Health & Welfare Plans Newsletter

September 26, 2019

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Job Openings

DC Plan Administrator

Northeast Professional Planning Group, Inc.
Red Bank NJ / NY

Assistant General Counsel, Retirement Services

NRECA
Arlington VA / DC

Retirement Services Specialist

State of Minnesota / Minnesota State Retirement System
Saint Paul MN

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Webcasts, Conferences

Benefits Emerging Leaders Working Group
October 10, 2019 in IL
McDermott Will & Emery LLP

Generations in the Workforce: Creating a Welcoming Workplace for All Ages
October 17, 2019 in GA
Worldwide Employee Benefits Network [WEB] - Atlanta Chapter

Annual Members Social
December 4, 2019 in PA
ASPPA Benefits Council [ABC] of Greater Philadelphia

►See 105 Upcoming Webcasts and Conferences

►See 1555 Recorded Webcasts


Discussions

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October 15 Deadline for Medicare Part D Notice of Creditable Coverage

"Paper delivery by hand or first-class mail is one option. Alternatively, CMS states that electronic delivery is permitted to 'plan participants who have the ability to access electronic documents at their regular place of work if they have access to the plan sponsor's electronic information system on a daily basis as part of their work duties.' This electronic distribution standard for the Notice is nearly identical to the ERISA electronic disclosure safe harbor."
ABD Insurance & Financial Services

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Editor's Pick 2019 Employer Health Benefits Survey

"Annual premiums for employer sponsored family health coverage reached $20,576 this year, up 5% from last year, with workers on average paying $6,015 toward the cost of their coverage. The average deductible among covered workers in a plan with a general annual deductible is $1,655 for single coverage. Fifty-six percent of small firms and 99% of large firms offer health benefits to at least some of their workers, for an overall offer rate of 57%."
Henry J. Kaiser Family Foundation

As Health Care Costs Rise, Workers at Low-Wage Firms May Pay a Larger Share

"Health insurance premiums and deductibles for job-based coverage edged upward in 2019, surpassing increases in both wages and inflation ... But the results were uneven, and many workers least able to afford it were confronted with higher-than-average costs. People at companies with large numbers of lower-wage employees faced bigger deductibles for single coverage and were asked to pony up a larger share of their incomes to pay premiums than those at firms with fewer people with low earnings[.]"
Kaiser Health News

Employer Strategies to Reduce Health Costs and Improve Quality Through Network Configuration

"While networks can mitigate cost growth, there are considerable challenges to developing and promoting these strategies, including concerns that tighter networks may limit enrollee choice and potentially expose employees to out-of-network charges. This analysis includes an overview of strategies employers are implementing and offers a deeper understanding of the successes, barriers, and trade-offs firms have experienced in their network decision-making."
The Peterson-Kaiser Health System Tracker

Bipartisan Push to Repeal ACA's Cadillac Tax Despite Objection of Experts

"Despite its bipartisan appeal, there is still opposition to the repeal of the Cadillac Tax. A letter to the Senate on July 29 from economists and other health experts argued that the tax 'will help curtail the growth of private health insurance premiums by encouraging employers to limit the costs of plans to the tax-free amount.' The letter also pointed out that repealing the tax 'would add directly to the federal budget deficit, an estimated $197 billion over the next decade, according to the Joint Committee on Taxation.' "
Sheppard Mullin

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Success in Value-Based Payment

"ACOs should proceed with caution as they enter models with accountability for financial risk such as the newly finalized CMS Pathways to Success program and certain private payer commercial models. In order to be successful in any model, it is critical that ACOs have an adequate foundation in place and a provider network built to provide coordinated care."
Berry, Dunn, McNeil & Parker, LLC

CMS Administrator to Insurers: The Public Is 'Frustrated with You'

"Public and provider frustration could soon result in elimination of private health plans, says CMS Administrator Seema Verma. Private health plans need to increase their level of innovation and shift to value. Keys to value partnerships include giving providers data, insights and timely feedback."
Healthcare Financial Management Association [HFMA]

In California, a 'Surprise Billing' Law Is Protecting Patients and Angering Doctors

"Three years ago, California passed one of the strongest laws in the country to outlaw surprise medical billing. That legislation made sure that when patients went to a hospital covered by their insurance, doctors couldn’t later ambush them with unexpected bills. Now lawmakers who want to ban surprise bills nationally are gravitating toward a California-style approach, making the California experience a key exhibit in the debate."
The New York Times; subscription may be required

Selected Discussions
on the BenefitsLink Message Boards

105(h) Testing for a HRA

It isn't entirely clear to me as to who can be excluded when performing the eligibility test. Treas. Reg. 1.105-11(c)(2)(iii) lists certain categories of employees who may be excluded. But if some of these people already are eligible to participate, it doesn't make sense to exclude them. For example, one can exclude employees with less than 3 years of service. Suppose the plan already allows everyone with 1 year of service to participate. I'd include anyone already eligible to participate, in the testing. Anyone else have a different opinion?
BenefitsLink Message Boards

Most Popular Items in the Previous Issue

Open Enrollment Trends for 2020
National Business Group on Health [NBGH]

Trump Administration Drives Down Medicare Advantage and Part D Premiums for Seniors
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

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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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