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June 20, 2019 logo logo
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[Guidance Overview]

Final Rules Issued for Individual Coverage HRAs

"Although the final rule retains seven of the eight classes of employees permitted under the proposed regulations ... it eliminates the class of employees below age 25.... [E]mployers may contribute more for employees based on the number of their dependents or on their age, but ... the maximum differential for contributions between older and younger employees [is limited] to a 3:1 ratio.... [An] ICHRA may integrate with Medicare (either Parts A and B or Part C). It may reimburse premiums for Medicare, including Part D, and for Medicare supplemental coverage."
Ballard Spahr LLP


Return on Investment for Wellness Programs

Sponsored by Lorman and BenefitsLink

July 17 webinar identifies various types of wellness programs and examines what return on investment businesses can actually expect in terms of hard measurable returns and softer returns that present measurement challenges. BenefitsLink discount.

[Guidance Overview]

District of Columbia's Universal Paid Leave Act Tax Goes Into Effect July 1, 2019

"The Act creates a paid leave system funded by employers that have employees working in the District, regardless of whether the employer themselves has a physical presence within the District. The Act applies broadly to all employers that directly or indirectly exercise control over employees working in the District and are required to pay unemployment insurance for those employees."
Eversheds Sutherland

Final Regs Permit Individual Coverage HRAs in 2020

"For the first time, employers will have the realistic opportunity to marry a tax-advantaged, defined contribution approach with an individual coverage market that is available to all employees and dependents regardless of health conditions. The Departments estimate that roughly 800,000 employers will offer ICHRAs to cover roughly 11 million individuals within five years."
ABD Insurance & Financial Services

Medical Cost Trend: Behind the Numbers 2020 (PDF)

"PwC's Health Research Institute (HRI) projects a 6 percent medical cost trend in 2020, a slight uptick over the past two years. After figuring in health plan changes, such as increased employee cost sharing and network and benefit changes, HRI projects a net growth rate of 5 percent.... Between 2020 and 2027, retail drug spending under private health insurance is projected to increase at a rate of 3 percent to 6 percent a year ... Obesity and Type 2 diabetes continue to produce high rates of hypertension and cardiovascular disease.... Nearly 75 percent of employers offer mental health disease management programs. Anytime access is expanded, costs will go up in the short term."

With Expected 6% Rise in Health Costs, 2020 May Be Year of 'Activist' Employer

"Employers' desire to more effectively manage healthcare spend previously meant shifting more and more costs to employees. However, continuing that trend is untenable ... and both employers and employees report dissatisfaction with high-deductible health plans."

An Examination of Surprise Medical Bills and Proposals to Protect Consumers from Them

"[This analysis uses] claims data from large employer plans to estimate the incidence of out-of-network charges associated with hospital stays and emergency visits that could result in a surprise bill.... For people in large employer plans, 18% of all emergency visits and 16% of in-network hospital stays had at least one out-of-network charge associated with the care in 2017."
The Peterson-Kaiser Health System Tracker

Making Virtual Health a Pillar of Your Health Plan Participants' Experience

"Nearly all health plans (94 percent) offer virtual health services, and 96 percent expect their reliance on this technology will grow ... However, despite being widely available, virtual health has generally not been embraced by health plan members. One of the most formidable barriers to adoption might be the members themselves."

Editor's Pick Stop-Loss Coverage by the Numbers

"Two primary diagnoses accounted for more than 40% of all claims of $1 million or more in 2018 ... Average stop-loss premium increases have been higher at lower specific deductible policy levels in recent years. Most plans that bid or renewed their stop-loss insurance stayed with the incumbent insurer."
Segal Consulting

Awaiting the Supreme Court on Risk Corridors

"We may learn the Supreme Court's decision on June 24. If the Court accepts the appeal, the case would be considered during the next term, which begins in October and runs through summer 2020.... If the Supreme Court does not accept the appeal, the case would be over and insurers would not recoup the more than $12 billion in unpaid risk corridor payments.... [T]his would likely have implications for litigation over unpaid cost-sharing reduction payments (CSRs) and could bolster the conclusion that insurers are entitled to these payments."
Katie Keith, in Health Affairs

Benefits in General

FASB Changes for Employee Benefit Plans with Master Trust Investments

"FASB issued Accounting Standards Update 2017-06 to provide additional guidance on disclosure of an employee benefit plan's interest in a master trust. The changes are aimed particularly at defined contribution plans, which generally have divided interests (rather than percentage interests) in master trusts. The guidance is effective for fiscal years beginning after December 15, 2018, and applies retrospectively to each period for which financial statements are presented."
McDermott Will & Emery

Press Releases

Louisiana Couple Pleads Guilty to Operating Fraudulent Multiple Employer Welfare Arrangement
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2019, 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, 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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