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Health & Welfare Plans Newsletter December 17, 2019 |
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Webcasts, Conferences FMLA Self Audits: Make Sure You Are In Compliance
Employee Assistance Programs
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[Guidance Overview] DOL Provides Welcome Clarifications of Exclusions from the FLSA Regular Rate of Pay "[Employers] should evaluate how they pay overtime and develop a strategy to not only ensure compliance with the new regulations, but also how best to take advantage of the regulations to save on overtime costs.... The Final Rule specifically addresses whether certain employee perks and benefits must be included in the FLSA regular rate of pay for overtime. Among the most relevant items for public agencies are the DOL’s clarifications that holiday-in-lieu pay and sick leave buy backs may be excluded from the regular rate." Liebert Cassidy Whitmore |
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![Sponsored by International Foundation of Employee Benefit Plans [IFEBP]](https://benefitslink.com/bnrs/2019/HBCE_2020EarlyRegDec_top.jpg "Sponsored by International Foundation of Employee Benefit Plans [IFEBP]")
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[Guidance Overview] California Individual Mandate for Health Coverage Takes Effect in 2020 "Beginning in 2021, employers with self-insured health plans must annually report to the California Franchise Tax Board (FTB) information about employees covered by the plan in the prior year. This reporting requirement may be met by filing with FTB copies of IRS Form 1095-C or Form 1095-B ... A penalty of $50 per covered individual applies for any failure to comply ... The reporting requirement will take effect for coverage provided in 2020[.]" Hanson Bridgett LLP |
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[Guidance Overview] Nevada Paid Leave Law Takes Effect January 1 "Effective January 1, 2020, all private employers with 50 or more employees in Nevada will have to provide employees with up to 40 hours of paid leave per benefit year.... [It] remains to be seen whether you can avoid all of the other requirements simply by having a policy that provides paid leave to all scheduled employees at this rate or better." Fisher Phillips |
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Funding Deal Repeals Health Taxes, Blocks Attempts to End 'Silver-Loading' "The bipartisan deal would prevent ... [administration efforts to end] 'silver-loading,' which helps insurers compensate for the loss of key ObamaCare payments and has the effect of giving greater financial assistance to many ObamaCare enrollees.... [T]he spending deal repeals three major taxes that had helped fund the law's coverage expansion ... a 40 percent tax on generous 'Cadillac' health plans, the 2.3 percent medical device tax and the health insurance tax." The Hill |
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Congress Poised to Repeal HIT, Medical Device and Cadillac ACA Taxes as Part of Spending Deal "Congress is expected to repeal the [ACA's] health insurance, medical device and 'Cadillac' tax as part of a must-pass spending agreement ... to avoid a government shutdown on [Dec. 20]. The repeals would represent a major windfall for both providers and payers that have lobbied fervently against the taxes since the ACA was passed in 2010. None of the taxes [is] in effect now, but the health insurance and device taxes were expected to resume next year." FierceHealthcare |
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[Sponsored]
COBRA: Simple Concept - Complicated Rules
Jan. 16 webinar. COBRA requirements for employers, including plans subject to COBRA, special COBRA rules for Health FSAs, when COBRA must be offered and for how long, and required notices. BenefitsLink discount. |
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With Surprise Billing Left on Cutting Room Floor, Study Finds Fix Could Save Billions "The year-end government funding package ... is not expected to include bipartisan legislation protecting patients who receive surprise medical bills sent by out-of-network specialists at in-network facilities -- a practice that, if amended, could reduce health spending for people with private insurance by up to $40 billion annually ... If in-network payments for [anesthesiologists, pathologists, radiologists and assistant surgeons] were reduced to 164 percent of Medicare rates -- equivalent to orthopedic surgeons -- total spending for people with insurance through their employer could fall by 3.4 percent." Morning Consult |
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Surprising Swings in Momentum for Legislation on Surprise Medical Bills "Generally, employers and consumer advocates favor benchmarking. Hospitals and doctors' groups, especially those backed by private equity firms, pushed for arbitration. The compromise approach tracks closely with legislation advanced by the House Energy and Commerce Committee: a median in-network benchmark with an arbitration 'safety valve' where either side can bring a bill to arbitration if it's more than $750. Previous versions allowed arbitration only for charges over $1,250." Kaiser Health News |
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Update on Federal Surprise Billing Legislation: Understanding a Flurry of New Proposals "[T]he HELP/E&C compromise package and the [Committee on Ways & Means] proposal are alike in assuring consumers that they will face no costs in surprise billing situations beyond those associated with in-network cost-sharing.... The W&M proposal looks to voluntary negotiation backed up by independent dispute resolution (IDR) to set rates and thus aligns more closely with the approach advocated by hospital and physician groups. The HELP/E&C proposal creates a payment standard with a backup IDR process and represents an attempt to bridge the gap between provider and insurer positions." The Commonwealth Fund |
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Benefits in General |
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"On remand and de novo review, the District Court ... entered summary judgment in Humana's favor. Nonetheless, [the plaintiff] filed a fee petition, asserting that ... convincing the appellate court to change the standard of review and remand her case entitled her to fees regardless of whether she ultimately won her claim for benefits.... [The Fifth Circuit] concluded that, while securing a change in the standard of judicial review was certainly a procedural success, it was not a success on the merits of [the] benefit claim." [Ariana M. v. Humana Health Plan of Texas, Inc., No. 18-20700 (5th Cir. Nov. 8, 2019; unpub.)] Robinson & Cole LLP |
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Press Releases |
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Most Popular Items in the Previous Issue |
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Text of IRS Q&As on the Individual Shared Responsibility Provision
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