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May 3, 2019 logo logo
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in Burlingame CA / Telecommute

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Krakow, Souris & Landry, LLC
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[Guidance Overview]

Massachusetts Extends Deadlines for PFMLA Notice to Employees and Private Plan Exemptions

"[If] an employer's exemption does not receive approval before September 20, 2019, that employer will be responsible for remitting the full contribution amount from July 1, 2019, forward. The guidance does not state what an employer should do regarding employee deductions if the employer's request for a private plan exemption is denied or not acted upon before September 20, 2019. Nor does the guidance address the issue of whether an employer could lawfully seek retroactive deductions from employees going back to July 1, 2019 if an exemption application is not timely approved."
Jackson Lewis P.C.


New ERISA Regulations for Disability Claims and Appeals

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[Guidance Overview]

Massachusetts Extends Critical Compliance Deadlines Under the Paid Family Medical Leave Law

"What should employers consider doing right now? ... Our company only has one employee in Massachusetts. Do we have to do anything? ... How do employers apply for an exemption? ... Do we have to use the Department's model notice form? ... What if employees don't want to contribute into the PFML trust fund? ... What if employees leave the company or retire before January of 2021? ... When the employer begins withholding PFML contributions on July 1, 2019, is the 2019 PFML income limit calculated using year-to-date wages?"

Minneapolis Paid Sick Leave Rules Apply to Non-Minneapolis Employers

"In 2018, the city amended the ordinance to say that sick and safe time only accrue for hours in which an employee works within the city, and sick and safe time can only be used when an employee is scheduled to perform work within the city.... [T]he Minnesota Court of Appeals found that the ordinance was both not preempted by state law and did not have an impermissible extraterritorial effect, making the ordinance once again enforceable against employers located outside Minneapolis." [Minn. Chamber of Commerce v. City of Minneapolis, No. A18-0771 (Minn. Ct. App. Apr. 29, 2019)]
Stinson Leonard Street

Employers' State Law Claims of Insurer Misrepresentation Not Preempted by ERISA

"Three employers provided their employees with health care insurance based on the insurer's representations that the monthly premiums would reflect only the cost of providing benefits. The employers later said these representations were false and that the insurer padded the premiums with hidden surcharges, which it used to pay kickbacks and to buy unauthorized insurance products.... [T]he Ninth Circuit upheld the employers' right to sue under state law ... [ruling] that the duties implicated in the employers' state-law claims do not derive from ERISA." [The Depot, Inc. v. Caring for Montanans, Inc., No. 17-35597 (9th Cir. Feb. 6, 2019)]
The Wagner Law Group

Employer-Provided Health Insurance Deductibles Soar, Leaving Americans with Unaffordable Bills

"In the last 12 years, annual deductibles in job-based health plans have nearly quadrupled and now average more than $1,300.... [M]ore than four in 10 workers enrolled in a high-deductible plan report they don't have enough savings to cover the deductible. One in six Americans who get insurance through their jobs say they've had to make 'difficult sacrifices' to pay for healthcare in the last year, including cutting back on food, moving in with friends or family, or taking extra jobs. And one in five say healthcare costs have eaten up all or most of their savings."
Los Angeles Times


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CBO Updated Budget Projections Incorporating the Effects of the Proposed Rule on Safe Harbors for Pharmaceutical Rebates (PDF)

"Implementing the rule as proposed would ... increase federal spending by about $177 billion over the 2020-2029 period: Spending for Medicare would increase by about $170 billion and spending for Medicaid by about $7 billion.... [The proposed rule] would eliminate the existing safe harbor for rebates paid by pharmaceutical manufacturers to health plans and PBMs in Medicare Part D and Medicaid managed care beginning January 1, 2020.... The rule would replace that safe harbor with two new ones: one related to upfront discounts for prescription drugs and the other to service fees." [Document date: May 2019]
Congressional Budget Office [CBO]

Federal Subsidies for Health Insurance Coverage for People Under Age 65: 2019 to 2029

"In an average month for each year during [2019-2029], between 240 million and 242 million such people are projected to have health insurance, mostly from employment-based plans.... Net federal subsidies for insured people will total $737 billion in 2019 ... That annual sum is projected to reach $1.3 trillion in 2029.... Since CBO's most recent report comparable to this one was published in May 2018, the projection of the number of people with employment-based coverage has risen by 3 million, on average, for the 2019-2028 period spanned by both reports.... Projected net federal subsidies for health insurance from 2019 to 2028 have risen by 2 percent." [Document date: May 2019]
Congressional Budget Office [CBO]

HHS Unveils Rule to Protect Health Workers' Religious, Moral Beliefs

"[HHS final regulations aim] to protect health-care workers who object to procedures such as administering vaccines derived from fetal tissue, or to referring patients for help in making end-of-life care decisions, such as for the use of breathing machines. It significantly broadens the agency's enforcement authority and spells out how HHS may revoke federal funds for violations."
The Wall Street Journal; subscription may be required

Benefits in General

Editor's Pick Things Employers Should Know About EBSA Investigations

"25% of EBSA investigations start with a participant complaint.... If the EBSA finds that a service provider is violating ERISA or ignoring plan terms, it may also conduct investigations of the plans that the service provider serves.... An employer will not know the focus of the EBSA investigation ... The initial notice will include an extensive document request ... The onsite visit is not a formal deposition ... There will be long periods of time between contacts with the EBSA investigator.... An employer's cooperation with the EBSA investigation can affect the outcome of the investigation."
Thompson Coburn

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2019, 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, 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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