Health & Welfare Plans Newsletter

June 21, 2019

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[Guidance Overview]

Texas Paid Sick Leave Ordinances in State of Confusion

"It was thought that the Texas Legislature would pass legislation that would prohibit these ordinances from existing in the first place. The legislative session ended, however, with no such legislation making its way to Governor Abbott's desk ... With the Austin ordinance declared unconstitutional by the Austin Court of Appeals and the Dallas and San Antonio ordinances scheduled to take effect on August 1, 2019, Texas employers are left wondering what to do about implementing paid sick leave for Dallas and San Antonio employees."
FordHarrison

[Guidance Overview]

Oklahoma Enacts Regulation of Pharmacy Benefit Managers

"[T]he Governor of Oklahoma recently signed [the Patient's Right to Pharmacy Choice Act (HB 2632)] into law. The purpose of the Act is to establish minimum and uniform access to providers, and standards and prohibitions on restrictions of patient's rights to choose pharmacy providers.... By regulating PBMs instead of health plans, the Act will impact self-insured health plans, but does not attempt to regulate such plans directly. This approach may ultimately help the Act avoid challenges by self-insured health plans on ERISA preemption grounds."
HUB International

[Guidance Overview]

Health Care-Related Expiring Provisions of the 116th Congress, First Session

44 pages. "This report describes selected health care-related provisions that are scheduled to expire during the first session of the116th Congress (i.e., during calendar year 2019).... This report generally focuses on two types of health care-related provisions ... The first type of provision provides or controls mandatory spending, meaning that it provides temporary funding, temporary increases or decreases in funding ... or temporary special protections that may result in changes in funding levels ... The second type of provision defines the authority of government agencies or other entities to act, usually by authorizing a policy, project, or activity. Such provisions also may temporarily delay the implementation of a regulation, requirement, or deadline, or establish a moratorium on a particular activity." [Report R45781, June 21, 2019]
Congressional Research Service [CRS]

PCORI Fee Due by July 31, 2019

"Because the PCORI fee only applies to plan years ending before October 1, 2019, the final PCORI fee payment for sponsors of calendar year plans (for the 2018 plan year) will be due by July 31, 2019. The final PCORI fee for plans with plan years ending on or after January 1, 2019 through September 30, 2019 will be due by July 31, 2020."
Buck

HHS Eliminates Tagline Requirements

"HHS recently released a draft of proposed regulations that would, among other proposed changes, remove the notice and tagline requirements. This means employers subject to these rules would no longer have to post a notice of non-discrimination or add non-English taglines to their communications.... HHS estimates that the cost savings for this and other related changes will be $3.6 billion over five years."
HUB International

HHS Fact Sheet Provides Reminder of HIPAA Liability for Business Associates (PDF)

"Business associates can be held directly liable for certain types of HIPAA violations. Business associates include TPAs, consultants or brokers, and other entities that receive PHI on behalf of a health plan. HHS actively enforces the HIPAA Rules, with costly outcomes for covered entities and business associates."
Cowden Associates, Inc.

President Trump to Issue Executive Order on Health Care Price Transparency

"The order will direct federal agencies to initiate regulations and guidance that could require insurers, doctors, hospitals and others in the industry to provide information about the negotiated and often discounted cost of care ... Consumers and employers will benefit because pulling back the secrecy around the prices will allow them to shop for lower cost care and benefits, advocates say. But industry groups including hospitals and insurers have balked at the idea, saying it could cause costs to climb if some businesses learn competitors are getting bigger discounts."
The Wall Street Journal; subscription may be required

More Work Needed to Shift Health Care Spending from Low-Value to High-Value Care

"[S]pending growth on the five frequently-cited, low-value services remained mostly flat (slower than the growth in total health care spending). Meanwhile, spending on the high-value services increased only moderately, with spending on three of the analyzed services ... growing faster than total health care spending. Though this is moving in the right direction, there is much more work to be done."
Altarum Institute

Your Employee Health Plan Could Soon Look Like Your 401(k)

"The new rules prevent employers from pushing individual employees into HRAs, but they can offer HRAs to a class of employees, such as all hourly workers or all new hires. Some analysts worry that HRAs will encourage companies to move from 'defined benefit' to 'defined contribution' health coverage, a bit like the switch from pensions to 401(k) plans for retirement. They fear the employer's contribution could lag."
The Wall Street Journal; subscription may be required

Benefits in General

More Organizations Are Expanding Severance Benefits

"Forty-four percent of 1,500 HR professionals polled ... said their organizations offer severance benefits to all workers -- not just executives and senior managers -- representing a 6 percent increase from 2017. A majority of respondents cited projecting an employee-first workplace culture as the top reason for expanding severance, followed by taking care of employees and protecting brand reputation."
Society for Human Resource Management [SHRM]; membership may be required to view article

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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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