Health & Welfare Plans Newsletter

February 17, 2020

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[Guidance Overview]

Agencies Publish Guidance for Employers on Responding to the 2019 Novel Coronavirus

"The CDC encourages employers not to require employees who have an acute respiratory illness to present a doctor’s note to validate their illness or to return to work because the medical facilities may be overwhelmed.... All employers should review the CDC’s complete Guidance for Businesses and Employers. The CDC’s guidance is not a legal mandate for employers. OSHA and many state laws, however, impose a general duty on all employers to provide workers with work environments free from recognized hazards."

Jackson Lewis P.C.

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[Guidance Overview]

Summary of Provisions of HHS' Proposed 2021 Notice of Benefit and Payment Parameters and Other Key Regulations (PDF)

"The notice includes important proposed rules and parameters for the operation of the individual and small group health insurance markets in 2021 and potentially 2022.... Those who are enrolled in a health reimbursement arrangement (HRA) with a noncalendar year plan year will be eligible for the special enrollment period annually. HHS has established that individuals and dependents who are provided a qualified small employer health reimbursement arrangement (QSEHRA) with a non-calendar year plan year may qualify for this special enrollment period. Although these individuals would be eligible for a [special enrollment period], their plan accumulators would reset if they made a plan change."

Wakely Consulting Group

Failure to Provide ERISA-Required Plan Document to Participant Costs Plan Sponsor $41,000

"This wrongdoing in this case continued when the plan participant, after discovering her claims would not be paid, requested a copy of the plan documents. She wanted to be able to review the documents to determine how to appeal and what rights she had under the plan. The plan sponsor failed to provide plan documents. In order to remedy the situation, the plan participant chose to sue her employer in order to cover her medical costs. During discovery, the requested plan documents were finally provided, several years late." [Kinsinger v. SmartCore, LLC, No. 17-643 (W.D.N.C. Aug. 27, 2019)]

Hall Benefits Law

Pharmacy Benefits Management: Balancing Compassion and Compliance in Managing High-Cost Drug Claims (PDF)

"Employers with self-funded benefit plans are performing an increasingly tenuous balancing act when it comes to unpredictable and budget-busting specialty drug costs. They want to meet the needs of plan members and their families whose lives may depend on one of the growing number of 'miracle' drugs being developed. But what should you do when high cost drug claims significantly change the organization's benefits plan?"

HUB International

Price Hikes Drove Employer-Sponsored Health Costs to Record High in 2018

"Average healthcare spending for people with employer-sponsored insurance rose to an all-time high in 2018, costing $5,892 per person annually, according to a study released Thursday from the Health Care Cost Institute. Average out-of-pocket spending increased to $907 per person annually."

HealthcareDIVE

Should Employers Allow Workers to Text That They're Off for FMLA?

"[S]hould employers let them text that they're off for [FMLA] reasons rather than call in? In some jurisdictions, they must be allowed this flexibility but in many other regions employers still may prefer to enforce call-in policies.... However, getting a text message or e-mail provides the employer with evidence of the reason, as opposed to a call to a live person whose recollection of the reason may differ from the employee's or a recording that may be erased[.]"

Society for Human Resource Management [SHRM]; membership may be required to view article

How Income-Advance Loans Help Financially Stressed Employees

"[A]verage liquidity among low-earning households is only $855 ... Add a financial shock to limited resources, and the researchers discovered a cascading effect, not only on employees' financial stability but also on the stability of their employers' business operations.... [Researchers] found that one offering in particular -- the income-advance (IA) loan -- helped employees who need assistance the most."

Society for Human Resource Management [SHRM]; membership may be required to view article

[Opinion]

The Health System We'd Have If Economists Ran Things

"[N]early 70 percent of health economists are comfortable charging people more if they engage in unhealthy behaviors that lead to higher health costs. The ACA allows marketplace plans to do just that based on smoking.... Many of today's conversations about reducing health spending focus on prescription drugs. A good deal of drug spending ends up as profits for the pharmaceutical industry -- drug company profit margins above 15 percent are not uncommon.... A plurality of health economists seem to question this argument."

The New York Times; subscription may be required

Benefits in General

[Official Guidance]

Text of IRS Form 2848, Power of Attorney and Declaration of Representative (PDF)

Revised Feb. 2020. "A separate Form 2848 must be completed for each taxpayer. Form 2848 will not be honored for any purpose other than representation before the IRS."

Internal Revenue Service [IRS]

[Guidance Overview]

SECURE Act Makes Significant Changes to Benefit Plans

"[The article includes a link to] a detailed analysis of the Act based upon the type of Plan, e.g., defined contribution, defined benefit, IRA, health and welfare plan ...[and] a chart showing the effective date of all provisions of the Act, whether the changes are mandatory or discretionary, and whether the change requires a plan amendment."

Williams Mullen

Press Releases

New Members of the NCEO Board of Directors
National Center for Employee Ownership [NCEO]

Upcoming Events About Health & Welfare Plans

Feb. 19
Webcast
Employee Assistance Programs
Lorman Education Services
Fee is required
Feb. 19
Webcast
10 Steps Employers Should Follow When Faced With Requests for Leave or Accommodation
Wagner Law Group P.C.
Feb. 20
Webcast
HSA to Z: The Ins and Outs of the Health Savings Account
workforce.com
Feb. 20
Georgia
Demystifying Pharmacy
Worldwide Employee Benefits Network [WEB] - Atlanta Chapter
Fee is required
Feb. 20
Ohio
Roundtable Discussion on Innovative Uses of Health Savings Accounts
Worldwide Employee Benefits Network [WEB] - Greater Cincinnati Chapter

Most Popular Items in the Previous Issue

Status of the State Individual Health Insurance Coverage Mandates
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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