Health & Welfare Plans Newsletter

August 14, 2020

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View job as Senior Retirement Analyst for Dunbar, Bender & Zapf, Inc. Senior Retirement Analyst  View job

Dunbar, Bender & Zapf, Inc.
Telecommute / Pittsburgh PA

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Dunbar, Bender & Zapf, Inc.
Telecommute / Pittsburgh PA

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Ascensus
CA

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Pentegra
Telecommute / West Harrison NY

View job as Defined Contribution Retirement Plan Consultant for First American Bank Defined Contribution Retirement Plan Consultant  View job

First American Bank
Elk Grove Village IL

View job as Testing Specialist for Ascensus Testing Specialist  View job

Ascensus
Telecommute / CA

View job as Deputy Director, Office of Communications for Centers for Medicare & Medicaid Services [CMS] Deputy Director, Office of Communications  View job

Centers for Medicare & Medicaid Services [CMS]
Washington DC

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[Guidance Overview]

Editor's PickThe Health Plan 401(k) Has Arrived (PDF)

"In the first five years alone, the estimate is that roughly 11 million individuals will be covered by an [Individual Coverage Health Reimbursement Arrangement (ICHRA)]. That increase in ICHRA enrollment will cause a corresponding decrease in traditional group health plan coverage ... Just as with the 401(k) plan's introduction in the 1980s, many employers will be driven by the desire to accomplish a pure defined-contribution alternative to their standard major medical plan.... ICHRAs offer two significant advantages that have the potential to be a compelling recruiting and retention feature to attract employees. [1] Increased plan options ... [2] Portability."

ABD Employee Benefits

[Guidance Overview]

Editor's PickHealth Savings Accounts (HSAs) (PDF)

28 pages. "This report summarizes the principal rules governing HSAs, covering such matters as eligibility, qualifying health insurance, contributions, withdrawals, and tax advantages. It incorporates changes made to HSAs as a result of the Coronavirus Disease 2019 (COVID-19) pandemic and corresponding recession. It concludes with a discussion of HSA data limitations and recent trends in HDHP enrollment and HSA utilization." [R45277 updated Aug. 13, 2020]

Congressional Research Service [CRS]

[Guidance Overview]

Employers May Need to Provide Employees with Documentation of Qualified Health Coverage Under Michigan No-Fault Auto Insurance Reform

"Michigan's no-fault law no longer requires Michigan drivers to carry unlimited medical coverage [PIP coverage]. Under certain circumstances, individuals with [qualified health coverage (QHC)] may be able to opt-out of PIP coverage under their no-fault policy, which generally will lead to a lower premium.... [C]arriers of fully insured group health plans must provide documentation to plan participants about whether their coverage under the group health plan is QHC. Private employers sponsoring self-funded group health plans are not required to comply with the bulletin's obligations because of ERISA preemption."

Miller Johnson

Puerto Rico Working Mothers Act Amended to Provide Additional Adoption Leave for Working Mothers

"[Under] an amendment to the Puerto Rico Working Mothers Act ... adoption leave benefits were extended to female employees adopting minors 6 years old or older. Now, these adopting mothers will have a paid leave of 5 weeks.... This amendment does not alter the adoption leave that was already provided for in the Working Mothers Act providing 8 weeks of paid leave to mothers adopting a child 5 years old or younger, not enrolled in school."

Jackson Lewis P.C.

Court Permits Fiduciary Breach and Mental Health Parity Claims Against Third Party Administrator

"UMR asserted that under ERISA, it could not be held liable for a monetary award based on unpaid [self-insured health plan] benefits. In its decision, the court acknowledged this general principle, but noted that while recovering unpaid benefits may have been the plaintiff's primary objective, other forms of relief may be available. For example, if the court found that the claim review process had not followed ERISA rules, it could order UMR to reprocess the claim. Since the court could grant other forms of relief that would be enforceable against UMR, it ruled that releasing UMR at this point in the case would be premature." [Daniel R. v. UMR, No. 19-069 (D. Utah Mar. 12, 2020)]

Hall Benefits Law

Caution Advised iconHIPAA Enforcement Relaxed But Not Abandoned

"[OCR] announced in March 2020 that it would exercise discretion in enforcement actions related to HIPAA restrictions that might otherwise limit the good faith provision of telehealth services. But with the pandemic and the implementation of work-from-home policies, health care providers -- so called 'Covered Entities' -- must be more vigilant than ever to employ commercially reasonable efforts to safeguard the protected health information (PHI) of patients."

Hodgson Russ LLP

[Opinion]

The Negative Economic Effects of Medicare for All and Medicare Buy-In Proposals

"Democratic lawmakers and candidates for political office recently have expressed a renewed interest in enlarging government healthcare programs. The specifics of each plan differ, but all proposals would significantly alter the existing healthcare landscape by expanding the share of the population covered by public payors and increasing the government's fiscal responsibility, influence, and control over the healthcare sector.... This paper discusses recent proposals to expand Medicare or offer a public option and lays out the likely impact such a move would have on various stakeholders."

U.S. Chamber of Commerce

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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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