Health & Welfare Plans Newsletter

March 21, 2019

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Jobs

Senior Retirement Plan Administrator
Goldberg, Swedelson & Associates
in Encino CA / Telecommute

Defined Contribution Account Manager
Nova 401(k) Associates
in Houston TX / Dallas TX / Austin TX / Scottsdale AZ / Telecommute

Defined Contribution Administrator
TPA firm in Phoenix, AZ
in Phoenix AZ

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Webcasts, Conferences

Social and Emotional Wellness Leads to Happier, Healthier Workplaces
April 10, 2019 in TX
Worldwide Employee Benefits Network [WEB] - Houston Chapter

Consumer Engagement in Health Care
April 16, 2019 WEBCAST
EBRI [Employee Benefit Research Institute]

►See 164 Upcoming Webcasts and Conferences

►See 1505 Recorded Webcasts


Discussions

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Reasons to Be Skeptical of the Workplace Wellness Industry

"[T]he workplace wellness industry has more than quadrupled since 2011, drawing in $8 billion in annual revenue and covering almost one in three in American workers.... [A] rigorous study of a comprehensive workplace wellness program concludes that it didn't change employees' behavior or health care costs in the first year. Employees who took part didn't become healthier or more productive, and were not more likely to go to the gym or run in a local race. Total health care costs didn't drop, either."
Scientific American

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2019 Onsite Employee Health Clinics Forum (June 27-28, 2019; Chicago, IL)

Sponsored by World Conference Forum

The largest attended conference on Onsite Health & Wellness Clinics! Leading strategies to build & expand worksite clinics: ensure a competitive benefits strategy and achieve a high performing & healthy workforce! Register now at 2019onsitehealth.com


Staying on the Level: Keeping Your Level-Funded Plan Compliant

"Even though insurance caps the employer's financial liability to the pre-set monthly contribution, a level funded plan is fundamentally a self-funded plan. As a result, it has to comply with the federal rules governing self-funded plans. These include: Use of plan assets ... ACA reporting.... HIPAA privacy and security.... 105(h) nondiscrimination rules.... On the other hand, because level funded plans are not insured plans, they are exempt from state regulation."
HUB International

What Can We Learn From 2018's Record-High HIPAA Penalties?

"While most of the penalties were assessed against providers, there are some lessons employers with health plans can learn from these enforcement efforts: [1] It's not the breach; it's the lack of compliance.... [2] We are (still) living in a material world.... [3] BAAs Matter.... [4] Those who know shouldn't speak."
HUB International

Michigan Releases Paid Sick Leave FAQs and Poster Ahead of Law's Effective Date

"The FAQs document answers 25 questions about the [Paid Medical Leave Act (PMLA)], including ... [1] Are there any employees who are not covered by the [PMLA]? ... [2] How does an eligible employee accrue paid medical leave? ... [3] May an employee carry over unused paid medical leave from one benefit year to the next?"
Epstein Becker Green

Why Employee Benefits Must Be Part of Your Business Strategy (PDF)

"Just as asking customers about your products can yield important information, asking employees how they feel about their benefits can add great value.... Questions to ask should include: [1] What is your overall perception of the benefit plans? ... [2] How are you and your family using the benefits? [3] How satisfied are you with the plan? [4] What would you do to improve the plan's effectiveness?"
CBIZ

[Advert.]

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

Sponsored by WEB - Worldwide Employee Benefits Network

Worldwide Employee Benefits Network provides me a forum for education and information exchange with other Benefits Executives. Join today.


GAO Report: Air Ambulance -- Available Data Show Privately-Insured Patients Are at Financial Risk

"69 percent of about 20,700 transports in the data set were out-of-network in 2017. This is higher than what research shows for ground ambulance transports (51 percent in 2014 according to one study) and other emergency services.... GAO reviewed over 60 consumer complaints received by two of GAO's selected states -- the only states able to provide information on the amount of individual balance bills -- and all but one complaint was for a balance bill over $10,000." [GAO-19-292; Mar 20, 2019]
U.S. Government Accountability Office [GAO]

Highlights of 9th Annual Healthcare Industry Pulse Survey

"[F]ully one-third of healthcare executives surveyed ... believe non-healthcare market entrants could upend industry business models.... [N]early 40% of respondents said a market in which the majority of value-based relationships include both upside and downside shared-risk remains three to five years off -- a concerning finding that might indicate payers and providers continue to struggle in their efforts to scale complex, value-based care and reimbursement models from pilot to production." [Free registration required for download of full survey results.]
Change Healthcare

Five New Massachusetts Bills Propose Telehealth Insurance Coverage, Practice Standards

"[Four of the] bills require certain groups or divisions to provide coverage for telemedicine services under varying conditions.... HB 917 (An Act to Facilitate the Provision of Telehealth Services) ... would not require health insurance plans to cover telehealth services. Instead, it proposes definitions, practice standards, prescribing, and informed consent rules for telehealth services."
Foley & Lardner LLP

Editor's Pick Seventh Circuit Holds the Parsonage Allowance Constitutional

"The Seventh Circuit's decision applied two tests: [1] the 'three-prong test' ... which requires that a statute have 'a secular legislative purpose,' not have the 'primary effect' of advancing or inhibiting religion, and 'not foster an excessive government entanglement with religion;' and [2] the 'historical significance' test ... which looks to 'historical practices and understandings.' The Seventh Circuit concluded both tests were satisfied." [Gaylor v. Mnuchin, Nos. 18-1277, 18-1280 (7th Cir. Mar. 15, 2019)]
Groom Law Group

[Opinion]

Understanding the Burning Platform of Health Care Spending Growth

"There is strong evidence that our health spending provides less-than-optimal value. For example, we know that a portion of health care spending is for things that are not, in fact, health care.... In addition, unmet needs persist -- for example, in prevention, mental health and substance abuse care, and chronic disease management.... [H]ealth care has become so expensive that even many of those who are technically insured can't afford it ... [T]here is a gap between what we spend on our health system and the health-return that we get from it. To close that gap, we must either spend less or spend more wisely (or a combination of the two)."
Bill Frist and Margaret Hamburg, in Health Affairs

Benefits in General

[Guidance Overview]

Editor's Pick DOL Fact Sheet: Adjusting ERISA Civil Monetary Penalties for Inflation (PDF)

"The Federal Civil Monetary Penalties Inflation Adjustment Act Improvements Act of 2015 requires EBSA to adjust ERISA's civil monetary penalties annually for inflation. ERISA monetary penalties assessed by a court (e.g., sections 502(c)(1) and (3)) rather than EBSA are not adjusted for inflation under the 2015 Inflation Act.... The table [in this Fact Sheet] shows the penalty amounts enforceable by EBSA for penalties assessed after January 22, 2019 for violations occurring after November 2, 2015."
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

Selected Discussions
on the BenefitsLink Message Boards

Using FSA for Cost of Gym Membership: Timing of Payment

Participant pays gym membership. He has a Letter of Medical Necessity and it has been determined that it would qualify for reimbursement. He paid the 2019 membership in December 2018. Can that count as reimbursement for 2019 if it was actually paid in 2018?
BenefitsLink Message Boards

Press Releases

Most Popular Items in the Previous Issue

Text of CMS Final 2020 Actuarial Value Calculator Methodology (PDF)
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

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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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