Health & Welfare Plans Newsletter

December 2, 2019

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Webcasts, Conferences

New HRA Regs and What They Really Mean
January 8, 2020 WEBCAST
Conference of Consulting Actuaries

Litigation and Legal Challenges in the World of Benefits Webinar
January 22, 2020 WEBCAST
Conference of Consulting Actuaries

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[Official Guidance]

Text of IRS Notice 2019-63: Transition Relief Related to Health Coverage Reporting Required by Sections 6055 and 6056 for 2019 (PDF)

10 pages. "This notice extends the due date for certain 2019 information-reporting requirements under sections 6055 and 6056 of the Internal Revenue Code from January 31, 2020, to March 2, 2020. This notice also provides relief from section 6721 and 6722 penalties for certain aspects of the 2019 information-reporting requirements under sections 6055 and 6056....

"This notice does not extend the due date for filing with the Service the 2019 Forms 1094-B, 1095-B, 1094-C, or 1095-C....

"[T]he Service will not assess a penalty under section 6722 against reporting entities for failing to furnish a Form 1095-B to responsible individuals in cases where the following two conditions are met ... [1] the reporting entity posts a notice prominently on its website stating that responsible individuals may receive a copy of their 2019 Form 1095-B upon request, accompanied by an email address and a physical address to which a request may be sent, as well as a telephone number that responsible individuals can use to contact the reporting entity with any questions.... [2] the reporting entity furnishes a 2019 Form 1095-B to any responsible individual upon request within 30 days of the date the request is received."

Internal Revenue Service [IRS]

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[Guidance Overview]

CMS Finalizes Hospital Pricing Transparency Rule

"The rule will require these various 'standard charges' to be [publicly] available beginning in 2021. The American Hospital Association and three other hospital advocacy groups have already announced plans to challenge the rule, particularly the breadth of CMS's definition for 'standard charges.' "

Davis Wright Tremaine LLP

Editor's Pick New Health Coverage Responsibilities for Employers of Immigrants

"Prior to the new requirement, immigrants who wanted to qualify for an employer-sponsored health plan had to be able to show that they had a green card, permanent resident or citizenship status. ... All refugees, asylum seekers or people on temporary visitor visas now must prove they can obtain health insurance before they receive a visa.... If you hire an employee who is in the process of obtaining a visa, you will need to ensure they comply. "

Employee Benefits Report

2019 Global Health Care Trends Survey

"The Deloitte 2019 global survey of health care consumers ... shows meaningful percentages of people who exhibit traditional 'consumer behaviors' when it comes to their health ... Some aspects of this behavior ... include: being proactive about health and using preventive care, willingness to disagree with a clinician, willingness to change doctors or health plans if unsatisfied with care or customer service, using technology and digital tools to improve/maintain health, willingness to share data if properly incentivized, and using tools/ratings to find the best quality of care and customer service."

Deloitte

Benefit Plan Management in a Collective Bargaining Environment

"Before throwing new ideas on the table at bargaining time, the employer should be educating the union on new ideas in the health care market and sharing annual benchmarking studies.... [Frequent meetings allow] for constant education to union leadership and helps them to feel involved in the ongoing administration and decision-making of the plans.... [S]haring actual data of your plan's experience on a monthly or quarterly basis is vitally important."

Findley

When Is Indemnity Health Insurance an Acceptable Alternative to a Fully-Insured Plan?

"[I]ndemnity insurance offers a low-cost alternative to traditional insurance premiums.... [M]any indemnity plans allow insured members to choose any doctor, specialist or hospital willing to accept that reimbursement.... Indemnity health insurance [may] not meet the requirements of the ACA, still leaving employers subject to ACA penalties. With fixed indemnity plans, the burden of researching costs rests on insured members."

Employee Benefits Report

Tips for Avoiding FMLA Pitfalls

"If you track FMLA leave according to a calendar year, you might end up with a situation where an employee who is giving birth or adopting late in the year can take 12 weeks at the end of the year through Dec. 31 and then on or after Jan. 1 take off another 12 weeks for a total of 24 weeks in less than 12 months. Called leave stacking, it is allowed by federal regulations.... If you want to avoid leave stacking, you can use a rolling FMLA year."

Employee Benefits Report

Judge Issues Temporary Injunction Blocking Implementation of San Antonio's Sick and Safety Leave Law

"On November 22, 2019, the judge issued a letter ruling granting the temporary injunction, thereby confirming the ordinance will not take effect on December 1, 2019. The ruling does not provide the reasoning and analysis underlying the judge’s decision but directs the parties to set a date for a trial on the merits as soon as possible." [Associated Builders & Contractors of South Texas, Inc. v. City of San Antonio, No. 2019-CI-13921 (Tex. 225th Dist. Ct. Nov. 22, 2019)]

Ogletree Deakins

HIPAA Breach Notification Failure Leads to $2 Million Settlement

"The enforcement action resulted from a complaint alleging that the health providers sent a bill to a patient containing another patient's protected health information (PHI). Further investigation revealed that, because of a mailing label error, the PHI of more than 575 patients was sent to the wrong addresses.... [T]he PHI included the individuals' names, account numbers, and dates of service."

Thomson Reuters Practical Law

Funding for ACA-Established Patient-Centered Outcomes Research Trust Fund (PCORTF) Expired in FY2019

"The termination date of [the Patient-Centered Outcomes Research Trust Fund (PCORTF)] has been extended twice ... with termination set to take place on December 20, 2019.... [S]everal bills have been introduced in the 116th Congress that would extend funding for PCORTF ... The bills would generally extend funding for PCORTF ... for between 7 and 10 additional years; extend the termination date for PCORTF; and stipulate various research related requirements for PCORI going forward."

Congressional Research Service [CRS]

Summary of Individual Market Enrollment and ACA Subsidies

"These state profiles summarize insurer financials, marketplace enrollment, and federal assistance provided to households purchasing insurance coverage through the insurance marketplaces, incorporating recently released data from the 2019 open enrollment period and estimated 2019 effectuated enrollment. [A table summarizes] estimates of effectuated marketplace enrollment and associated federal financial assistance for calendar year (CY) 2016 through CY 2019 time period."

Milliman

Benefits in General

Planning for 2020: Year-End Deadlines and Considerations for Employee Retirement, Health and Welfare Plans

"As the end of the year approaches, employers should be aware of important year-end deadlines and considerations related to their retirement and health and welfare plans."

Husch Blackwell

The Value of an HSA as a Tool for Retirement Savings

"While many employees still think of an HSA as little more than an FSA with a rolling balance, its value as a retirement savings vehicle has been largely under-appreciated. In fact, some retirement experts are even going as far as to advise employees to max out their HSA contributions before maxing out what they’re kicking in to their 401(k)."

Chelko Center for Benefits Management

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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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