Health & Welfare Plans Newsletter

July 19, 2019

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[Guidance Overview]

IRS Permits New Benefits in High Deductible Health Plans

"[Notice 2019-45] has two major limitations: [1] Only the specific treatments covered by the Notice are covered. Even if other treatments may meet the three-pronged test ... they are not permitted to be covered.... [2] The Notice specifically says that male sterilization services (vasectomies) cannot be covered.... [M]any state laws require that health insurance cover vasectomies. In those states, anyone with health insurance (as opposed to an employer's self-insured plan) will not be able to have an HSA."
Venable LLP

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[Guidance Overview]

IRS Provides Guidance on Preventive Care for High-Deductible Health Plans and HSAs

"[Notice 2019-45] may present an opportunity to 're-launch' HSA/HDHP options and potentially increase employee take-up.... Plans will need to engage in a significant education campaign between now and the 2020 open enrollment season to help employees and dependents with chronic conditions understand the specific impact of the guidance on their health care coverage options for next year."
Eversheds Sutherland

[Guidance Overview]

IRS Expands Preventive Care Benefits for HSA-Compatible HDHPs

"[Notice 2019-45] does not affect what is considered preventive care for purposes of the ACA preventive care mandate. Whether cost-sharing may be imposed on the specified services depends on whether the treatment would be considered preventive under the ACA."
Buck

[Guidance Overview]

New HRA Regs: Premium Tax Credit and Employer Mandate Impact on Individual Coverage HRAs

"[T]he new Individual Coverage HRA is a group health plan subject to ERISA and the [ACA].... The final HRA regulations contain very little substantive guidance regarding the impact that Individual Coverage HRAs will have on employer mandate compliance."
Proskauer

[Guidance Overview]

Impact of New DOL Regs on Retiree-Only HRAs

"Prior to the issuance of the new HRA final regulations, most employers treated non-coordinated, individual insurance policies as exempt from ERISA. This is especially true for post-65 retiree arrangements ... If the plan sponsor does not select the menu of insurers who offer the individual policies, does not select the individual coverage levels, and has no involvement in the design of the individual policies or eligibility or claims determinations, such arrangement should be exempt under the ERISA General Rule."
Kilpatrick Townsend & Stockton LLP, via Lexology; free registration required

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Bill to Repeal ACA's Excise Tax on High-Cost Plans Passes House

"A House bill (H.R.748) to permanently repeal the [ACA's] 40 percent excise tax on high-cost health plans, often referred to as the 'Cadillac tax,' passed the House of Representatives by a vote of 419-6 on June 17, 2019. A similar bill in the Senate (S.684) has 42 bipartisan sponsors but is not scheduled for further action at this time."
Segal Consulting

Questions to Ask Wellness Program Providers

"[1] Can you show how this program has led to the results you are promising? ... [2] What data are you gathering to measure your results? ... [3] How is that data put together to show the program's return on investment?"
Society for Human Resource Management [SHRM]; membership may be required to view article

California Individual Health Coverage Mandate Includes Employer Reporting

"Self-insured plan sponsors, health insurers and other entities that provide MEC to residents must report to the California Franchise Tax Board by March 31 of the year after close of each coverage year. Additional notices must go to covered individuals and their dependents by Jan. 31 after the coverage year ends. Failure to report this coverage can trigger penalties of $50 per affected individual per tax year."
Mercer

Compromise Bill Bringing Paid Family Leave to Oregon

"Under Oregon's new law, covered employees will be provided up to 12 weeks of paid family leave each year. For pregnancy and childbirth, an additional two weeks of paid family leave will be available. The paid family leave is in addition to the paid sick time already required by law. Employees can be paid 100% wage replacement all the way up to 120% in certain circumstances."
HR Daily Advisor

Employees Busted Taking FMLA Leave for a Caribbean 'Booze' Cruise -- Yet Another Reminder Leave Abuse is Alive and Well

"How can employers minimize the chances of getting stung by this same tactic? ... [H]ere are a number of tools that have worked for my clients as they have fought FMLA leave abuse, especially in the dead of summer[.]"
FMLA Insights

Are the Markets Ready for the HRA Rule?

"Starting with the 2020 plan year, employers will be able to use [HRAs] to help pay for individual market coverage for their employees.... [S]ome see potential benefits for employers and employees, and a chance for the kind of growth in the individual market that can only come as a result of migration from the much larger group market. Yet, now that this migration is possible, how likely is it? ... While [the] focus here is on factors relevant to migration from the small-group market, similar considerations would apply to self-insured employer plans."
Robert Wood Johnson Foundation

Benefits in General

Trump to Nominate Eugene Scalia for Labor Secretary

"In private practice, Scalia has been known for his challenges to federal regulations on behalf of corporate clients.... Representing the U.S. Chamber of Commerce, Scalia played a major role in convincing an appeals court judicial panel to vacate the Obama [DOL]'s fiduciary rule.... If confirmed, Scalia will be returning to the department where he previously served as solicitor in President George W. Bush's administration, overseeing litigation and legal advice on rulemakings and administrative law."
InsuranceNewsNet.com

Selected Discussions
on the BenefitsLink Message Boards

Exclude Retirees When Distributing an SPD?

Is anyone aware of any authority that would support a view that a defined benefit multiemployer pension plan could exclude retirees from a mass distribution of an updated SPD? Even though the language in 29 CFR section 2520.104b-2 is somewhat inconsistent, it appears that retirees in pay status are not excluded from a mass distribution of an updated SPD.
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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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