Health & Welfare Plans Newsletter

January 16, 2020

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Allentown PA

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[Guidance Overview]

New Jersey Department of Labor Releases Final Regs for Earned Sick Leave Law

"[T]he Department clarified that if an employer chooses to maintain a single paid time off (PTO) bank to comply with the ESLL, the entire PTO bank must comply with the requirements of the ESLL. Thus, if an employer wants to satisfy its obligations under the ESLL with, for example, its single bank of 80 hours of PTO (which may be used for any purpose, including sick time, vacation, personal days, etc.), it must permit employees to use all 80 hours in accordance with the ESLL. This approach means employees would be permitted to use all 80 hours for sick time without providing advance notice to the employer and such absences could not be held against employees or counted under the employer's attendance policy."

Littler

[Sponsored]

Now is the time to become a member of ECFC

Sponsored by ECFC [Employers Council on Flexible Compensation]

ECFC is dedicated to maintaining and expanding employee benefit programs on a tax-advantaged basis. Members include employers, TPAs, health plan providers, brokers, payers, providers, payment networks, processors, and financial institutions. Learn more


[Guidance Overview]

Pittsburgh's Paid Sick Days Act to Take Effect at Long Last

"Following a nearly four-year legal battle, Pittsburgh's Paid Sick Days Act will take effect on March 15, 2020. Pittsburgh employers should evaluate whether they will need to make any changes to their current practices, policies or handbooks to ensure compliance."

Buck

[Guidance Overview]

February 1 Deadline for DC Paid Family Leave Notice

"By February 1, 2020, DC employers must post the PFL Notice at each worksite in a conspicuous place or places where notices are posted customarily. Employers also are required to send the PFL Notice to remote (teleworking) covered employees to post at their individual worksites. In addition, employers are required to inform employees about their eligibility for DC PFL at three times[.]"

Epstein Becker Green

Minor Deficiencies in COBRA Notices Can Amount to Big Penalties

"[A] recent increase in litigation involving COBRA notice deficiencies is good reason for employers to start taking a closer look at notices.... Employers can protect themselves by knowing some of the common deficiencies, carefully reviewing their COBRA notices, and quickly correcting any deficiency. Even if an employer uses a vendor, the employer should review notices, procedures for sending notices, and its contract with the vendor to ensure it includes appropriate representations and indemnity provisions."

Stinson

Keeping Score: PPO Network Performance

"Based on [an] analysis of large company data, network usage (the percent of average in-network spend) varied from 96% to 97% among the top four national networks. And, the discounts varied from an average of 50% to 55%. Of course, a five percent discount advantage seems like a valuable improvement. However, the average per employee per year medical costs for the groups with the network that reported a 55% was the same as the average cost for the networks reporting the 50% discount."

Chelko Center for Benefits Management

Employers Are Targeting Sleep to Improve Workers' Health and Lower Medical Costs

"About 1 in 4 large employers offer programs to help workers get better sleep and more than half plan to implement such efforts by 2021 ... Benefits officials say promoting a good night’s sleep for employees is as important as making sure their blood sugar and cholesterol are under control."

McDonough County Voice

CMS-Specified Shoppable Services Accounted for 12% of 2017 Health Care Spending Among Individuals with Employer-Sponsored Insurance

"In 2021, hospitals will be required to display, in a consumer-friendly manner, standard charges for at least 300 shoppable services.... CMS specifies 70 services for which hospitals must make price information available for if they provide them (the remaining 230 will be selected by hospitals)....  The 70 CMS-specified shoppable services totaled 12 percent of 2017 medical spending (excluding prescription drug spending from the denominator) among individuals with employer-sponsored insurance. These services made up 16 percent of out-of-pocket medical spending (see table)."

Health Care Cost Institute

[Opinion]

AHIP Amicus Brief in Support of Supreme Court Review of U.S. v. Texas (PDF)

33 pages. "[In] insisting on a district court 'do-over,' the decision below unnecessarily 'prolong[s] the uncertainty this litigation has caused to the future of this indubitably significant statute' and 'ensures that no end for this litigation is in sight.' ... Such a 'do-over' in the lower courts raises the prospect of years of further litigation. To avoid that undesirable limbo, AHIP urges this Court to grant certiorari[.]" [U.S. House of Representatives v. Texas, No. 19-481 (cert. pet. and motion to expedite consideration filed Jan. 3, 2020; responses of federal respondents and state respondents, each filed on Jan. 10, 2020)]

America's Health Insurance Plans [AHIP]

[Opinion]

Nudging Into Insurance Coverage: Lessons from 401(k) Auto-Enrollment

"Auto-enrollment is a kind of 'nudge,' building on the behavioral bias toward inertia. But the very bias that makes auto-enrollment powerful also presents challenges for policy makers. People who are auto-enrolled may underuse their entitlement and may remain enrolled in an option that is poorly suited to their circumstances."

Nathan Hodson, in Health Affairs

Benefits in General

One More ERISA Supreme Court Case But Also One Less

"Having already accepted three ERISA cases for the current term, on January 10, 2020, the high court agreed to hear a case involving preemption.... The case surrounds an Arkansas statute regulating pharmacy benefit managers' drug-reimbursement rates, which is similar to laws enacted by most states.... [Separately,] the Justices passed on the opportunity to clarify the standard for what plaintiffs must plead in their complaint for breach of the fiduciary duty of prudence when a plan is invested in employer stock[.]"

Murphy Austin

Is My Employee Common-Law Married?

"Oklahoma remains one of about only a dozen states that recognize common law marriages.... If you're an Oklahoma employer and you believe there's any question as to whether an employee is married (thereby creating a situation in which you're required to provide benefits or time off under the FMLA), have your employee and the spouse sign a simple one-page Common Law Marriage Affidavit[.]"

McAfee & Taft

Press Releases

Most Popular Items in the Previous Issue

Questions Employees Are Asking in 2020 About ACA 1095-Cs
International Foundation of Employee Benefit Plans [IFEBP]

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2020 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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