Health & Welfare Plans Newsletter

June 14, 2019

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[Guidance Overview]

HHS Proposes to Narrow Scope of ACA Nondiscrimination Regs

"[The] new proposal encourages a return to existing civil rights laws.... [No] longer would all operations of an non-health care entity be covered, but instead only the individual activities funded by HHS. As a result, the proposed rules would be inapplicable to most self-insured plans.... HHS proposes repealing in their entirety the provisions requiring taglines and nondiscrimination notices."
Proskauer

[Guidance Overview]

Connecticut Set to Expand Paid Family Leave Benefits

"The bill makes several substantive changes to CTFMLA, including compensating employees on leave, expanding coverage to employers with as few as 1 employee, and covering employees who have worked for their employer for as few as 12 weeks, with no minimum hours requirement. Sole proprietors/self-employed individuals may voluntarily enroll in the program."
Littler

[Guidance Overview]

Key Takeaways from OCR's Proposed Rule to Scale Back the Non-Discrimination Requirements Applicable to Health Care Entities

"[1] The Proposed Rule would eliminate the definitions section of the regulations, potentially making sweeping changes to whom and how the regulations apply ... [2] The Proposed Rule would eliminate certain costly administrative requirements, such as taglines ... [3] The Proposed Rule would eliminate the individualized focus of the Section 1557 non-discrimination requirements, instead assessing whether an entity meaningfully complies based, in part, on the size of its LEP population ... [4] The Proposed Rule would retain many of its access and communication provisions for LEP and disabled individuals, and might maintain the requirement for entities to issue assurances of compliance ... [5] Finally, the Proposed Rule would eliminate the private right of action under Section 1557."
ReedSmith

New Final Rule Lets Employees Use HRAs to Buy Health Insurance

"Under the new HRA rule: [1] Employers may either offer an [individual coverage HRA (ICHRA)] or a traditional group health plan but may not offer employees a choice between the two. [2] Employers can create classes of employees around certain employment distinctions ... and then offer an ICHRA on a class by class basis. [3] Employers that offer an ICHRA must do so on the same terms for all employees in a class of employees, but they may increase the ICHRA amount for older workers and for workers with more dependents. [4] Employers can maintain their traditional group health plan for existing enrollees, with new hires offered only an ICHRA."
Society for Human Resource Management [SHRM]; membership may be required to view article

Self-Funded vs. Fully-Funded: Weighing the Cost Savings for Your Business

"Employers without the time or resources to devote to a more hands-on, complex plan should probably stay with a simpler plan like a fully insured plan. Self-funding has a number of compliance requirements that are not always present for a fully-insured plan, such as non-discrimination requirements and 5500 tax filings."
OneDigital Health and Benefits

Massachusetts Supreme Judicial Court Affirms $2 Million Jury Verdict in Favor of Employee Who Vacationed During FMLA Leave

"The court stated, 'DaPrato took FMLA leave to allow his foot to recover fully from surgery. Such recovery could take place in a warm climate as well as in a New England winter.' However, the court also warned, 'An employee recovering from a leg injury . . . may not climb Machu Picchu without abusing the FMLA process. Careful consideration of the reasons for the medical leave and the activities undertaken, including the timeline for rehabilitation and recovery, are required to determine whether the FMLA leave has been abused.' " [DaPrato v. Mass. Water Res. Auth., No. SJC-12651 (Mass. June 5, 2019).]
Choate Hall & Stewart LLP

The Battle over Paid Sick Leave in Texas Continues

"Laws in Dallas and Austin require employers to provide six to eight paid sick days a year, depending on employer size. San Antonio's law allows employees to accrue up to 64 paid hours per year.... Although the Austin ordinance was challenged, no legal action has been taken to halt the Dallas or San Antonio ordinances, which are scheduled to take effect on Aug. 1."
Society for Human Resource Management [SHRM]; membership may be required to view article

Larger HSA Balances Result in Increased Use of Health Care Services and Spending (PDF)

"The average HSA balance more than doubled between 2014 and 2016 among enrollees with employee-only coverage.... Individuals with $3,000 or more in their HSA at the beginning of the year made an additional 50 visits to primary care physicians and specialists per 100 plan enrollees. Their spending was about $20 higher for primary care office visits and $28 higher for specialist visits. Spending associated with outpatient services was $551 higher."
Employee Benefit Research Institute [EBRI]

DOL Releases Annual Self-Insured Health Plan Report to Congress

"The DOL acknowledges incompleteness of the information due to inherent challenges in data collection, including the fact that the Form 5500 data includes only plans with 100 or more participants or assets held in trust, and does not capture data for governmental or church plans. As a result, the report's usefulness in identifying self-insurance trends is limited, especially among small plans that are not required to file Form 5500 because they are unfunded, insured, or a combination of both. Unlike last year, the report did not mention proposed changes to the Form 5500 that would result in the collection of more detailed funding and benefit information[.]"
Thomson Reuters / EBIA

Benefits in General

[Official Guidance]

Text of DOL Final Regs: Electronic Filing of Notices for Apprenticeship and Training Plans and Statements for 'Top Hat' Plans

13 pages. "This document contains final regulations that revise the procedures for filing apprenticeship and training plan notices and 'top hat' plan statements with the Secretary of Labor. The final regulations require electronic submission of these notices and statements, as opposed to paper filings. The final regulations will make filing these notices and statements easier and lower regulatory burdens on these plans. The final regulations also will enable the [DOL] to make reported data more readily available to participants and beneficiaries and other interested members of the public than in the past."
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

Press Releases

Most Popular Items in the Previous Issue

Text of Agency FAQs: Individual Coverage and Excepted Benefit Health Reimbursement Arrangements (PDF)
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]; Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]; and Internal Revenue Service [IRS]

Text of Final Regs: Health Reimbursement Arrangements and Other Account-Based Group Health Plans
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]; Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]; and Internal Revenue Service [IRS]

HHS, DOL and Treasury Expand Access to Quality, Affordable Health Coverage Through Health Reimbursement Arrangements
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]; Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]; and Internal Revenue Service [IRS]

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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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