicare wellness visit is on preventing disease and disability by coming up with a 'personalized prevention plan' for future medical issues based on the beneficiary's health and risk factors."
Kaiser Health News

Benefits in General

[Guidance Overview]

Changing Cybersecurity Baselines?

"On March 5, 2019 the [FTC commissioners] voted 3-2 to issue a proposed amendment to its Standards for Safeguarding Customer Information Rule ... The Proposal ... if finalized, could raise the baseline for plan fiduciaries when developing prudent cybersecurity programs.... [W]hile the steps outlined in the FTC's proposal do not apply to many financial institutions, the Proposal provides insight into changes that the other regulators could make and what plans and participants may expect."
Groom Law Group

Press Releases

Most Popular Items in the Previous Issue

17 Ways Employers Are Fighting Prescription Drug Costs
International Foundation of Employee Benefit Plans [IFEBP]

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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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