Health & Welfare Plans Newsletter

April 11, 2019

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Advanced Planning Presents: Employee & Executive Benefit Planning in a Tight Labor Market
April 25, 2019 WEBCAST
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CareFirst - Leading Wellness Engagement Through Technology
May 2, 2019 in MD
Worldwide Employee Benefits Network [WEB] - Baltimore Chapter

FMLA: Examining Critical Issues and Key Topics
May 8, 2019 in TX
Worldwide Employee Benefits Network [WEB] - Houston Chapter

What's up on the Hill? An Employee Benefits Update from Washington, D.C.
May 9, 2019 in OH
Worldwide Employee Benefits Network [WEB] - Northeast Ohio Chapter

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[Guidance Overview]

Responding to 2016 '226J' Letters from the IRS: How to Reduce Your Penalties

"[Q]uestions to consider ... [1] Was a corrected Form 1094-C filed with the IRS for the 2016 year, and if so, is the IRS using the corrected data? ... [2] Is the plan at issue a calendar year plan? ... [3] Was minimum essential coverage offered to at least 95 percent of full-time employees during each calendar month of the year? ... [4] If minimum essential coverage was offered to 95 percent of full time employees, did the coverage provide minimum value and was it affordable? ... [5] Do any of the affordability safe harbors apply?"
Greensfelder

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[Guidance Overview]

New Jersey Issues Individual Mandate Reporting Requirements

"The State expects that employers will use the current IRS ACA Forms 1095-C, 1094-C, 1095-B and 1094-B for reporting to New Jersey for employees and former employees such as retirees and COBRA beneficiaries enrolled in self-insured coverage.... Employers must file the forms through New Jersey's W-2 filing system. Out-of-state employers that withhold and remit New Jersey Gross Income Tax for New Jersey residents have the same reporting requirements as employers located in New Jersey."
Buck

New York Employers Must Increase Paid Leave for All Voters

"Effective immediately, New York's amended voting leave law requires employers to provide employees with 'up to three' hours of paid time off to vote at 'any election.' Further, employers must post a notice in the workplace outlining employees' rights under this new law not less than ten working days before every election."
Fox Rothschild LLP

Plan May Deny Coverage for Bariatric Surgery

"[T]he Fifth Circuit, in Rittinger v. Healthy Alliance Life Insurance Company, has ruled that a plan administrator that has been granted discretionary authority with regards to claim decisions, may deny a claim for bariatric surgery when there are conflicting medical opinions as to whether the surgery falls within an exception that would have given the participant coverage for the procedure." [Rittinger v. Healthy Alliance Life Ins. Co., No. 17-20646 (5th Cir. Jan. 31, 2019)]
The Wagner Law Group

District Court Further Extends Review of CVS/Aetna Merger

"[T]he parties closed the transaction back in November of 2018, after reaching a proposed settlement with the [DOJ] Antitrust Division that required CVS to divest its Part D Medicare business to WellCare ... [T]he Court continues to assess whether the proposed settlement adequately addresses the competitive harms addressed in the DOJ's complaint that originally sought to derail the merger ... Pending a decision by the Court, CVS has voluntarily agreed not to integrate Aetna's operations into CVS."
Akerman

DOJ Response Opposes Obama-Era 1557 Regulation

"[On] April 5, the federal government ... filed its response to the motions for summary judgment.... [T]he government fully agreed with the plaintiffs that the parts of the 2016 regulation on Section 1557 -- those that prohibit discrimination on the basis of gender identity and termination of pregnancy -- conflict with the statute and are substantively unlawful." [Franciscan Alliance, Inc. v. Azar, No. 16-108 (N.D. Tex. response to motion for summary judgment filed Apr. 5, 2019)]
Katie Keith, in Health Affairs

DOJ Seeks Expedited Oral Arguments in ACA Appeal

"The request for expedited oral arguments comes two weeks after the DOJ notified the federal appeals court that it would abandon its partial ACA defense. The DOJ's filing said the other parties and intervenors involved in the case don't oppose the motion to expedite."
HealthLeaders Media

CMS Expands Telehealth Benefits under Medicare Advantage

"Historically, MA Plans have been able to offer certain telehealth services as part of their supplemental benefits. The Final Rule ... [allows] MA Plans to offer telehealth services outside of supplemental benefits, which CMS contends will expand patients' access to telehealth services from more providers in both rural and urban settings throughout the United States."
Sheppard Mullin

Helping Your Employees Deal with Stress

"Chronic stress can also cause a variety of health symptoms that might affect the overall well-being of your employees.... Employees that battle these conditions tend to need extra health care, which directly contributes to the amount of money employers are spending on health benefits. You could be paying as much as 50% more on the health care costs of your stressed employees."
Grooms Benefit Solutions

Press Releases

AGW Capital Advisors is Certified for Fiduciary Excellence
Centre for Fiduciary Excellence [CEFEX]

Most Popular Items in the Previous Issue

Employer Worksite Clinics: An Evolving Employer-Based Healthcare Delivery System (PDF)
Gallagher and National Association of Worksite Health Centers [NAWHC]

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David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
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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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