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Pension Plan Administrator
American Pension Advisors, Ltd.
in Indianapolis IN

Compliance Administrator III
Associated Pension Consultants
in Chico CA / Telecommute

Client Service Manager
July Business Services
in Waco TX / Telecommute

Retirement Plan Administrator
CMC Interactive, LLC
in New York NY

Retirement Plans Sales & Relationship Development
Qualified Pension Consultants, Inc.
in Independence OH

Human Resources Specialist 4 (Health and Welfare Strategist)
Pennsylvania State University
in University Park PA

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Webcasts, Conferences

Benefits Conference
October 16, 2019 in OH

Employer Program at 2019 HLTH
October 27, 2019 in NV

2019 Top 10 HSA Issues
November 7, 2019 WEBCAST

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►See 1541 Recorded Webcasts


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[Guidance Overview]

October 14 Deadline Nearing for Medicare Part D Creditable/Non-Creditable Coverage Notices

"Plan sponsors that offer prescription drug coverage must provide notices of creditable or non-creditable coverage to Medicare-eligible individuals before each year's Medicare Part D annual enrollment period -- this year, by October 14. The notice obligation is not limited to retirees and their dependents but also includes Medicare-eligible active employees and their dependents and Medicare-eligible COBRA participants and their dependents."


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[Guidance Overview]

Applying the California Consumer Privacy Act to Health Care: The HIPAA Exemption, Exercise Apps, and Marketing Data

"On its face, the text of [California] section 1798.145(c)(1)(B) appears to exempt not only certain kinds of information regulated by HIPAA, but also a certain kind of organization, namely, a 'covered entity' who maintains patient information in a certain way ... In other words, the CCPA exempts an organization that 'maintains patient information in the same manner' as PHI under HIPAA. The consequence of this reading is that a health care provider might be exempt as a whole; all of its non-health care information might qualify for the CCPA's HIPAA exemption so long as the health care provider protects 'patient information' in the right way."

Carlton Fields

Employer Requirements for Medicare Part D Creditable Coverage

"How do I determine whether my coverage is creditable?  ... Is there a simplified way to determine creditable coverage status? ... To whom must I provide a creditable coverage notice? ... Can you provide a sample of what I’m supposed to send to employees? ... Is this the only time of year I must provide a creditable coverage notice? ... Do I have any other prescription drug creditable coverage reporting obligations?"

OneDigital Health and Benefits

Editor's Pick Final MHPAEA FAQs Include Claims Form for Requesting Plan Documents

"Along with the FAQs, the DOL also issued: [1] An updated claims form for use by participants and beneficiaries in requesting documentation from a health plan or insurer concerning treatment limits under the MHPAEA. A fact sheet, and related introduction and compendium, which collectively address recent DOL enforcement efforts under the MHPAEA."

Thomson Reuters Practical Law

Keys to Successful Employee Health and Wellness Programs

"Dedicated leadership, adequate resources and promotion of flexible work arrangements are key to the success of health and wellness programs for federal workers.... Agencies were evaluated in 16 areas ranging from their nutrition and weight management programs to stress management and vaccinations offered."

Government Executive

Wearables Can Boost (and Sustain) Activity Levels

"While participants in all three groups had higher activity levels than the control group, those in the competition arm saw the largest and most sustained improvements in activity. Participants in this group had 1,166 more steps per day than people in the control group, and 609 more steps per day three months after the study concluded. The findings from [this] study ... demonstrate -- scientifically -- that engagement programs, if designed correctly, can move people toward healthy behaviors."


Workplace Wellness Programs: Put Your Money Where Your Mouth Is

"There are many digital health solutions and niche solutions in the market to address mental wellbeing, stress management and financial fitness; but ultimately, there has to be strong leadership support, mid-level manager support and strategic communications in place to create a foundation for a strong program. A compelling incentive is also paramount to create engagement and participation."

Frenkel Benefits

Parking Expense and Food Cost Relief Could Be on the Way

"The IRS is considering methods for simplifying the parking calculation, including: [1] Institute a safe harbor for leased parking expenses  ... [2] Allow taxpayers to use average parking costs by region ... [3] Reverse the guidance that says value cannot inform expense."


