Health & Welfare Plans Newsletter

July 26, 2019

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Plan Administrator
Tennessee Pension Administrators
in Knoxville TN

Financial Client Services Representative
Mutual of America
in Blue Bell PA

Account Manager
Pentegra
Telecommute

RPS Business Development Officer
Heartland Financial
in Denver CO

Benefit Account Manager
BASIC pacific
in Roseville CA

Relationship Manager
The Retirement Plan Company (TRPC)
in Brentwood TN / Telecommute

Health Insurance Specialist (Data Analysis and Studies)
Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services
in Woodlawn MD / Telecommute

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[Guidance Overview]

New HRA Rules Provide Employers of All Sizes with Additional Benefit Options

"Employees who are eligible for an ICHRA from their employer cannot also be eligible for a traditional group health plan from their employer.... With certain exceptions, an ICHRA must be offered on the same terms to each employee within the same class.... Participants in an ICHRA must be offered the opportunity to opt-out and waive future reimbursements under the ICHRA at least once per plan year."
Miller Johnson

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[Guidance Overview]

Editor's Pick How the 2020 ACA Affordability Decrease Affects Employers

"[Rev. Proc. 2019-29] decreases the affordability threshold for ACA employer mandate pay or play purposes to 9.78% for plan years beginning in 2020.... In most cases, ALEs that do not meet the federal poverty line affordability safe harbor will want to use the rate of pay affordability safe harbor.... Consider creating a fixed percentage-based contribution structure if you are going to rely on the Form W-2 affordability safe harbor."
ABD Insurance & Financial Services

[Guidance Overview]

Moving Targets: Possible Delays to Texas Paid Sick Leave Ordinances

"San Antonio's PSST ordinance's effective date has been delayed until December 1, 2019 ... Dallas's PSST ordinance is still scheduled to go into effect on August 1, 2019 ... [T]he Dallas Office of Equity & Human Rights ... has posted Final Rules and answers to certain Frequently Asked Questions on its website, all part of the planned rollout.... Austin's PSST ordinance was originally slated to take effect on October 1, 2018 ... Ongoing litigation ... has resulted in a temporary injunction, which has prevented the ordinance from taking effect."
Littler

IRS Releases ACA Shared Responsibility Affordability Percentage for 2020

"Many employers use the FPL safe harbor to develop employee contributions for self-only coverage to avoid ACA assessments under 4980H. Using the FPL safe harbor also simplifies ACA reporting and coding of Form 1095-C.... The maximum monthly contribution will be 9.78% of $12,490, divided by 12, or $101.79. The amounts for prior years are also included in [this article]."
Buck

Additional Preventive Care Benefits Permitted Under High-Deductible Health Plans: A Game Changer?

"[G]rowth in HSA-eligible health plan enrollments may also be held back because what constitutes an HSA-eligible health plan does not provide employers their desired level of flexibility around the design of the health plan -- specifically, the flexibility to provide benefits prior to when the minimum deductible for that year is satisfied. That game changer may now be here."
Paul Fronstin, EBRI [Employee Benefit Research Institute]

DOL Advisory Opinion Addresses ERISA Bona Fide Association and MEWA Status

"[Advisory Opinion 2019-01A addresses] whether the health plan of a hardware retailer's cooperative would qualify as an employee welfare benefit plan maintained by a bona fide group or association of employers, and whether the plan would be a fully insured multiple employer welfare arrangement (MEWA).... [T]he retailer proposed to amend its existing health plan for its corporate employees (and employees of certain wholly owned corporate stores) to add coverage for the cooperative's employer members and their employees."
Thomson Reuters / EBIA

Recent Court Decision Highlights Importance of Clear Anti-Assignment Language in Health Plan Documents

"The court made a point of addressing each of the arguments ... to ensure clear precedent was set for future cases. While this isn't the first court to rule in favor of the health plan on this issue, it is the most complete ruling to date." [Medical Society of the State of New York v. UnitedHealth Group, No. 16-5265 (S.D.N.Y. Mar. 28, 2019)]
Hall Benefits Law

More Workers Eligible for Health Coverage Despite Lack of Growth in Employer Offer Rates

"In 2008, 56.4 percent of private-sector employers offered health benefits. By 2016, it was down to 45.3 percent. It then increased to 46.9 percent in 2017. Yet, the increase in offer rates did not continue in 2018.... Between 2014 and 2018, the percentage of workers eligible for health coverage increased from 75.4 percent to 78 percent."
Employee Benefit Research Institute [EBRI]

Senate Finance Committee Passes Drug Pricing Package

"The main components of the [Prescription Drug Pricing Reduction Act of 2019 are a] $3,100 cap on what Medicare beneficiaries pay out-of-pocket on prescription drugs, set to take place in 2022, and a limit on prescription drug price hikes under Medicare Part D.... [CBO projects] a $31 billion reduction in cost sharing and premiums by unsubsidized Part D enrollees."
HealthLeaders Media

Is Prescription Drug Pricing the Cure for Partisanship?

"By limiting reimbursement and pulling back money as rebates, the Medicare provisions could result in substantial savings to the program. In addition, the [Prescription Drug Pricing Reduction Act of 2019] contains provisions addressing site-of-service reporting and impact on reimbursement."
Sheppard Mullin

A Rising Interest in Outsourcing Benefits Administration (PDF)

"Finance executives continue to view the design of benefits offerings as an important part of their companies' financial and human resource management strategies... [As] companies look for ways to focus more on the strategic value of benefits planning and less on the time-consuming administrative aspects, they are more likely to consider the advantages of outsourcing some parts of benefits administration."
Prudential

Editor's Pick IRS Expands HDHP Coverage to Include Treatment for Certain Chronic Health Conditions

"An employer that wants to expand the range of covered preventive services should keep a few points in mind. [1] Update plan document ... [2] Summary of Benefits and Coverage ... [3] ERISA-directed disclosures ... [4] Plan enrollment implications ... [5] Insurance Carrier/TPA approval ... [6] Medical trend."
HUB International

Understanding the Senate Finance Committee's Drug Pricing Package

"[This post summarizes] key provisions from the package, explaining how it aims to lower prescription drug prices. Next, [it situates] the Committee's package within the broader set of drug pricing reforms being considered by the federal government. Finally, [it explains] the key objections levied by Senators during Thursday's markup and how those objections might affect the development of the package going forward."
Health Affairs

Benefits in General

Family-Friendly Benefits on the Rise

"Check out these 4 benefits offerings that are top of mind for many prospective employees: [1] Fertility preservation ... [2] Parental leaves of absence ... [3] Flexible working arrangements ... [4] Adoption assistance programs."
OneDigital Health and Benefits

Most Popular Items in the Previous Issue

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David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
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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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