Health & Welfare Plans Newsletter

September 20, 2019

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Sixth Circuit: Change in Health Plan Premium Payment Method Did Not Trigger a COBRA Qualifying Event

"[T]he courts do not always agree regarding what constitutes a 'loss of coverage' sufficient to be a qualifying event that triggers COBRA compliance obligations. Although an employer's plan documentation cannot foresee and address every fact pattern, this litigation should encourage employers to review their plans' terms governing the interaction of COBRA and leaves of absences - including under the FMLA." [Morehouse v. Steak N Shake, No. 18-4186 (6th Cir. Sep. 13, 2019)]
Thomson Reuters Practical Law

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House Speaker Pelosi Unveils Bill to Lower Prescription Drug Prices

"House Speaker Nancy Pelosi unveiled her plan to lower drug prices by [1] giving the government the ability to negotiate prices for up to 250 of the costliest drugs, including insulin; [2] slapping pharmaceutical companies with penalties if they refuse to negotiate; and [3] seeking Medicare rebates from drug makers if they raise prices beyond inflation."
American Journal of Managed Care

Comparing Federal Legislation on Surprise Billing

"The Alexander-Murray bill [S 1895] was approved by the Senate HELP Committee by a large bipartisan majority on July 8, 2019. Soon after, the Pallone-Walden bill [HR 3630] was approved by of the House Energy and Commerce Committee by voice vote. There may yet be action from the Senate [HELP] Committee and other House committees, ... but for the moment these two bills indicate significant movement on this issue."
The Commonwealth Fund

Employers Expect Health Benefit Costs to Rise 3.9% in 2020

"Early indicators are that cost-shifting to employees will be less of a factor than in recent years, with just 43% of responding employers raising deductibles or otherwise cutting benefits to hold down cost in 2020.... [E]mployers have been adopting tactics that seek to reduce cost via improved health outcomes, such as targeted support for specific health conditions and steering plan members to higher-quality providers."
Mercer

Medical Care Premiums in the United States

"Based on March 2019 civilian worker data from the NCS: [1] The 15 percent of workers participating in a plan without an employee contribution requirement had an average employer paid premium of $595.61 per month. [2] The 85 percent of workers participating in a plan with an employee contribution requirement had a premium cost to employees of $135.12 and $450.54 to the employer. [3] Seventy-one percent of workers have a flat dollar contribution requirement for single coverage premiums and a median contribution amount of $119.23."
U.S. Bureau of Labor Statistics [BLS]

HSAs: Moving from Spending to Saving to Strategizing

"It's possible that employees are delaying care until they can afford it -- a negative consequence of many HDHP plans -- but an alternative explanation could be that consumers are less discerning in their health care spending when they know they have enough saved up to cover the bills. Still another possibility: employees are simply experiencing more health issues as they age."
Voya

Congress Weighs Renewing Tax Credit for Paid Family and Medical Leave

"A Senate bill (S 1628) would continue the credit for three years and improve employers’ ability to claim the credit. A House measure (HR 3301) would merely extend the credit for one more year without any other changes. The tax credit, enacted by Republicans as a two-year pilot program under the Tax Cuts and Jobs Act, is currently set to expire Dec. 31, 2019."
Mercer

Benefits in General

Number of Employers Offering Financial Wellness Programs Doubles in Recent Years

"[M]ore than twice as many companies are offering workplace financial wellness programs to employees today compared to four years ago (53 percent today versus 24 percent in 2015).... 55 percent of employees today rate their own financial wellness as good or excellent, down from 61 percent a year ago.... 45 percent of employees perform caregiving duties for a family member, a number significantly underestimated by employers.... While 88 percent of employers offer some type of caregiving resources, 71 percent of employees are unaware of these offerings[.]"
Merrill Lynch

Press Releases

Most Popular Items in the Previous Issue

CHIP Notice Revised
The Wagner Law Group

Text of CMS Publication: HIOS Portal User Manual (PDF)
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

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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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