Editor's Pick Surprise Medical Bills: An Overview of the Problem and Approaches to Address It (PDF)

11 pages. "Potential approaches for paying providers include setting a payment benchmark and arbitration. If a payment benchmark is set below the average in-network rate, it could lead to lower provider payments and premiums and could increase the incentives for out-of-network providers to join a network. Arbitration could put downward pressure on provider rates, but it is administratively burdensome and could result in even higher provider rates if providers increase charges to put themselves in a better bargaining position."

American Academy of Actuaries

Guide to State Individual Mandates

"To date, California, the District of Columbia, Massachusetts, New Jersey, Rhode Island, and Vermont have passed state individual mandates.... Essentially, even if you have one employee filing taxes in one of these states, your company must comply with that state’s individual mandate. This means companies will not only have to be ACA complaint at the federal level, but also at the individual state levels."

Tango Health

Options for Reinvesting Savings from Restored Federal Cost-Sharing Reduction Payments: Potential Effects of Two Policy Alternatives on Spending and Enrollment in the Individual Health Insurance Market

"Earlier research established that the federal government would likely save money if federal CSR payments to insurers were restored, but total health insurance enrollment -- and, in particular, enrollment on the individual market -- would decrease. The authors of this report analyze what would happen if federal lawmakers used the savings from restoring CSR payments to provide additional health insurance subsidies or to finance reinsurance. Additionally, they examine how these scenarios would affect premiums and out-of-pocket premium spending both in California and at the national level."

RAND Corporation

Income, Poverty and Health Insurance Coverage in the U.S. in 2018

"The U.S. Census Bureau announced today the median household income was not statistically different from the 2017 median, and the official poverty rate decreased 0.5 percentage points from 2017. At the same time, the rate and number of people without health insurance increased from 7.9%, or 25.6 million, in 2017 to 8.5%, or 27.5 million, in 2018."

U.S. Census Bureau

Views of ACA Consumers on the Future of Coverage (PDF)

10 presentation slides. "Two-thirds of people receiving federal subsidies say they would go uninsured without the ACA ... The unsubsidized are more likely to say costs should be reduced ... Coverage for pre-existing conditions tops list of benefits valued by ACA consumers ... Younger consumers are more likely to support expansion of Medicare-like coverage ... The future of health care may play a big role in 2020 elections."


Telemedicine Company Owner Pleads Guilty to $424M Medicare Fraud Scheme

"Federal prosecutors described the scheme ... as one of the largest healthcare fraud schemes ever investigated. [The defendant] was the owner of Video Doctor USA and Telemed Health Group LLC, and was the CEO of AffordADoc. He pleaded guilty to two related counts of accepting kickbacks and money laundering, and will be sentenced in December."

HealthLeaders Media


ERIC Comments on DC Universal Paid Leave Program Benefits Regulations

"It is critical that UPL benefits run concurrently, and are not allowed to stack, with similar benefits available under the federal [FMLA], D.C. FMLA, or other paid leave benefits.... [It] is critical that employees are able to determine the benefit amount that an employee is receiving through UPL.... [The regulations do] not adequately put a limit on what qualifies as retaliation and does not provide a process or standard by which employers may disprove the claim of retaliation."

The ERISA Industry Committee [ERIC]

Benefits in General


American Academy of Actuaries Comment Letter to Actuarial Standards Board on Second Exposure Drafts of ASOP Nos. 27 and 35 (PDF)

"We believe much good work has been done to improve the clarity of the proposed [Actuarial Standard of Practice No. 27, Selection of Economic Assumptions for Measuring Pension Obligations, and Actuarial Standard of Practice No. 35, Selection of Demographic and Other Noneconomic Assumptions for Measuring Pension Obligations]. Nevertheless, we have some comments on the current exposure drafts."

American Academy of Actuaries

Press Releases

OneDigital Partners With Worldwide Broker Network
OneDigital Health and Benefits

NTSA Establishes Elite Advisor Council
National Tax-Deferred Savings Association [NTSA]

Most Popular Items in the Previous Issue

Renewal Considerations for 2020
Watko Benefit Group, Inc.
1298 Minnesota Avenue, Suite H
Winter Park, Florida 32789
(407) 644-4146

Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager

BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2019, 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, 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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