Health & Welfare Plans Newsletter

June 12, 2019

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[Guidance Overview]

Three Month Delay for Massachusetts Paid Family and Medical Leave Contributions

"Contributions into the state trust are now set to begin on October 1, 2019.... Though the legislature still needs to vote to adopt the decision to delay, the extra time will enable the Department of Family and Medical Leave to work out some of the still-looming questions surrounding the law (for example, whether contributions will be made on a post- or pre-tax basis), and give employers and covered business entities the bandwidth to set up the proper payroll contributions and notify their workforces."
Mintz

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[Guidance Overview]

Agreement in Place to Delay Required Massachusetts PFMLA Contributions Until October 1, 2019

"It is not clear what other amendments are being considered at this time.... [T]he coalition proposed additional amendments that would further align the PFMLA with the federal Family and Medical Leave Act (FMLA). The letter proposed new language that clarifies intermittent leave counts against one's total allotment of leave and includes a definition of a 'serious health condition' as a condition that makes the covered individual unable to perform the functions of the covered individual's job."
Jackson Lewis P.C.

[Guidance Overview]

Massachusetts Governor and Legislative Leaders Agree to 3-Month Delay of July 1 Paid Family and Medical Leave Contributions

"It appears that the contribution rate will increase from 0.63% to 0.75% to make up for the 3 months of lost contributions, while the January 1, 2021 and July 1, 2021 effective dates for the commencement of leave benefits will remain the same."
Seyfarth Shaw LLP

House Energy and Commerce Committee Hearing: No More Surprises -- Protecting Patients from Surprise Medical Bills

Page includes video of the hearing, along with Memorandum from Chairman Pallone to the Subcommittee on Health, opening statement from Chairman Pallone, and opening statement of Subcommittee Chair Eshoo, along with testimony from: [1] Sonji Wilkes, Patient Advocate; [2] Sherif Zaafran, MD, FASA, Physicians for Fair Coverage; [3] Rick Sherlock, Association of Air Medical Services; [4] James Gelfand, The ERISA Industry Committee; [5] Thomas Nickels, American Hospital Association; [6] Jeanette Thornton, America's Health Insurance Plans; [7] Claire McAndrew, Families USA; and [8] Vidor E. Friedman, MD, FACEP, American College of Emergency Physicians.
Energy & Commerce Committee, U.S. House of Representatives

Parental Leave Favoring Moms Yields $5 Million Class-Action Settlement

"This settlement far exceeds a similar $1.1 million agreement announced last year in a separate complaint ... Whether these recent EEOC actions signal increased enforcement of gender-neutral parental leave policies is unclear."
Mercer

Commuter Benefits: Where They've Been, Where They're Headed

"Always on the cutting edge, San Francisco, California, was one of the first cities to mandate that employers with 20 employees or more must offer commuter benefits. Berkeley and Richmond were soon to follow in the Golden State, as well as the rest of the Bay Area. In 2016, both Washington D.C., and the five boroughs of New York City mandated that employers with 20 or more workers must offer commuter benefits."
Connect Your Care

Adaption of Telemedicine Services in Healthcare Industry

"Telemedicine is revolutionizing the healthcare industry and is expected to grow from a $21.56 billion market in 2017 to a $93.45 billion market in 2026. This growth is highly attributable to the accessibility and convenience of telecommunication devices and the inevitability of government initiatives for reimbursement."
WithumSmith+Brown, PC

2019 Scorecard on State Health System Performance

"[M]ost states are losing ground on key measures related to life expectancy as premature deaths from suicide, alcohol, and drug overdose continue to increase. Several states that most recently expanded eligibility for their Medicaid programs saw meaningful gains in access to health care; in other states prior gains eroded between 2016 and 2017."
The Commonwealth Fund

Disclosure Rules May Be Coming for Health Plans

"A bipartisan bill called the Lower Health Care Costs Act ... addresses surprise medical bills ... [and improves] transparency to ensure that pharmacy benefit managers pass along drug discounts to customers.... [D]eep inside the bill, on page 111, are new sweeping ... and onerous commission disclosure provisions.... [B]rokers would have to disclose their compensation, in writing, at the time an employer signs up for benefits, regardless of how large the employer is. Failure to comply might ultimately result in the employer being required to terminate its carrier or broker relationship.... Disclosure is also required anytime an employee makes written request for it."
ERISAPros

[Opinion]

Transparency, Regulation Needed to Rein in Pharmacy Benefit

"With pharmacy benefit managers playing an increasingly pivotal role not only in drug pricing but also in administering patient drug benefits, the American Medical Association (AMA) [[on June 10] called for oversight and transparency for the lightly regulated industry. The new policy ... responds to pharmacy benefit managers (PBMs) -- middlemen -- operating in a 'black box' with limited transparency to show what goes on behind closed doors.... [T]he AMA is concerned that the rebate process results in list prices above what they would be absent rebates, as neither PBMs nor manufacturers have an incentive to lower list prices."
American Medical Association [AMA]

Selected Discussions
on the BenefitsLink Message Boards

Entity Change: Effect on 125 Plan and FSA?

Entity "A" sponsors a Section 125 Plan. Entity "A" is now changing their name, and will become entity "B." Same employees, but new name, EIN, and management roles. Can the new entity simply adopt the existing plan assets and liabilities, via a resolution and amendment, similar to what happens in a 401(k) plan, or are there different requirements for this situation for the 125 plan? They do have an FSA -- don't know if there are other types of benefits as well. Assuming they have premiums paid through this plan, do you have any experience with whether the insurance carriers just allow the policies to "transfer" to the new entity, or will they have to re-apply, etc.?
BenefitsLink Message Boards

Press Releases

HERO Announces Board of Directors, Adds Two New Members
Health Enhancement Research Organization [HERO]

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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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