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Health & Welfare Plans Newsletter December 16, 2019 |
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Webcasts, Conferences Employment Law & Benefit Update
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Discussions |
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This Newsletter:
BenefitsLink Retirement Plans Newsletter:
Message Boards Digest:
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[Official Guidance] Text of 2019 Instructions for IRS Form 8885: Health Coverage Tax Credit (PDF) "The HCTC expires at the end of 2019. The HCTC can't be claimed for coverage months beginning in 2020. The advance monthly payment program will continue through December 2019 but will not accept HCTC payments in 2020." [Also available: 2019 IRS Form 8885] Internal Revenue Service [IRS] |
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[Official Guidance] Text of IRS Q&As on the Individual Shared Responsibility Provision 14 Q&As, including: "What changes did the Tax Cuts and Jobs Act make to the individual shared responsibility payment? ... What are the statutory exemptions from the requirement to have minimum essential coverage? ... Are US citizens and U.S. residents living abroad subject to the individual shared responsibility provision? ... If I receive my coverage from my spouse's employer, will I have minimum essential coverage? ... My employer tells me that our company's health plan is 'grandfathered.' Is my employer's plan minimum essential coverage?" Internal Revenue Service [IRS] |
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[Guidance Overview] Employers in Union-Related Group Health Plans Must Still Comply with ACA Reporting Requirements "Employers should not make the mistake of concluding that, because the plan has all the coverage information, only the plan is responsible for the ACA reporting requirements for union employees.... To make the reporting easier for employers in multiemployer plans, the IRS has provided interim, simplified reporting rules." Jackson Lewis P.C. |
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[Guidance Overview]
"On December 12, 2019, the [DOL issued] revised regulations clarifying when employers need not pay overtime on perks. The final rule revises the regulations ... to clarify and update the 'regular rate' requirements under section 7(e) of the Fair Labor Standards Act (FLSA) ... focusing on the types of compensation that employers must include in the overtime calculation." Littler |
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[Guidance Overview] How to Prepare for Duluth, Minnesota's Earned Sick and Safe Time Ordinance "The City of Duluth, Minnesota's Earned Sick and Safe Time Ordinance (ESST) will go into effect on January 1, 2020 ... The ESST applies to any individual, corporation, partnership, association, nonprofit organization, or group of people that has at least five employees, whether or not all of the employees work in the City.... Employers must provide eligible employees in Duluth with one hour of ESST time for every 50 hours worked or frontload 40 hours." Jackson Lewis P.C. |
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House Votes to Give the Government the Power to Negotiate Drug Prices "The central -- and most contentious -- provision of [HR 3, which passed Dec. 12,] is its language enabling [HHS] ... to negotiate the price of up to 250 commonly used drugs, including insulin. It would also require the manufacturers to offer the agreed-on prices to private insurers, giving it huge reach." The New York Times; subscription may be required |
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"While states, DOL, HHS, and the research GAO reviewed identified some instances of noncompliance with MH/SU parity requirements, the extent of compliance with these requirements is unknown.... GAO is recommending that DOL and HHS evaluate whether relying on targeted oversight is effective for ensuring compliance with MH/SU parity requirements or whether alternative approaches are needed." [GAO-20-150; Dec. 13, 2019] U.S. Government Accountability Office [GAO] |
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Private Health Insurance Costs Are Skyrocketing "Per capita spending for private insurance has grown by 52.6% over the last 10 years. Per-capita spending for Medicare grew by 21.5% over the same period, and Medicaid 12.5%. Private insurance generally pays higher prices for care than Medicare, which generally pays more than Medicaid. There’s a long-running debate about whether public programs deliver efficiency because of their purchasing power, or simply underpay." Drew Altman, via Axios |
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[Opinion] Make 'Surprise Medical Bill' Arbitration Less Arbitrary "[A] reasonable argument could be made for a strictly limited arbitration provision, to help fine-tune benchmark rates to adjust for localized market idiosyncrasies. But the outline of the revised bill goes far beyond this ... Rather than helping to ensure access to emergency care by refining benchmarks to account for local circumstances, this array of permitted justifications is so broad as to eliminate constraints and considerations of value-for-money from the determination of payment for emergency care altogether." Chris Pope, Manhattan Institute for Policy Research |
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[Opinion] To Manage Health Costs, Ditch the Silos "As long as employers organize and incentivize benefits programs to be managed independently -- health care in one silo, pharmacy in another, absence and disability in a third, and workers' compensation in a fourth -- program managers will have every incentive to shift cost and risk across these boundaries and to employees." CFO |
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[Opinion] In Medical Billing, Fraudulent Charges Weirdly Pass as Legal "Much of what we accept as legal in medical billing would be regarded as fraud in any other sector.... Why do insurers pay? Partly because insurers have no way to know whether you got a particular item or service. But also because it’s not worth their time to investigate the millions of medical interactions they write checks for each day." Kaiser Health News |
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Selected Discussions |
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ERISA Plan Administrator's Address vs. Plan's Situs "I've been told by a vendor that the address for an ERISA plan administrator must be in the same state as the plan situs. Is that correct?" BenefitsLink Message Boards |
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Press Releases |
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EBRI and NAGDCA Form Public Retirement Research Lab
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Most Popular Items in the Previous Issue |
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Applying the ACA Employer Mandate to Rehired Employees
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Surprise Billing in Private Health Insurance: Overview and Federal Policy Considerations
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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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