Health & Welfare Plans Newsletter

May 13, 2019

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Jobs

Automatic Rollover IRA Sales Specialist
PenChecks Trust
in San Diego CA / Telecommute

Management and Program Assistant (Pathways Intern)
Pension Benefit Guaranty Corporation
in Washington DC / Telecommute

Actuary- DH
Pension Benefit Guaranty Corporation
in Washington DC / Telecommute

Manager - North America Benefits
Air Products and Chemicals, Inc
in Allentown PA

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[Official Guidance]

Text of DOL FAQs, Part 2: Federal District Court Ruling About Final Rule on Association Health Plans (PDF)

"[These FAQs are intended to provide additional clarification on the scope of the enforcement relief described in the Department's [April 29 statement] ... [1] Are Pathway 1 AHPs affected by the district court's decision or the related enforcement policy? No.... [2] Can a 'Pathway 2' AHP formed pursuant to the Department's final rule prior to the district court's decision market to, and sign up, new employer members and remain within the scope of the Department's enforcement relief? No.... [3] How does the Department's enforcement relief apply to insured AHPs formed under the Department's final rule whose insurance contract term is longer than one year? ... [4] My association was designed to meet the test established in the Department's sub-regulatory guidance for purposes of acting as an 'employer' that is able to sponsor a 'Pathway 1' AHP. May the association seek an advisory opinion from the Department to confirm that the association meets the test?"
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

[Advert.]

New ERISA Regulations for Disability Claims and Appeals

Sponsored by Lorman and BenefitsLink

May 23 webinar will explain what new practices to follow, how to change past practices to become compliant with the new regulations, and the risks of non-compliance.BenefitsLink discount.


[Guidance Overview]

Massachusetts Employers May Be Approved Now for Private Plans That Do Not Provide Paid Leave Benefits Until 2021

"In a significant departure from [their] previous position ... the [Massachusetts Department of Family and Medical Leave (DFML)] has confirmed that benefits under a private PFML plan that has been approved for an exemption do not have to begin until January 2021. Employers thus may receive approval of a private plan even though the plan does not provide paid leave benefits until January 2021, when the public program's leave benefits commence."
Seyfarth Shaw LLP

[Guidance Overview]

Massachusetts Paid Family and Medical Leave: Workforce Notice and Exemption Applications

"By June 30, employers must provide Massachusetts employees and 1099-MISC contractors with written notice regarding PFML and must hang a PFML poster in its Massachusetts facilities. Also, employers can now apply for private plan exemptions."
Nixon Peabody LLP

[Guidance Overview]

Westchester County, NY Enacts Standalone Paid 'Safe' Time Ordinance

"[B]eginning October 30, 2019, [the 'Safe Time Leave Law'] will require all private employers to provide up to 40 hours of paid leave for victims of domestic violence and human trafficking. This ordinance will apply to employees who are employed in the county for more than 90 days in a calendar year on a full-time or part-time basis, with few exceptions. The new paid leave requirement is in addition to existing paid or unpaid leave obligations employers have under the county's paid sick leave ordinance[.]"
Littler

Paid Sick Leave: A Way Forward (PDF)

20 pages. "This paper examines what paid sick leave is and charts its transition from the exception to the rule. It highlights major compliance challenges these incongruous laws create for private-sector employers, identifies issues for lawmakers and enforcement officials to consider when drafting and enforcing laws, and discusses possible fixes for reducing discrepancies and enhancing administrative ease without sacrificing employee access to paid leave. Finally, [the authors] explore the viability of a federal solution."
HR Policy Association

[Advert.]

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Sponsored by WEB - Worldwide Employee Benefits Network

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Steps for States Considering a 1332 Waiver (PDF)

11 presentation slides. Topics: [1] Pre-application process overview; [2] Identify policy problem and solution; [3] Strategy and coalition building; [4] Data gathering and actuarial analysis; [5] Legislative authority; [6] Preparing the application; [7] State public comment.
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

How Big Can Big Claims Get?

"Claims $10 million, $20 million or bigger are hitting employers like bolts of lightning, blowing up self-insured health budgets. Most often, these claims are driven by specialty drug treatments for rare, extreme conditions ... Because the drug treatment protocols for conditions like hereditary angioedema and hemophilia are more maintenance-like than curative, those $10-$20 million claims are becoming annuities.... [B]uying stop loss -- through direct markets or by accessing reinsurance markets through a captive -- may not be a complete solution."
Mercer

Benefits in General

2019 ERISA Advisory Council Issue Statement: Improving the Financial Statement Audit Process (PDF)

"[T]he focus of this inquiry is on increasing the knowledge and understanding of the plan administrators that procure financial statement audit services and on improving the procedures that such plan administrators implement in selecting an auditor, preparing for the audit, communicating with the auditor before, during, and after the audit, and adopting changes in the plan's documentation, operations, policies, or procedures based on the results of the audit."
Advisory Council on Employee Welfare and Pension Benefit Plans, Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

Selected Discussions
on the BenefitsLink Message Boards

HIPAA Privacy Notice -- Post on Website Rather Than Personally Deliver?

Plans must provide a notice of the availability of the Privacy Notice at least once every 3 years. Can this "notice of the Privacy Notice" be merely posted on the company's intranet/website? Does it follow the same electronic disclosure requirements applicable to qualified plans?
BenefitsLink Message Boards

Press Releases

NAPA Welcomes Jania Stout as 2019 President
National Association of Plan Advisors [NAPA]

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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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