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Health & Welfare Plans Newsletter June 10, 2019 |
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[Official Guidance]
Draft 2019 IRS Form 1095-A: Health Insurance Marketplace Statement (PDF) June 7, 2019. "This Form 1095-A provides information you need to complete Form 8962, Premium Tax Credit (PTC). You must complete Form 8962 and file it with your tax return (Form 1040 or Form 1040NR) if any amount other than zero is shown in Part III, column C, of this Form 1095-A (meaning that you received premium assistance through advance credit payments) or if you want to take the premium tax credit."
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[Guidance Overview]
Paid Leave Soon to Become Law in Nevada "Although originally styled as 'sick leave' legislation, the final bill as enrolled requires that paid leave be made available to employees to be used for any reason. With limited exceptions, employers with 50 or more employees must provide paid leave to their employees in proportion to the number of hours worked. The bill makes no exception for part-time employees. The legislation becomes effective on January 1, 2020."
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Connecticut Legislature Passes Most Generous Paid Family Leave Bill in U.S. "12 weeks of paid leave will be provided to new parents and employees who need time to attend to health issues or the health issues of a family member. A sliding scale going up to 95% of salary for minimum wage workers, capped at $900 per week, will determine the level of benefits. The pay will be provided through a state-run insurance system funded by a 0.5% payroll tax."
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Requiring Notice to HR in Addition to Manager Improperly Imposed Heightened FMLA Leave Notice Burden "The employee contacted her manager but did not contact HR, as the employer's FMLA policy required. However, employees weren't required to contact HR for any other type of leave, so the employer could not refuse FMLA leave on that basis." [Moore v. GPS Hospitality Partners IV, LLC, No. 17-500 (S.D. Al. June 3, 2019)]
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Congress Focuses on Surprise Billing: A Summary of Three Bipartisan Proposals "[This article] provides a high-level summary of three bipartisan proposals addressing the issue of surprise medical bills: [1] A discussion draft of the No Surprises Act, released on May 13, 2019... [2] The Stopping the Outrageous Practice (STOP) of Surprise Medical Bills Act of 2019 (S. 1531) ... [3] A discussion draft of the Lower Health Care Costs Act of 2019, released on
May 23, 2019[.]"
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District Court Orders Nationwide Injunction: Contraceptive Mandate Under ACA Cannot Be Enforced "On June 5, 2019, Judge Reed O'Connor of the Northern District of Texas issued a permanent injunction against the [ACA's] contraceptive mandate. The court found that the contraceptive mandate and the Obama-era accommodations process for religious entities violate the Religious Freedom Restoration Act (RFRA) and can no longer be enforced by the federal government against those who object to contraceptive coverage. This means that entities and individuals covered by Judge O'Connor's decision are fully exempt from the contraceptive mandate." [Deotte v. Azar, No. 18-825 (N.D. Tex. June 5, 2019)]
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New State Waiver Applications, Risk Adjustment Data "On May 31, 2019, CMS issued risk adjustment data validation (RADV) results for the 2017 plan year and finalized a new change to the risk adjustment holdback policy for 2018 and beyond. On June 5, CMS informed Colorado and North Dakota that their applications for state-based reinsurance programs under Section 1332 of the [ACA] were complete. Comments on those waiver applications can be made through July 5."
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Affordable Care Act PCORI Fee Deadline is July 31 "If a plan is fully insured, then the health insurer is responsible for paying the fee. For self-insured plans, the plan sponsor (generally the employer) is responsible for paying the PCORI fee. For self-insured health plans, the fee is calculated using the average number of total lives covered by the plan (both employees and dependents)."
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The ACA's Effects on Patients, Providers and the Economy: What We've Learned So Far "[The authors] find strong evidence that the ACA's provisions have increased insurance coverage. There is also a clearly positive effect on access to and consumption of health care, with suggestive but more limited evidence on improved health outcomes. There is no evidence of significant reductions in provider access, changes in labor supply, or increased budgetary pressures on state governments, and the law's total federal cost through 2018 has been less than predicted."
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[Opinion]
33 pages. "Proposals to expand access to public health insurance plans are being put forward to provide a way to supplement efforts to strengthen insurance markets under the [ACA] or to replace the ACA marketplaces and/or other health insurance programs altogether.... This issue paper ... outlines four approaches aiming to achieve such goals and highlights the key design elements that would need to be specified for an approach to be fully evaluated and implemented."
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Press Releases |
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HealthSavings Administrators Survey Reveals Registered Investment Advisors Are Missing the Mark on HSAs
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IRI Retirement Fact Book 2019 Now Available
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Finzo NZ Limited is Certified for Investment Support Services
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Most Popular Items in the Previous Issue |
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Recent Trends in Stop Loss Claims
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Connect
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Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager
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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