Health & Welfare Plans Newsletter

May 31, 2019

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Jobs

Defined Benefit Plan Administrator
Northeast Professional Planning Group, Inc
in Red Bank NJ / Tarrytown NY

DC Plan Administrator
Northeast Professional Planning Group, Inc.
in Red Bank NJ / NY

Retirement Plan Services Division Head
1st Source Bank
in South Bend IN

Retirement Plan Administrator
Rogers Wealth Group
in Fort Worth TX

Employee Benefits Law Specialist
Employee Benefits Security Administration, U.S. Department of Labor
in Washington DC / Telecommute

Auditor
Employee Benefits Security Administration, U.S. Department of Labor
in Kansas City MO / Telecommute

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[Guidance Overview]

Maine Becomes First State to Require Unrestricted Paid Leave

"Maine's Governor Janet Mills has signed into law an Act Authorizing Earned Employee Leave, which will require covered employers to provide employees with up to 40 hours of paid personal leave per calendar year. Unlike other paid family and sick leave laws that have been enacted around the country, Maine's law would be the first law to allow employees to use earned paid leave for any purpose, including non-medical personal reasons."
Proskauer

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[Guidance Overview]

HHS Proposes Eliminating Mandatory Notices, Gender Identity Protections from Nondiscrimination Rules

"According to HHS, those required to provide notice have reported that this rule required such entities to send 'billions' of notices in aggregate each year, and HHS estimates that the cost of this requirement is $3.2 billion over a five-year period. Furthermore, HHS reports that the rule has not had a meaningful impact on language access since 2016, specifically suggesting that many providers have not been providing this notice. Therefore, the proposed rule would eliminate the requirement for entities to send notice and tagline inserts in communications to patients and customers."
McGuireWoods

[Guidance Overview]

Paid Family and Medical Leave Coming to Massachusetts

"While MPFML is similar to the FMLA, it is considerably more expansive in terms of the leave and benefits it provides. The following chart identifies certain important distinctions between the two laws."
Morgan Lewis

PCORI Fee Due by July 31

"For fully insured health plans, the insurance carrier files Form 720 and pays the PCORI fee.... Employers that sponsor self-insured health plans must file Form 720 and pay the PCORI fee. For self-insured plans with multiple employers, the named plan sponsor is generally required to file Form 720."
Willis Towers Watson

2020 Inflation Adjustments Are Rolling Out Just in Time for 2020 Planning

"In the last few weeks ... federal agencies released some of the applicable inflation-adjusted benefits limits for 2020, including 2020 limits related to health savings accounts (HSAs)."
Lockton

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Can Our Health Plan Require Cost-Sharing for Out-of-Network Lactation Counseling?

"As preventive services, prenatal and postnatal lactation support, counseling, and equipment rental must be covered without cost-sharing ... [P]articipants must be able to access required preventive services from in-network providers.... [If] a plan's network does not include a provider who offers a particular preventive service, the plan must cover the service without cost-sharing when performed by an out-of-network provider."
Thomson Reuters / EBIA

Communication About Healthcare Benefits: Still Broken

"At present, employees don't have an appetite to learn about health insurance because it's an alphabet soup of acronyms: HDHP, CDHP, HSA, HRA, FSA, HMO, PPO, etc. Few employees understand how different plans work or how costs are shared. The result is that people don't look for savings or even think there are bargains to be found."
Treasury & Risk; free registration required

Arbitration Approach Favored in Pending Surprise-Bill Legislation

"An arbitration approach -- backed by hospitals -- to resolve surprise medical bills remains most popular among various options in Congress. Hospital advocates wrote Congress this week to criticize legislation that uses a rate-setting approach. Researchers have found positive effects from one state's arbitration approach."
Healthcare Financial Management Association [HFMA]

Trends in Health Care and Insurance That Employers Should Monitor

"Insurers are playing defense by buying doctor groups, specialty practices and freestanding, independent medical facilities.... [H]ospital systems are beginning to offering their own insurance products and reducing or eliminating insurance offerings from other health insurers ... [P]harmacogenomics involves using an individual's genome to determine whether or not a particular therapy, or dose of therapy, will be effective.... Further advancements in pharmacology are focused on prescription adherence through the use of technology."
CBIZ

Victory for Fathers in a Parental Leave Case That Could Be a Harbinger

"[T]he JPMorgan Chase policy appeared to be gender-neutral on its face, offering 16 weeks of paid leave to primary caregivers and two weeks to other caregivers. But the lead plaintiff in the case ... contended that the company made it difficult for biological fathers to qualify as primary caregivers."
The New York Times; subscription may be required

Workers on FMLA Leave Have No Right to Be 'Left Alone,' Court Says

"Employers cannot generally require employees on FMLA leave to remain on-call or continue working, but the statute does not provide any right to be 'left alone,' said the 3rd U.S. Circuit Court of Appeals. Because the worker was terminated for failing to timely and meaningfully respond to a one-time inquiry that was unrelated to the exercise of her FMLA rights, there was no FMLA interference and summary judgment in favor of the employer was upheld, the court held." [Reagan v. Centre Lifelink Emergency Medical Services, Inc., No. 17-3056 (3rd Cir. May 2, 2019)]
HR Dive

Bipartisan Group of Senate Finance Committee Members Establishes Paid Family Leave Working Group

"On May 22, 2019, members of the U.S. Senate Finance Committee, which has jurisdiction over federal tax policy and significant health care policy, announced a bipartisan working committee of Finance Committee senators to consider the issue of federal paid family leave policy. The paid family leave working group plans to meet regularly and devise a list of principles on which all member senators reach agreement by consensus."
Hunton Andrews Kurth

Benefits in General

Highlights from the Lex Machina 2016-2018 ERISA Litigation Report

"From 2010 to 2018, ERISA case filings declined from nearly 9,000 cases to about 6,600 cases. Delinquent Contribution case filings have seen a significant decline from nearly 4,400 cases in 2010 to over 1,900 cases in 2018.... The Northern District of Illinois has the most case filings by nearly 650 cases ... Judges in the District of South Carolina are the top four most active ERISA judges from 2016 through 2018.... In ERISA cases overall, 74% resolved with a likely settlement.... Over the three-year period from 2016 to 2018, courts awarded over $1 billion in Approved Class Action Settlement damages."
Lex Machina; free registration required to view full report

Can Employees Release ERISA Fiduciary Breach Claims?

"[A] federal district court ... determined that a general release that stated 'by signing this document you are releasing all known claims' without mentioning ERISA prevented a participant from suing an ESOP trustee for fiduciary breach. The decision contains a good discussion of the factors to be reviewed in determining whether such a release is valid and enforceable." [Innis v. Bankers Trust Co. of South Dakota, No. 16-650, (S.D. Ia. Apr. 30, 2019)]
Cohen & Buckmann, P.C.

Selected Discussions
on the BenefitsLink Message Boards

Can a QDRO Apply to a Welfare Benefit Plan?

I would be interested in reading comments from our QDRO legal beagles -- how should a life insurance plan administrator respond when someone provides an order purporting to be a QDRO?
BenefitsLink Message Boards

Press Releases

Regional Leader Goes National
Northeast Professional Planning Group [NPPG)]

Most Popular Items in the Previous Issue

Paid Family Leave in the United States (PDF)
Congressional Research Service [CRS]

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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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