Health & Welfare Plans Newsletter

August 26, 2019

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Jobs

Distribution Assistant Team Leader
Nova 401(k) Associates
in Scottsdale AZ

Experienced 401(k) Distribution Specialist
Nova 401(k) Associates
in Scottsdale AZ

Senior Pension Consultant
The Ryding Company
in Westlake Village CA / Telecommute

Participant Services Specialist
BlueStar Retirement Services, INC
in Ponte Vedra Beach FL

Senior Plan Operations Specialist
BlueStar Retirement Services, INC
in Ponte Vedra Beach FL

Special Projects Account Manager
Nova 401(k) Associates
in Houston TX / Telecommute

RVP - Retirement Plans Wholesaler
Nationwide
in Sacramento CA

Client Relationship Manager
Loren D. Stark Company
in Houston TX

Pension Administrator
KB Pension Services
in Bradenton FL

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[Guidance Overview]

Massachusetts Department of Family and Medical Leave Releases Updated Proposed Regs (PDF)

"Covered employers and business entities have to provide their current workforce with written notice of their rights and obligations by September 30, 2019 ... [C]overed employers and business entities should start making deductions from workers' wages toward the PFML program beginning October 1, 2019. The PFML posting requirement became effective on July 1. Finally, first quarter contributions to the Trust Fund, along with a report, which is a newly added requirement, will be due on January 31, 2020."

Epstein Becker Green

[Advert.]

Join Us This January in Clearwater Beach, Florida

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

The 29th Annual Health Benefits Conference & Expo (HBCE) is taking place January 20-22, 2020. Don't miss the opportunity to learn how to raise employee engagement without raising costs. Register by August 31 to save!


Health Plans: What to Expect Next Year (and Beyond)

"Prescription drug coverage reporting required.... PCORI Fee goes away for all plans.... High deductible health plan and health savings account (HSA) limits will increase... ACA cost sharing changes.... ACA employer mandate affordability will be 9.78%.... Relief for high deductible health plans covering male sterilization as preventive care ends.... Self-funded plans have some work to do on determining essential health benefits.... Changes in preventive services.... State individual mandates and employer reporting."

HUB International

Administration Again Attempts to Lower Drug Prices

"The full impact of the proposed plan on all stakeholders has not been fully evaluated.... For PBMs, would the existence of pathways #1 and #2 alter how the PBMs negotiate formulary drugs with pharmaceutical manufacturers? Could the PBMs' push for manufacturers to use pathway #2 at some time in the future point to remaining on formulary drugs? Would importing drugs create shortages in foreign countries, potentially impacting U.S. diplomacy with them?"

Wilson Sonsini Goodrich & Rosati

The New Hospital Price Disclosure Rule Is Important, But Only a First Step

"[As] the administration acknowledges, this regulation by itself will not fully address the opacity of today's market. Further disruptive changes will be necessary to give consumers usable pricing information. Among other things, meaningful transparency requires even stricter standardization of the services being priced and 'all in' pricing that matches how consumers think about the services they need."

Health Affairs

Influence of Out-of-Network Payment Standards on Insurer-Provider Bargaining: California's Experience

"[S]takeholders report that an [out-of-network (OON)] payment standard set at payer-specific local average commercial negotiated rates has changed the negotiation dynamics between hospital-based physicians and payers.... [L]everage has shifted in favor of payers, and payers have an incentive to lower or cancel contracts with rates higher than their average as a means of suppressing OON prices. Physicians reported that this experience of decreased leverage is exacerbating provider consolidation."

RAND Corporation

Things You Might Not Know About Health Savings Accounts

"[1] You could get two tax benefits.... [2] There are limits on who's eligible and how much you can contribute.... [3] You can use your HSA to save for retirement.... [4] You may be able to invest your HSA funds."

Motley Fool

Health Insurers Set to Expand Offerings Under the ACA

"[C]ompanies that are currently in the ACA marketplaces said they want to expand, despite lingering risks ... Many ACA plans keep costs down with smaller selections of health-care providers, with some insurers, including Bright and Oscar, often building plans around a single major hospital system. Both Bright and Oscar said they are seeing increased interest from health-care providers in offering such plans."

The Wall Street Journal; subscription may be required

Why Trendy Employee Benefit Options May Have Unintended Negative Consequences

"Employees vary in terms of their interests and personal preferences, and those differences need to be respected. Being alert to the potential for peer pressure and ensuring that offerings are truly voluntary is critical, especially if non-traditional benefits are being offered."

Xpert HR

[Opinion]

DOJ's Proposed Remedy in Texas v. United States Is an Unrealistic Solution

"DOJ argues that the court should invalidate the ACA only in the states that brought suit.... This proposed remedy is illogical on many levels ... [T]his approach completely upends the intent of ERISA, as employers would need to have different health benefit plans depending on where their employees, retirees, and dependents live."

Georgetown University Health Policy Institute

Press Releases

Most Popular Items in the Previous Issue

Life Expectancy in 2019 (PDF)
Society of Actuaries

Employer Makes $1.3 Million FMLA Mistake by Firing Worker After Mexico Trip
Society for Human Resource Management [SHRM]; membership may be required to view article

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Lois Baker, J.D., President  loisbaker@benefitslink.com
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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