Health & Welfare Plans Newsletter

July 15, 2020

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View COVID-19 News and Resources

[Guidance Overview]

Self-Insured Health Plans Must Pay PCORI Fees by July 31, 2020

"The Further Consolidated Appropriations Act 2020, signed into law on December 20, 2019, extended the [PCORI] Trust Fund for 10 years. With this new change in law, the PCORI fee, which expired in 2019, was reinstated and extended through 2029.... A basic summary of the application of PCORI fees applied to certain types of coverage [is shown in a chart]."

Withum Smith+Brown, PC

[Guidance Overview]

IRS Releases Draft of 2020 Form 1095-C

"If an employer utilized individual coverage HRAs, the employer will need to know the employee's date of birth to be able to complete this new section.... As a result of the new individual coverage HRAs satisfying an employer's ESR requirement responsibility, the draft Form 1095-C added eight new line 14 codes that can be used by employers.... While the draft Form 1095-C may alarm employers upon first glance, in reality most employers will not be impacted by the new sections and codes. Only employers who adopted individual coverage HRAs will need to be concerned with the new details of the draft Form 1095-C."

Accord

[Guidance Overview]

IRS Addresses W-2 Reporting for FFCRA Sick and FMLA+ Leave

"The main reason for [the guidance in Notice 2020-54] is to give self-employed individuals, who also receive compensation as employees, additional information they may need to correctly claim any tax credits they're due under the FFCRA. Self-employed individuals may claim tax credits for FFCRA sick and FMLA+ leave payment equivalent amounts they would have been entitled to receive were they employees of an employer. The credit they can claim as self-employed individuals is reduced if they also received FFCRA sick or FMLA+ leave payments as an employee."

Lockton

[Guidance Overview]

Governor Signs New Law Mandating Paid Sick Leave for All Colorado Employees

"The new law mandates that nearly all employees working for public and private employers in Colorado must begin accruing at least one hour of paid sick leave for every 30 hours worked, up to 48 hours total, which balance shall carryover year-to-year subject to the limit. This requirement goes into effect for covered employers with 16 or more employees on January 1, 2021, and for all other covered employers on January 1, 2022."

Holland & Hart LLP

[Guidance Overview]

Editor's Pick Health Coverage for Employees on Military Leave

"Employers need to offer USERRA continuation coverage to employees who lose health plan coverage because they are called to active duty. Employers that are ALEs subject to the ACA employer mandate should take extra precautions in determining if and when employees will lose active coverage."

ABD Insurance & Financial Services

Supreme Court Upholds Employer Rights in Contraceptive Coverage Challenge

"The decision now goes back to the lower courts in New Jersey and Pennsylvania to determine whether the expansion was a product of reasonable decision-making or if it is arbitrary and capricious, which would violate the APA. For this reason, we will most likely see additional action taken up this fall. Further, the outcome of the 2020 election could have some impact on its future." [Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania, No. 19-431 (S. Ct. Jul. 8, 2020)]

OneDigital Health and Benefits

Employer Experiences with Direct Primary Care

Transcript of panel discussion/webinar among three employers. Topics: [1] Why did you start an on-site clinic? ... [2] How did you get past any internal hurdles of moving to a self-funded clinic? ... [3] How did you choose your provider/partner? ... [4] Are you being billed as fee-for-service or one monthly fee that includes all monthly visits, or PEPM (Per employee, per month) payment methods? ... [5] How did you onboard different vendors? ... [6] What services do you offer at your clinic? ... [7] How is your clinic connected to local providers? ... [8] Through this experience what do you think your savings have been to overall health care spend?"

The Alliance

Class Action Lawsuit Accuses UnitedHealth of 'Looting' Billions from Employer Plans Through Cross-Plan Offsetting

"A pair of workers enrolled in a UnitedHealthcare insurance plan have filed a class-action suit claiming the healthcare giant took more than $1 billion annually from employer plans for 'cross-plan offsetting.' ... The plaintiffs aim to block UnitedHealth from continuing to use cross-plan offsetting 'for good.' The plaintiffs in the latest case argue that the practice has been deemed illegal under [ERISA] by several courts and has come under fire from the [DOL]." [Scott v. UnitedHealth Group Inc., No. 20-1570 (D. Minn. complaint filed Jul. 14, 2020)]

FierceHealthcare

Ten Years Later: Reflections on Critics' Worst-Case Scenarios for the ACA

"This article considers five frequently heard worst-case scenarios related to the ACA and provides research evidence that these fears did not come to pass."

Stacey McMorrow, Linda J. Blumberg, and John Holahan, via Journal of Health Politics, Policy and Law

CalPERS Announces Health Plan Premiums for 2021

"The overall impact of COVID-19 on CalPERS' 2021 rates will be a modest 0.57%. Factors included in projecting COVID-19's impact included the savings due to delayed and deferred care this year, which CalPERS was able to use to reduce rate increases for next year."

California Public Employees' Retirement System [CalPERS]

Benefits in General

[Guidance Overview]

Editor's Pick Summary of CARES Act and FFCRA Tax Credit and Payroll Tax Relief (PDF)

15 pages; current as of Jul. 6, 2020. "This chart is a high-level overview of the various payroll and tax credit programs under the CARES Act and FFRCA [including the payroll tax credit for Emergency Sick and Family Leave]."

Troutman Sanders

DOL Announces Appointments to ERISA Advisory Council

"The appointees and the expertise they represent are:

  • Employee Organizations: John R. Harney is a partner at O'Donoghue & O'Donoghue LLP....
  • Employers: Glenn Butash is Managing Counsel, U.S. Compensation and Benefits, at Nokia Corp....
  • General Public: Peter Wiedenbeck is the Joseph H. Zumbalen Professor of the Law of Property at the Washington University School of Law....
  • Accounting: James Haubrock is a shareholder with Clark Schaefer Hackett....
  • Insurance: Lisa C. Allen is a Senior Compliance Consultant for the Altera Group....

Butash has been reappointed and will serve as the chair of the 2020 ERISA Council. Current member David Kritz will serve as the Council's vice chair."

Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

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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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