Health & Welfare Plans Newsletter

October 21, 2019

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[Guidance Overview]

Individual Coverage HRAs: Proposed Regs Address Employer Mandate and Nondiscrimination

"Although the simplifying assumptions and nondiscrimination relief are helpful, they still creates significant administrative work to determine the cost of coverage for each work location and keeping track of employee movements. An employer could neutralize much of that burden by setting the ICHRA dollar amount high enough so that the most expensive silver-level individual plan remains affordable. Of course, that could result in significant additional ICHRA funding costs."
HUB International

[Guidance Overview]

Section 1557 Update: The ACA Nondiscrimination Rules

"The 2016 Rule is still effective, but the unlawful portions of the rule -- e.g. the prohibition against discrimination on the basis of gender identity and termination of pregnancy -- are now vacated, so HHS cannot enforce those provisions.... There continues to be a private right of action under section 1557, so covered entities could still be sued. Some courts have already found discrimination against transgender individuals violated the section 1557 statute, without relying on the 2016 Rule."
Groom Law Group

[Guidance Overview]

Editor's Pick The New York State Election Leave Law: A Reminder and Some Recommendations

"The law covers employees who are scheduled to work on a qualifying election day, and, based on guidance from the New York State Board of Elections, appears to apply to election day only, and not to early voting periods. It does not appear that employers may compel employees to use available paid leave accruals in conjunction with this leave."
Hodgson Russ LLP

[Guidance Overview]

California Requires Employee Notice Regarding Flexible Spending Accounts

"A new California state law requires an employer to notify its employees who participate in a flexible spending account (including health, dependent care, or adoption assistance flexible spending accounts) of any deadline to withdraw their funds before the end of the plan year. The employer must provide such notice in at least two of the following five forms, only one of which may be electronic: [1] email, [2] telephone, [3] text message, [4] postal mail, or [5] in-person."
Haynes and Boone, LLP

What Michigan's No-Fault Auto Insurance Overhaul Could Mean for Employer Health Plan Costs

"The overhaul of the state's no-fault auto insurance system  -- set to take effect in July 2020 -- will not result in cost spikes next year for the health insurance premiums of many Michiganders, particularly those whose employers already cover car crashes ... But how much the controversial overhaul will raise the cost of health insurance for Michigan employers with self-funded plans, some of which have traditionally not covered auto accidents, remains an open question."
Detroit Free Press

As Court Case Imperils ACA, Some States Prepare Contingency Plans

"Lawmakers in states including Louisiana, Nevada, New Mexico and California have passed bills or are reviewing action aimed at dealing with the fallout if the ACA is overturned.... Plans include giving subsidies to insurers that cover high-cost consumers, possible emergency legislative sessions to address sudden coverage gaps, and regulations that prevent people from being denied coverage even if the law is no longer in effect."
The Wall Street Journal; subscription may be required

It's Still the Prices, Stupid: Why the U.S. Spends So Much on Health Care

"The conclusion that prices are the primary reason why the US spends more on health care than any other country remains valid, despite health policy reforms and health systems restructuring that have occurred in the US and other industrialized countries since the 2003 article's publication. On key measures of health care resources per capita ... the US still provides significantly fewer resources compared to the OECD median country.... Because the differential between what the public and private sectors pay for medical services has grown significantly in the past fifteen years, US policy makers should focus on prices in the private sector."
Health Affairs

Assessing Drug Price Increases in Medicare Part D and the Implications of Inflation Limits

"Among the top 25 drugs by total Medicare Part D spending in 2017, all of which were brand-name drugs, 20 had list price increases between 2016 and 2017 that exceeded the inflation rate, in some cases by several percentage points ... Among the 96 drugs used by more than 1 million Part D enrollees in 2017, roughly one-fifth of these drugs (22 drugs) had list price increases between 2016 and 2017 above the rate of inflation."
Henry J. Kaiser Family Foundation

Editor's Pick Planning for Unexpected Health Care Costs in Retirement (PDF)

11 pages. "[1] Even though the fear of a health care shock is pervasive, very few retirees experience a catastrophic one. [2] The likelihood of experiencing health care shocks increases with age, particularly after age 80. [3] Very few retirees saw a permanent increase in health care costs after having a large health care expense. [4] Because health care expenses tend to increase with age, [the authors] offer guidelines for how much a retiree might need for annual out-of-pocket expenses at different ages."
T. Rowe Price

Spread of ACOs and Value-Based Payment Models in 2019: Gauging the Impact of Pathways to Success

"Looking across all payers, there was a net decrease in ACO contracts over the past year (third quarter of 2018 to third quarter of 2019) -- the first decrease seen to-date. ... The proportion of ACOs taking on any downside risk is generally increasing across all ACO types and sizes, with some important patterns emerging. ... CMS is also planning a rapid expansion of other value-based options beyond ACOs[.]"
Health Affairs

Benefits in General

Remembering a True Public Servant: Alan Lebowitz

Photo of Alan Lebowitz"In September, [EBSA] lost a true pioneer, its greatest individual influence, and dearest friend, Alan D. Lebowitz. Alan was the first Deputy Assistant Secretary of EBSA and its preceding agencies. He spent nearly three decades of his 43-year federal career crafting and shaping the agency's regulatory, compliance assistance, public outreach, education, and enforcement programs. When he retired in 2013, he left his influence on nearly every part of the agency."
U.S. Department of Labor [DOL] Blog

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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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