Health & Welfare Plans Newsletter

November 19, 2019

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Webcasts, Conferences

Telehealth Trends: Risks, Rewards and Reimbursement
November 14, 2019 WEBCAST
Nixon Peabody LLP

Diversity, Inclusion & Holiday Cheer
December 12, 2019 in NY
Worldwide Employee Benefits Network [WEB] - New York Chapter

What's Up in Washington? - Annual Legal and Regulatory Update
January 29, 2020 in OH
Worldwide Employee Benefits Network [WEB] - Greater Cincinnati Chapter

►See 114 Upcoming Webcasts and Conferences

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[Guidance Overview]

A Primer for Washington Employers on Complying with the Paid Family and Medical Leave Program (PDF)

"[K]ey dates that employers should be aware of include ... [1] July 1-August 31, 2019: Employers had to begin reporting and remitting premiums for Quarters 1 and 2. [2] December 31, 2019: Washington's current Family Leave Act will sunset. [3] January 1, 2020: Employees are eligible to take leave."

Epstein Becker Green, via Employee Benefit Plan Review

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[Guidance Overview]

Nevada Labor Commissioner Issues Advisory Opinions Regarding Paid Personal Leave Law

"While the law applies to employers with 50 or more employees in Nevada, it is silent on how the 50-employee threshold should be calculated. In its guidance, the Labor Commissioner addressed this by applying standards from the FMLA The Labor Commissioner determined that based on the plain and unambiguous language of the so-called existing policies exemption, 'employers already providing leave that matches or exceeds' the minimally required leave amount are 'explicitly exempt from the other requirements' of the law."

Proskauer

[Guidance Overview]

Editor's Pick HHS Proposals Would Impose Extensive Cost-Sharing Disclosures on Health Plans and Insurers

"[G]roup health plans and health insurers would be required to provide participants, beneficiaries, or enrollees (or their authorized representatives), upon request, cost-sharing information for a covered item or service from a particular provider or providers. These disclosures would be made using a self-service tool made available by the plan or insurer on an internet website. The required disclosures would: [1] Include estimates of participants' cost-sharing liability for covered items or services furnished by specific health providers. [2] Need to be available in paper form in some cases."

Thomson Reuters Practical Law

What Employers Need to Know About Oregon's Paid Family-Leave Law

"The only requirement for an employee to be eligible for paid leave is that the employee must have earned at least $1,000 in wages during the previous year. Such broad coverage means that essentially all employers will have some compliance obligations under the new law."

Oregon Business

House Energy and Commerce Leaders Want Answers from Ascension and Google on Health Data Sharing Arrangement

"Energy and Commerce Committee leaders wrote to the CEOs of Ascension and Google ... following reports that the health information of tens of millions of Ascension's patients has been shared with Google as part of an initiative called 'Project Nightingale.' ... [L]ongstanding questions related to Google's commitment to protecting the privacy of its own users' data raise serious concerns about whether Google can be a good steward of patients' personal health information.... Concerns have also been justifiably raised about Ascension's decision not to notify its patients that their information would be shared with Google or how their information would be used."

Energy & Commerce Committee, U.S. House of Representatives

Bariatric Surgery: The Dollars and Sense of Health Plan Coverage

"Should bariatric surgery be covered under our benefits plan? ... Who should be covered under this benefit? Are there reasonable patient qualifications? ... Should coverage be limited to certain providers? ... What if my employee doesn't live near a Bariatric Surgery Center of Excellence? ... What role can a workplace health center play in supportive local care? ... What's in it for the employer? Is there a positive ROI for covering bariatric surgery?"

Healthstat

Editor's Pick Examining Medicare for All, Comparing International Health Care Models

"[A]cross these eight countries, the ability of citizens to obtain expensive medical procedures tends to increase in proportion to their ability to purchase insurance for medical care beyond what public entitlements cover. Single-payer systems, which restrict the ability of individuals to purchase private insurance, deliver consistently worse access to specialty care or surgical procedures -- without reducing individuals' overall out-of-pocket health-care costs."

Manhattan Institute

Benefits in General

[Official Guidance]

Agencies Release Advance Copies of Form 5500 Annual Return/Report for 2019

"[EBSA, IRS and PBGC have] released advance informational copies of the 2019 Form 5500 Annual Return/Report and related instructions.... The advance copies of the 2019 Form 5500 are for informational purposes only and cannot be used to file a 2019 Form 5500 Annual Return/Report."

Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]; Internal Revenue Service [IRS]; and Pension Benefit Guaranty Corporation [PBGC]

Best Practices in Administering Benefit Claims: Distinguishing an Inquiry from a Claim

"Careful consideration should be given to whether a participant's (or beneficiary's) communication triggers the plan's claims process. ... [D]oes the plan require claims to be in writing, or are telephonic claims accepted? Has the participant or beneficiary submitted all required documentation with the claim? Should an inquiry, although not technically a claim, be processed through the plan's claims procedures? When is it appropriate to do so?"

Proskauer

Press Releases

IRI Announces New Board Members
Insured Retirement Institute [IRI]

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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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