Health & Welfare Plans Newsletter

April 3, 2019

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Ascensus
in Roseville CA

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Bronfman Rothschild
in Appleton WI

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[Guidance Overview]

Massachusetts Releases Updated Proposed Paid Family and Medical Leave Regs: What You Need to Know

"The proposed regulations clarify a number of key issues ... including the private plan exemption, the July 1st payroll deductions, benefits accrual during PFML leave, the interaction of PFML leave and paid time off policies, and the applicability to contract workers paid on an IRS Form 1099-MISC.... [T]he DFML posted new toolkits and other clarifying information for employers and workers online."
Seyfarth Shaw LLP

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Guide to Correcting ACA Reporting Mistakes

"If correcting information on the Authoritative Transmittal ... file a standalone, fully completed Form 1094-C including the correct information and enter an 'X' in the 'CORRECTED' checkbox.... If correcting information on a Form 1095-C that was previously filed with the IRS, file a fully completed Form 1095-C including the correct information and enter an 'X' in the 'CORRECTED' checkbox.... If you are required to file 250 or more information returns, you must file electronically."
OneDigital Health and Benefits

DOL 'End Run' Around the ACA Ends in Defeat

"The case will effectively put a hold on development of AHPs in all states, even those states that were open to implementation of the Final Rule. These states may now need to unwind any prior AHP related approvals. Under the ruling, small groups, individuals, and sole proprietors are not permitted to band together to gain the buying power of a large group for purposes of purchasing health insurance unless the group qualifies as an 'employer' or an Association under pre-Final Rule guidance." [State of New York v. U.S. Department of Labor, No. 18-1747 (D.D.C. Mar. 28, 2019)]
Winston & Strawn LLP

Eighth Circuit Troubled by ERISA Aspects of 'Cross-Plan Offsets'

"The 8th Circuit Court ruled that cross-plan offsetting was 'questionable at the very least,' in 'tension with the requirements of ERISA' and 'straddling the line of what is permissible.' While declining to affirmatively decide whether the practice violated ERISA, the court opined that it potentially violated ERISA's exclusive benefit rule by failing to pay a benefit owed to a beneficiary under one ERISA plan in order to recover money for the benefit of a different ERISA plan, and it may also be a prohibited transfer of assets from one ERISA group health plan to another." [Peterson v. UnitedHealth Group Inc., No. 17-1744 (8th Cir. Jan. 15, 2019)]
Willis Towers Watson

The ACA Is Still Here: A Summary of Key Developments and Issues (PDF)

49 presentation slides, from ABA EBC 2019 Midwinter Meeting. Topics: [1] The continued viability of the ACA: Texas v. United States, The status of the contraceptive mandate, Wellness program litigation; [2] MEWAs: Cease and desist orders that DOL can issue to pursuant to ACA regulations; [3] Association health plans and skinny plans: Regulations & lawsuits; [4] Surprise Billing.
Employee Benefits Committee [EBC], American Bar Association

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DOL Calling! Tips for Navigating a FMLA Audit

"The DOL's investigation consists of an examination of company records to determine which laws/exemptions apply, an examination of employee records, interviews of management, and interviews with certain employees in private.... [1] Maintain accurate records.... [2] Have a written FMLA policy, and keep it current.... [3] Train managers and supervisors on FMLA policy.... [4] Conduct an internal audit.... [5] Ensure that FMLA notice requirements are satisfied."
Bradley

Assessing the Value of an Employee Well-Being Program

"If employers are not seeing immediate savings from their health & wellbeing programs, they tend to assume the wellness program is not worth the continued investment. Employers should look at their investment under a different lens and shift their focus ... because the benefits equate to more than lower costs if appropriately structured. Healthcare cost savings will come in time ... As an organization's wellbeing program matures, so does the ability to demonstrate measurable results."
Keller Benefit Services

Fixing Surprise Medical Bill Problem Shouldn't Fall To Consumers, House Subcommittee Told

"Around 60 percent of people are covered by employer-sponsored insurance, which is regulated by the federal government, and are not protected by the nearly two dozen state laws governing balance billing.... [W]itnesses testifying before the panel were firm that any answer needed to be worked out between key stakeholders -- providers and insurers -- instead of forcing consumers to file complaints and go through arbitration processes."
Kaiser Health News

Benefits in General

Editor's Pick Legal Privilege Issues Arising in Employee Benefit Matters (PDF)

5-page outline, from ABA EBC 2019 Midwinter Meeting. Topics: [1] Attorney-client privilege: internal investigations, fiduciary exception; [2] Accountant-client privilege; [3] Governmental privileges: Deliberative process privilege, informant privilege, Presidential communications privilege, FOIA exemptions involving privilege.
Employee Benefits Committee [EBC], American Bar Association

FASB Amends Master Trust Reporting Requirements for Employee Benefit Plans

"This guidance will reduce diversity in disclosures relating to master trust interests in employee benefit plan financial statements and provide the users of these financial statements with more information, especially when a plan has a specific (divided) rather than proportionate (undivided) interest in a master trust."
EisnerAmper

Selected Discussions
on the BenefitsLink Message Boards

Missed Several Payroll Deductions for Health & Welfare Plans: OK to 'Make Up'?

Company offers several different welfare options in addition to health insurance, such as FSA, dental, short term disability, etc. Starting in mid 2018 (at least) through March 2019, some payroll deductions were never made. For example, one participant did not have their dental and FSA deducted from their paycheck starting in October 2018. The proposed solution is to just double up deductions each payroll starting in April 2019 until the participants have "paid" for the benefits they were credited with. Is this a common solution when you are talking about 5-6 months of deductions spread over more than one plan year?
BenefitsLink Message Boards

Press Releases

Marsh & McLennan Agency to Acquire Centurion
Marsh & McLennan Companies, Inc.

Most Popular Items in the Previous Issue

Text of DOL Q&As About Federal District Court Ruling on Final Rule on Association Health Plans (PDF)
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

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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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