Health & Welfare Plans Newsletter

October 8, 2019

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[Guidance Overview]

IRS Explains Application of Employer Mandate to Individual Coverage HRAs

"The IRS has now proposed rules explaining precisely how an employer can satisfy the ACA employer mandate and avoid penalties simply by offering an individual coverage HRA (ICHRA). Warning: The proposed rules are not for the faint of heart."
Lockton

[Advert.]

2020 Onsite Employee Health Clinics Forum (January 23-24; Phoenix, AZ)

Sponsored by World Conference Forum

The leading forum on building & expanding on-site health clinics -- incorporating strategies that reduce costs, ensure employee satisfaction and positively impact patient behavior.


Accidental Death Benefit: Death by Speeding Vehicle Excluded Under 'Crime' Exclusion

"Unum, the administrator, granted the life insurance benefit but denied the accidental death benefit because of an exclusion for 'accidental losses caused by, contributed by, or resulting from ... an attempt to commit or commission of a crime.' Speeding is a misdemeanor under Wyoming law.... [The court found that] Unum's interpretation, that speeding was a 'crime', was reasonable." [Caldwell v. Unum Life Ins. Co. of America, No. 17-8078 (10th Cir. Sep. 18, 2019)]
Lane Powell PC

Editor's Pick Variation in U.S. Private Health Plans' Coverage of Orphan Drugs

"Health plans restrict access to orphan drugs approximately one-third of the time, and restrictions vary considerably across plans. Plans more often add restrictions for orphan drugs that are indicated for diseases with a higher prevalence and that have higher annual costs."
American Journal of Managed Care

Editor's Pick Coordinating HSA Contributions with the Commencement of Social Security Benefits

"[T]he Medicare-eligible employee who receives Social Security benefits while participating in the HSA plan has unwittingly become covered by Medicare A ... and now is ineligible for the HSA income tax deduction, starting with the retroactive commencement of the Medicare A coverage. Participating in the HSA plan prior to the commencement of Medicare A coverage is permitted, but the income tax deduction is prorated for the year in which participation began and excludes the part of the year when Medicare A coverage is effective."
Quarles & Brady LLP

Make an Impact with Branded Wellness

"When employees receive a branded wellness email or see a branded wellness poster in the office, their reaction should be to automatically think wellness and hopefully be reminded to check in with their health and wellbeing.... Establishing a brand will provide easy recognition to all wellness communications, make the program more official, and add tremendous value to your company culture."
Frenkel Benefits

How Does Common-Law Marriage Affect FMLA Leave?

"[An] employee who formed a common-law marriage prior to a state's abolition of such unions would still be considered married and would be eligible to take spousal leave under the FMLA. With respect to health care and other benefit plans, the plan determines who is an eligible spouse ... Most plans state that a spouse is defined by state law, and they do not make exceptions for common-law spouses."
Society for Human Resource Management [SHRM]; membership may be required to view article

Benefits in General

[Official Guidance]

IRS Extends Oct. 15 Deadline for Victims of Tropical Storm Imelda

"Victims of Tropical Storm Imelda in parts of Texas, including the Houston area, have until Jan. 31, 2020, to file various individual and business tax returns and make tax payments ... The IRS is offering this relief to ... Chambers, Harris, Jefferson, Liberty, Montgomery and Orange counties in Texas, but taxpayers in localities added later to the disaster area will automatically receive the same filing and payment relief."
Internal Revenue Service [IRS]

Court Penalizes Employer $41,140 for Failure to Timely Provide Plan Documents

"The documents were not provided until 748 days after the ERISA-required 30-day period to provide documents had expired, and then only in response to a lawsuit claiming an ERISA fiduciary breach for misappropriating employee contributions. The federal district court assessed a penalty of $55 per day ... a penalty determined by the court to reflect 'both the egregiousness of the [plan administrator's] misconduct as well as the extraordinary length of delay.' " [Kinsinger v. SmartCore, LLC, No. 17-643 (W.D.N.C. Aug. 27, 2019)]
Haynes and Boone, LLP

Press Releases

Plan Retention, Cybersecurity, Fee Compression Top Advisor Concerns
National Association of Plan Advisors [NAPA]

Most Popular Items in the Previous Issue

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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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