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Health & Welfare Plans Newsletter November 22, 2019 |
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Webcasts, Conferences Paid Family and Medical Leave: What Employers in New Jersey Need to Know
Paid Family and Medical Leave: What Employers in New York Need to Know
Resolving ERISA Liens
Healthcare Coverage and Costs: Assessing Medicare-Based Approaches
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Discussions |
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This Newsletter:
BenefitsLink Retirement Plans Newsletter:
Message Boards Digest:
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Employers Are Affected by Latest Healthcare Transparency Rules "For the self-insured employer, supporting and rolling out this level of transparency will be costly, with investments in new technology and communication plans to effectively launch the initiative with employees ... [T]he employer cost savings will be greatest prior to employees meeting their deductible or out of pocket spending. Once those milestones are reached, there is little incentive for employees to continue researching and shopping for care." Tango Health |
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Group Benefits Testing Overview: There's Still Time for 2019 "If the test is done during the year and the failure is caught early enough, an employer can quickly make changes; communicate those changes to affected highly compensated employees and owners ... If the test is done retrospectively, you may need to re-characterize the 'discriminatory benefits' as taxable benefits or the plan risks losing its tax-favored status, and all plan participants lose the income tax exclusion." Findley |
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How Common Is Out-of-Network Billing? "In 2017, nationally: 16.5% of visits with emergency room services had an out-of-network claim from an emergency medicine specialist. 12.9% of visits with lab/pathology services had an out-of-network claim from a pathologist. 8.3% of visits with anesthesiology services had an out-of-network claim from an anesthesiologist.... Variation across states differs by type of service. Pathology and emergency services had the largest variation. Cardiovascular and surgery services had the the smallest variation." Health Care Cost Institute |
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Signs Your Health Plan's Administrative Platform is Becoming Obsolete "Plans that opt to patch together several point solutions -- for claims processing, risk adjustment, medical management and more -- take on the challenge of keeping all the pieces working in unison to support efficient plan operations and top-quality member care.... [H]ow do you know whether your platform is suited to support today's challenges, whether it's on the road to becoming obsolete or -- even worse -- already there? " Evolent Health |
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Case Studies of Employer Healthcare Cost Control "Employers across the country have increased their premiums to a point where finding a difference between a traditional PPO and a high deductible health plan (HDHP) is getting more and more difficult. So how do you manage those costs while still offering plans your employees will love?" Benefitfocus |
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DOL Speeds Up Plans to Seek Comments on Improving the FMLA "Earlier this year, the DOL estimated it would request information on this topic in April 2020. But in this fall's regulatory agenda ... the DOL said it may seek comments on improving the FMLA as soon as this month." Society for Human Resource Management [SHRM]; membership may be required to view article |
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Comparison of CBO-Scored Surprise Billing Legislation "In 2019, the Congressional Budget Office has released scores on four separate policy proposals related to surprise billing. An 'unofficial' score on a fifth proposal was leaked to press in September. This factsheet describes each of the proposals and its CBO score. The takeaway is that proposals that rely more heavily on arbitration to determine out-of-network provider payments save less, and relying on arbitration based on providers' billed charges actually increases costs for the government and consumers alike." Families USA |
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[Opinion] Some Reminders on How HIPAA Works "[W]hat we have today is a set of privacy and security rules that work really well where they apply -- but that don't apply at all in an increasing range of situations where health information is collected, created and analyzed, including wearables, mobile applications, community and patient support groups, personal health records and a broad array of 'consumer directed' health care activities." Wilmer Hale |
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Benefits in General |
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[Official Guidance] Draft of IRS Publication 15-A: Employer's Supplemental Tax Guide, for Use in 2020 (PDF) 28 pages. Topics include: [1] Who are employees? [2] Employee or independent contractor? [3] Employees of exempt organizations. [4] Religious exemptions and special rules for ministers. [5] Wages and other compensation. [6] Sick pay reporting. [7] Pensions and annuities. Internal Revenue Service [IRS] |
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[Official Guidance] DOL Regulatory Agenda, Fall 2019 Prerule Stage (EBSA): "Open MEPs" and Other Issues Under Section 3(5) of ERISA. Proposed Rules (EBSA):
Final Rules (EBSA): Adoption of Amended and Restated Voluntary Fiduciary Correction Program. Prerule Stage (WHD): Request for Information: The Family and Medical Leave Act of 1993. U.S. Department of Labor [DOL] |
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[Official Guidance] IRS Regulatory Agenda, Fall 2019 Proposed Rules:
Final Rules:
Internal Revenue Service [IRS] |
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461 pages. "In 2017, 173.0 million workers had earnings taxable under the Social Security program.... Social Security taxable earnings totaled $6.998 trillion ... In 2017, 177.0 million workers had earnings taxable under the Medicare program.... Medicare taxable earnings totaled $8.654 trillion. Medicare taxes totaled about $251 billion." U.S. Social Security Administration [SSA] |
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Are You Periodically Benchmarking Your Group Benefits Plan? "For those employers looking to target a more specific comparison, consider using e-surveys of key employers within your region or industry. This gets very specific and takes a bit longer. To garner cooperation/participation, your company would need to play a key role in reaching out to those targeted employers to encourage their participation, and in exchange, they would receive the results on a de-identified basis." Findley |
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Press Releases |
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OneDigital Acquires Ohio Benefits & Insurance Group
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Most Popular Items in the Previous Issue |
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