Health & Welfare Plans Newsletter

February 10, 2020

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Northbrook IL / Telecommute

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Elk Grove Village IL

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Dresher PA

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Kansas City MO / Telecommute

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Kansas City MO / Telecommute

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Webcasts, Conferences

Millennial State & Local Government Employee Views on Their Jobs, Compensation & Retirement
February 13, 2020 WEBCAST
National Institute on Retirement Security

Roundtable Discussion on Innovative Uses of Health Savings Accounts
February 20, 2020 in OH
Worldwide Employee Benefits Network [WEB] - Greater Cincinnati Chapter

What To Do When Culture Sucks
March 4, 2020 in OH
Worldwide Employee Benefits Network [WEB] - Greater Cincinnati Chapter

Annual Legal & Regulatory Update
March 12, 2020 in OH
Worldwide Employee Benefits Network [WEB] - Northeast Ohio Chapter

Are You Getting Good Data on What is Driving Your Healthcare Costs?
March 24, 2020 WEBCAST
University Conference Services

ERISA Basics National Institute
June 15, 2020 in DC
American Bar Association Joint Committee on Employee Benefits [JCEB]

►See 115 Upcoming Webcasts and Conferences

►See 1459 Recorded Webcasts


Discussions

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[Guidance Overview]

Cafeteria Plan Need Not Provide Mid-Year Election Changes

"The IRS has reiterated, in IRS Information Letter 2019-0028, that while a Section 125 cafeteria plan may allow participants to make a mid-year pre-tax contribution election change because of the occurrence of certain events (informally called change in status or qualifying events), the plan is not required to make this option available."

The Wagner Law Group

[Guidance Overview]

Editor's Pick Modified HIPAA Rules for Sending Records to Third Parties

"Covered entities are no longer required by HIPAA to send non-electronic protected health information (PHI) to a third party at the patient's request. In addition, covered entities are no longer limited to charging a reasonable cost-based fee when sending records to a third party."

Holland & Hart LLP

[Guidance Overview]

CMS Issues Proposed Basic Health Plan Methodology

"CMS issued new proposed methodology for determining the amount of federal funds for the [Basic Health Plan (BHP)] for plan year 2021. The proposed methodology for 2021 is largely consistent with the final methodology adopted for 2019 and 2020 (which itself largely incorporated a prior final administrative order).... CMS continues to take the position that it cannot provide states with the CSR component of their BHP payment in the absence of a congressional appropriation for CSR funding."

Katie Keith, in Health Affairs

[Guidance Overview]

New Jersey Department of Labor Adopts Regulations Implementing Earned Sick Leave Law

"The Department's Responses ... illuminate how the NJ DOL interprets the ESLL and employer compliance obligations.... [1] Only one set of rules may apply to an umbrella paid time off (PTO) policy.... [2] All requests by employees to use earned sick leave are considered presumptively valid.... [3] Employers may require 'return to work' notes.... [4] Employers may not require employees to use accrued earned sick leave.... [5] Employers need not permit employees to use more than 40 hours of earned sick leave in any benefit year.... [5] The NJ DOL intends to adopt a formal regulation for determining when an employee who works both inside and outside New Jersey will be covered under the ESLL; in the meantime, guidelines in the Department's FAQs should be followed."

Epstein Becker Green

Active Benefits Enrollment and Enhanced Engagement Leads to Higher Employee Retention and Cost Savings (PDF)

"37%: The potential percentage decrease in employee turnover as a result of active participation and year-round engagement in benefit enrollment.... For an average group with 10K employees, every 10% improvement in active participation could retain 70 additional employees saving $1.05 million."

Benefitfocus

Are Employees Ready for Digital Healthcare?

"[N]early seven in ten US employers (68%) plan to invest more in digital health solutions over the next five years. The survey used a broad definition of digital health, ranging from apps to help find providers, to virtual healthcare, to smart pill bottles to aid medication compliance, to chat-bots for diagnosing simple medical issues, and more."

Mercer

Congress Revives Surprise Billing Debate with Proposal for 'Mediation'

"A major House committee has unveiled largely provider-friendly legislation to tackle surprise medical bills.... Payers want out-of-network payments linked to a benchmark rate, but providers want a 'baseball-style' arbitration process where both parties submit an amount and an independent arbiter picks one. Ways & Means wants to use a two-step process for resolving disputes." [House Ways and Means Committee has released: [1] Discussion Draft; [2] Summary of the proposal; and [3] Section-by-section summary.]

FierceHealthcare

New Lawsuits Challenge Abortion Policy, Advisory Opinion on Association Health Plan

"On January 30, 2020, seven Democratic attorneys general, led by California, challenged parts of a recent final rule to require separate transactions for abortion coverage.... In a far less straightforward case, two businesses known as Data Marketing Partnership and LP Management Services sued the [DOL] over their status as a single-employer self-insured group health plan under [ERISA]. The lawsuit stems from a request from LP Management Services -- a Georgia-based data-sharing partnership -- for an advisory opinion on its status under ERISA."

Katie Keith, in Health Affairs

Selected Discussions
on the BenefitsLink Message Boards

Trigger Audit Risk When Going from Small to Large Plan?

"Client is moving from the short Form 5500 to the long form due to the number of participants. Does that switch increase the possibility of triggering an audit? (There are some other issues that require some expensive clean up.)"

BenefitsLink Message Boards

Press Releases

401(k) Champion Award Seeks Applications
Jackson, Grant Investment Advisers, Inc.

Most Popular Items in the Previous Issue

Engaging and Monitoring Health Plan TPAs: Understanding Your Fiduciary Obligations (PDF)
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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