Health & Welfare Plans Newsletter

June 24, 2019

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Jobs

Defined Benefit Plan Administrator
Northeast Professional Planning Group, Inc
in Red Bank NJ / Tarrytown NY

Retirement Plan Consultant
QPC, LLC - Qualified Plan Consultants, LLC
in Fort Lauderdale FL / Telecommute

Defined Benefits Actuarial Consultant
USI Consulting Group
in Glastonbury CT

401(k) Plan Sales
Mutual of America
in New York NY

Pension Administrator
Associated Pension Consultants
in Chico CA / Telecommute

Pension Information System Modeler-DE
Pension Benefit Guaranty Corporation
in Washington DC / Telecommute

Senior Auditor
Alerus Financial
in Excelsior MN / Grand Forks ND

Plan Administration Specialist
First Mercantile Trust
in Dubuque IA / Cordova TN

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[Guidance Overview]

The New HRA Regs: Individual Coverage HRAs

"The new Individual Coverage HRAs can integrate with: [1] individual insurance coverage purchased on the ACA marketplace; [2] individual insurance coverage purchased outside of the ACA marketplace (including on a private exchange); [3] student health insurance coverage; [4] individual insurance coverage obtained in states that have received a [Section 1332] waiver ... [5] individual catastrophic coverage; [6] 'grandmothered' coverage (i.e., non-grandfathered coverage that is not compliant with ACA but that [HHS] has announced it will not take enforcement action on); and [7] coverage under Medicare Parts A, B, C, or D and Medigap."
Proskauer

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[Guidance Overview]

Paid Sick Leave in San Antonio and Dallas Survives the Texas Legislature

"[T]he Texas Legislature recently wrapped up its legislative session without passing a law curtailing city-specific paid sick leave laws -- and the Legislature will not meet again until 2021. In the meantime, Dallas' and San Antonio's paid sick leave laws are scheduled to go into effect on August 1, 2019. (Austin's ordinance is stayed pending an appeal to the Texas Supreme Court.) ... [U]nless the Texas Supreme Court rules that the laws are unconstitutional, employers in Dallas and San Antonio should begin preparing to comply with the paid sick leave requirements."
Seyfarth Shaw LLP

Annual PCORI Fee Deadline Is July 31

"Who needs to pay the PCORI fee? ... To which plans does the PCORI fee apply? ... Does the PCORI fee apply to HRAs? ... Does the PCORI fee apply to dental and vision coverage? or health FSAs or HSAs? ... How is the PCORI fee calculated? ... How much do I need to pay? ... How do we file the PCORI fee?"
ABD Insurance & Financial Services

U.S. Supreme Court Takes Up Insurers' $12 Billion Obamacare Dispute

"The U.S. Supreme Court on Monday agreed to decide whether the federal government must pay insurers $12 billion under an Obamacare program aimed at encouraging them to cover previously uninsured people after the healthcare law was enacted in 2010. The justices will hear an appeal by a group of insurers of a lower court ruling that Congress had suspended the government's obligation to make the payments. The insurers have argued that the ruling would allow the government to pull a 'bait-and-switch' and withhold money they were promised." [Maine Community Health Options v. U.S., Nos. 17-2395 (Fed. Cir. Jul. 9, 2018; cert. granted Jun. 24, 2019)]
Reuters

New Executive Order May Make More Health Care Prices Public

"The White House will release an executive order Monday afternoon intended to require insurance companies, doctors and hospitals to give patients more information about precisely what their care will cost before they get it.... Exactly what information hospitals and insurers will have to disclose is not specified in the executive order ... White House officials said the details would be worked out during the rule-making process. Hospitals and insurance companies are likely to lobby to make any disclosures as general as possible."
The New York Times; subscription may be required

Administration Plans to Require Hospitals to List 'Shoppable' Prices

"Hospitals could be required to provide prices in an 'easy-to-read, patient-friendly format' before they provide services to patients under rules that will be proposed in an executive order signed by President Donald Trump.... [HHS] Secretary Alex Azar said the order would 'put American patients in control and address the fundamental drivers of high American healthcare costs.' "
FierceHealthcare

A Brief Look at the Medicare Secondary Payer Rules

"[The Medicare Secondary Payer Rules] prevent employers (whose plans would pay before Medicare) from coercing, inducing, or incentivizing employees, their spouses, or dependents to elect Medicare over employer-sponsored coverage.... The Rules apply to active employees and their spouses regardless of how they become eligible for Medicare (age or disability).... These Rules generally apply to employers who have 20 or more employees (full-time and part-time) worldwide."
HUB International

[Opinion]

A Simple Solution to Lower Drug Prices for All Americans

"There's a simple solution for lowering prices of both old and new drugs for all Americans, not just for seniors under Medicare: a windfall profits tax that takes back surplus profits derived from excessive prices. This tax would be equal to the difference between a drug's list price -- the price that is used for patient payments -- and the drug's justified price, multiplied by the number of units sold."
Center for American Progress

[Opinion]

New Rule Could Mean Consumer Confusion, Higher Premiums in Marketplace

"The rule will almost certainly raise marketplace premiums because HRAs will be more attractive to firms with sicker-than-average employees.... The rule has guardrails designed to prevent that from occurring, but employers may still find ways to target sicker workers.... Employees will need to do considerably more work to enroll in an individual market plan than an employer's group plan.... The new rules will likely expand enrollment in short-term plans[.]"
Center on Budget and Policy Priorities

[Opinion]

Non-English Speakers Would Be Disadvantaged by Trump Administration Plan to Ease Language Rules on Health Notices

"The government acknowledged in the proposal that the change would lead to fewer people with limited English skills accessing health care and fewer reports of discrimination. But it also questioned the need for these notices, pointing out that in some areas health organizations spend money to accommodate a small contingent of language speakers. For example, notices in Wyoming must account for the 40 Gujarati speakers -- a language of India -- in the state."
Kaiser Health News

Selected Discussions
on the BenefitsLink Message Boards

ACA Reporting -- Are Late Filing Penalties Being Imposed in Practice If Employer Responds and Files?

Does anyone know if the IRS is actually assessing late filing or failure to file penalties on an ALE if the ALE [1] timely responds to the Letter 5699 indicating they will file within 90 days, and [2] files 1095-Cs and 1094-C within the 90 days?
BenefitsLink Message Boards

Press Releases

Most Popular Items in the Previous Issue

Your Employee Health Plan Could Soon Look Like Your 401(k)
The Wall Street Journal; subscription may be required

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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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