Regulatory Advisory Services Consultant
MassMutual
in Enfield CT

Associate Attorney - Tax
Carlsmith Ball LLP
in Honolulu HI

Employee Benefits Law Specialist, Office of Health Plan Standards and Compliance Assistance
Employee Benefits Security Administration, U.S. Department of Labor
in Washington DC / Telecommute

Benefit Calculation Analyst
Stanley Benefit Services, Inc.
in Greensboro NC

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Ohio Health Insurer In-House and General Counsel Seminar
September 18, 2019 in OH
Squire Patton Boggs

Health Plan Update
September 19, 2019 WEBCAST
Thompson Hine LLP

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[Guidance Overview]

New Jersey Updates Reporting Details for Its Individual Mandate; California Enacts Its Own Individual Mandate

"[T]he State of New Jersey enacted its own Individual Mandate beginning in 2019 to try to guard against adverse selection in the State’s Exchange. New Jersey’s Individual Mandate created more reporting obligations for employers who have employees who are New Jersey residents.... [T]he State of California created its own Individual Mandate beginning in 2020. The California Individual Mandate will create additional employer reporting responsibilities beginning in 2021."

Accord

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[Guidance Overview]

New Jersey to Require Certain Employers to Provide Pretax Transportation Fringe Benefits

"Every employer with at least 20 employees must offer all employees the opportunity to utilize a pretax transportation fringe benefit.... The law will take effect on March 1, 2020, or once the regulations are adopted, whichever comes first."

Ogletree Deakins

[Guidance Overview]

New Law Provides Puerto Rico Employees with Unpaid Leave to Deal with Situations of Domestic Violence and Abuse

"This special leave may only be used to tend to specific matters outlined in the Act, such as obtaining a restraining order, securing safe housing and seeking medical treatment. The employee must notify the employer of his or her intention to seek this special leave with at least a two-day notice, except in situations where there is imminent danger."

McConnell Valdes

Why Medicare's Expanded Telehealth Reimbursement Matters

"Not only does telehealth offer a bridge to treatment, especially for older patients with physical disabilities or who lack transportation, it can also help an organization’s bottom line. A 2019 telemedicine study ... found net cost savings range between $19 and $121 per visit."

HealthTech

California Expands Definition of Domestic Partner

"Fully insured plans ... in California will now be required to offer coverage to both same and opposite sex couples who meet the new requirements. Many employers currently only recognize opposite sex domestic partners when one of the partners is at least age 62, as long as they meet the other requirements under California law. ... [T]his amendment could have a significant impact to both employers and employees alike."

Burnham Benefits

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Figuring Out the 'Best' Healthcare Option for Early Retirees

"[If] employer-based healthcare is so critical to so many individuals’ personal and financial well-being, what happens when their coverage is no longer available after retiring from that employer? Certainly, if coverage is available via a spouse, pursuing that path often becomes a logical choice. But for some retirees, whether by choice or by misfortune, employer-provided healthcare is terminated, no spousal coverage is available, and other options must be explored."

Nerd's Eye View

[Opinion]

Health Insurance Companies Are Useless, So Let's Get Rid of Them

"The most perplexing aspect of our current debate over healthcare and health coverage is the notion that Americans love their health insurance companies.... The truth is that private health insurers have contributed nothing of value to the American healthcare system. Instead, they have raised costs and created an entitled class of administrators and executives who are fighting for their livelihoods, using customers’ premium dollars to do so."

Los Angeles Times; subscription may be required

High-Tech vs. High-Touch: The Best Ways to Help with Enrollment Decisions

"To extend both the communication moment of impact and employee reach, employers are offering a combination of the tried and true communication (newsletters, flyers and face-to-face meetings) and the integration of emerging tech-enabled and on-demand solutions such as portals, comparison tools, social media, text messaging and mobile apps. These can all help educate employees and prepare them to make benefit decisions in the ways that work best for them. The challenge is striking the right balance for your organization."

Voya

Plan Service Provider Contracts: To Provide or Not to Provide to Plan Participants

"Several courts don’t require disclosure of service provider contracts because they simply don’t govern the relationship between the plan participant and the provider.... Other courts have avoided determining as a matter of law that a service provider’s contract is not subject to disclosure because the terms of the contract could affect the plan participant’s rights. ... The tension in these decisions leads to one conclusion -- you probably should read the service provider contract before determining whether disclosure is required."

Thompson Hine, via Lexology; free registration required

Most Popular Items in the Previous Issue

Unbelievable: ERISA's Broken Promise
Peter J. Wiedenbeck, Washington University in St. Louis - School of Law, via SSRN

Annually Required CHIP Notice, 2019 Edition
Kushner & Company

ACA Litigation Round-Up: AHPs, Short-Term Plans, CSRs, and Risk Adjustment
Katie Keith, in Health Affairs