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Health & Welfare Plans Newsletter January 23, 2020 |
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Webcasts, Conferences Data Review: Is Your Plan Design Encouraging Appropriate Opioid Use?
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Discussions |
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This Newsletter:
BenefitsLink Retirement Plans Newsletter:
Message Boards Digest:
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[Guidance Overview] New Jersey Department of Labor Issues Final Earned Sick Leave Law Regulations "Though short on substantive changes, an extensive comment-and-response section provides more guidance to the NJDOL's interpretation and enforcement of the ESLL. Significantly, it discusses the ESLL's interplay with collective bargaining agreements (CBAs), existing paid time off (PTO) policies, and employee leave laws. It also explains the permissible use and payment of ESLL." Jackson Lewis P.C. |
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![Sponsored by International Foundation of Employee Benefit Plans [IFEBP]](https://benefitslink.com/bnrs/2020/IFEBP_MarchGlobal_top.jpg "Sponsored by International Foundation of Employee Benefit Plans [IFEBP]")
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[Guidance Overview]
15 pages. "All private employers with at least one employee in Massachusetts have PFML obligations, including collecting and remitting covered employees' contributions to the trust fund or maintaining an approved private plan. Employers with 25 or more employees in the state must also contribute to the PFML program, but smaller employers are exempt from making contributions." Mercer |
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Supremes: You Can't Hurry Love ... Nor a Decision on Constitutionality of ACA "On January 21, 2020, the High Court decided not to hurry the decision of whether to hear a case appealing a decision from Texas that the ACA is unconstitutional.... [The] Court will not decide whether to take the case for months and, if it takes it, won't hear it until the Fall. This means the case will likely not be decided before the November Presidential election." [U.S. House of Representatives v. Texas, No. 19-481 (cert. pet. filed Jan. 3, 2020; motion to expedite consideration denied Jan. 21, 2020)] Murphy Austin |
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"In granting certiorari, the Supreme Court is poised to resolve a conflict over PBM regulation. The D.C. and Eighth Circuits hold that all PBM regulation is preempted, while the First Circuit holds that none is preempted.... The decision in Rutledge also, hopefully, will clarify the scope of ERISA preemption by adding to over fifteen Supreme Court decisions on what it means for a state law to 'relate to' an ERISA plan." [Pharmaceutical Care Mgmt. Assoc. v. Rutledge, Nos. 17-1609 and 17-1629 (8th Cir. June 8, 2018; cert. pet. granted Jan. 13, 2020)] Seyfarth |
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"Most plans have a set period (such as March 31 of the following year, for a calendar year plan) to submit expenses for the prior year. If any money is left over after that period, the employer has four options.... [T]he employer should make sure that its plan document permits any or all of these options ... Employers using a third-party administrator (TPA) to administer the health FSA should also make sure the option they choose can be handled by the TPA." HUB International |
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Pharmacy Benefits Contract Reviews Can Provide Big Savings, Offset Rising Costs "When asked to identify cost management strategies, employers typically don't mention what may be the simplest and least disruptive way to reduce their benefit costs: re-negotiating their pharmacy benefit management (PBM) contract." HUB International |
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2020 Planning for Health and Welfare Benefit Plan Operations "The IRS ... extended the deadline for furnishing 2020 Forms 1095-C to individuals from January 31, 2020 to March 2, 2020. The deadline for filing the forms with the IRS electronically ... is March 31, 2020.... The Massachusetts 1099-HC must be provided to employees by January 31, 2020 ... [A] copy of the ACA Form 1095-C must be submitted by June 30, 2020 (District of Columbia) or by March 31, 2020 (New Jersey).... [E]mployers should ensure that they submit an Annual Reporting Form for 2019 to the San Francisco Office of Labor Standards Enforcement by April 30, 2020." Buck |
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Making Personalized Benefits Communication Easy to Access "Ease of access and ease of use need to be the highest priority if we are going to get the right people to use their benefits at the right time. It's also an often overlooked question when pursuing personalization. And it becomes even more important to consider when you're using personalization and engagement to drive health strategy." Segal Benz |
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Blues Health Insurers Fund U.S. Non-Profit's Generic Drug Expansion "The Blue Cross Blue Shield Association and 18 Blue Cross Blue Shield health insurers are working with Civica Rx, a non-profit formed two years ago to try to increase competition for hospital-based generic drugs. The new subsidiary will focus on drugs that members can purchase via mail order or in retail pharmacies. It aims to launch new rivals starting in 2022 for about 7 to 10 expensive generic drugs where there is currently only one manufacturer[.]" Reuters |
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"[1] Expanding leave entitlement by redefining threshold eligibility.... [2] Improper identification and description of your FMLA leave year.... [3] Inaccurate or non-compliant rules about required or permissive substitution of paid time off and/or disability benefits during leave.... [4] Failing to describe employees' notice obligations (or failing to accurately capture difference between foreseeable and unforeseeable situations).... [5] Outdated information about military family leave entitlements.... [6] Explanation of what happens if employee fails to pay benefit premiums during leave.... [7] Overstating fitness for duty requirements.... [8] Failing to attach DOL's FMLA Poster or include all of its detail in the policy.... [9] No state law addendums where required ... [10] Leaving out descriptions of employer's recertification and second/third opinion rights." FMLA Insights |
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Benefits in General |
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[Guidance Overview]
"Starting with the 2021 Plan Year, 401(k) plan sponsors will need to track hours of service performed by part-time employees ... and will be required to permit certain part-time employees to make elective deferrals in a 401(k) Plan beginning in the 2024 Plan Year.... The SECURE Act increases by ten-fold the penalties in connection with failing to file an annual report for a qualified retirement plan.... [E]mployers should analyze their leave programs and make sure they do not want to make changes to take the tax credit in 2020.... [T]ax-exempt employers no longer need to include the value of qualified transportation fringe benefits in their UBIT." Groom Law Group |
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Selected Discussions |
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Reader Poses Question on Premium Tax Credit and Retiree HRA Account "We have a participant who is receiving a Premium Tax Credit. As such, we have suspended his retiree HRA account for the time period he is receiving the PTC. Participant sends in reimbursement request for expenses incurred prior to receiving PTC. Currently, we deny participants from receiving reimbursement because the account is in 'suspension'. Therefore, no activity allowed in HRA period. Participant is claiming that expenses were incurred prior to receiving PTC so they should be eligible for payout even while account is suspended. IRS PTC Q&A states the following: 'What if the retiree coverage consists of retiree only health reimbursement arrangement (HRA)? If an individual is covered by an HRA, including an individual coverage HRA, for a month, regardless of the amount of reimbursement available under the HRA, the individual is not eligible for the PTC for that month.' Looking for clarification on 'for that month' -- Does it mean that only expenses incurred and submitted for reimbursement while receiving PTC 'for that month' are not eligible or does this also include any previously incurred expenses while the account is suspended or frozen?" BenefitsLink Message Boards |
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Press Releases |
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Most Popular Items in the Previous Issue |
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Texas Surprise Billing Legislation and Rules Went Into Effect on January 1
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'Transparency in Coverage' Rule: Potential Requirements for Employers
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