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Health & Welfare Plans Newsletter October 15, 2020 |
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Newly Posted Employee Benefits and Covid-19: Options for Employers and Employees
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Discussions |
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This Newsletter:
BenefitsLink Retirement Plans Newsletter:
Message Boards Digest:
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[Guidance Overview]
"[T]he amended law ... requires employers to: [1] Provide employees each pay period on a pay statement or in a separate writing the amount of safe/sick time accrued and used during the period and their total accrued leave balance; [2] Reimburse employees for their fee/costs/expenses for obtaining requested documentation from a doctor or other third party to support the need for leave ... [3] Provide an updated notice of rights to current employees no later than October 30, 2020 and to subsequent hires at the commencement of employment." Buck |
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[Guidance Overview]
37 presentation slides. Topics: [1] Communications from ESD. [2] The waiting period. [3] PFML notice requirement. [4] Intermittent leave. [5] Supplemental benefits. [6] Short term disability. [7] Benefits continuation. [8] When is leave protected? [9] Intersection of Escriba, PFML, and FMLA. [10] Voluntary plans. Davis Wright Tremaine LLP |
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"Evaluation of employer data ... revealed four common patterns in incentive designs ... [1] Incentives focused on participation (participation-focused); [2] Incentives focused on health improvement or outcomes (outcomes-focused); [3] Incentives focused on a combination of participation and outcomes (combination); and [4] Incentives that started with a focus on participation and then shifted to a focus on outcomes (participation-to-outcomes).... [W]hile most employer well-being initiatives used a mix of outcomes- and participation-focused incentives, the most successful also invested in creating and sustaining a more supportive workplace health culture." Health Enhancement Research Organization [HERO] |
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"[Seema Verma, the head of the Centers for Medicare & Medicaid Services (CMS)] did tout models that required providers to take on financial risk at a faster pace, potentially alluding to the direction CMS wants to steer value-based care models. 'I think the issue we have in value-based care is that many of our models unfortunately are not working the way we would like them to,' she said. 'They are not producing the types of savings the taxpayers deserve.' " FierceHealthcare |
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"The imposition of [a spousal surcharge] may make it more economical for each partner to obtain coverage under his or her own plan. Twenty-seven percent of employers surveyed by Willis Towers Watson were levying the surcharges in 2019, but that percentage was projected to jump to 43% in 2021. The details of the surcharges -- the amount and when they apply -- depends on the plan. If the spouse is unemployed or if the covered employee's income falls below a certain threshold, the surcharge may not apply." Morningstar |
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"FedEx is not increasing deductibles or out-of-pocket maximums for current medical, dental or vision plans for 2021 ... However, paycheck contributions for medical, dental and vision benefits will increase the same amount they did for 2020.... FedEx said it will spend about $2 billion for 2020 to continue covering roughly 70% of member health care costs." Memphis Commercial Appeal |
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"Here are 14 payers that are returning premium revenue to members due to lower healthcare costs during the COVID-19 pandemic." Becker's Hospital Review |
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"Plans will be required to base their decisions about medical necessity on evidence-based standards developed by nonprofit professional associations like the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Previously, plans were only required to provide coverage at parity for nine behavioral health disorders." AISHealth |
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"There are an increasing number of cases in which courts have found that changes in employees' behavior might suggest that the employee is suffering from a serious health condition, and that the employer is obligated to treat the behavior as a request for FMLA leave.... [It] is critical that employers identify all situations in which the employee may be suffering from a medical condition and proactively engage the employee in a discussion about what we can do to help." FMLA Insights |
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"Design, strategy and company dollars continue to be redefined to create a competitive total rewards package encompassing base salary, well-being, benefits, recognition and development promoting employers of choice. Companies large and small would do well to incorporate the following strategies into their compensation packages: Unlimited PTO ... PTO buy/sell plans ... Mandated or employer-sponsored paid leaves ... Expanded parental leave policies." Voya |
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"Although there is no federal law that requires employers to provide their employees with time off to vote, currently, 30 states have these provisions, some of which are paid and others unpaid. For companies with a workforce spread across states, it may be beneficial to extend the same leave benefits to all employees, regardless of location." OneDigital Health and Benefits |
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[Opinion]
"It is increasingly apparent that the scope of ERISA preemption needs to be curtailed to allow states to continue their traditional role as the regulators of health care. Otherwise, we risk creating a significant 'blind spot' when it comes to regulating health insurance for the 60 percent of US workers who receive their health care coverage through employer-sponsored plans. If ERISA preemption is not narrowed, the federal government could step up its oversight of employer-sponsored plans to match state efforts, but this is a second-best solution that would split the health insurance market." Carmel Shachar, via Health Affairs Blog |
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Benefits in General |
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"[1] Follow the fiduciary designation process set out in the Plan; [2] know that a general delegation of fiduciary duties is not enough; [3] be able to establish that the delegation applies to the specific claim at issue." [Hampton v. National Union Fire Ins. Co. of Pittsburgh, No. 18-6725 (N.D. Ill. Oct. 7, 2020)] Lane Powell PC |
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Selected Discussions |
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► It's easy to sign up and participate in discussions! Post answers, ask questions, create custom feeds and views. Join your peers (and potential referral sources or customers)—there is no charge. |
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"I've seen auditors attach to the 5500 as the audit report a letter that basically says 'Hey. we're working on the audit.' The benefit of this approach (which is what I don't like about it) is the filing will be accepted without error. I think it's a little disingenuous. Although it looks like you're 'doing the right thing' by disclosing the fact that you are working on the audit, it has the effect of hiding the fact that you haven't done the audit. Do others recommend in favor of or against this approach?" BenefitsLink Message Boards |
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Press Releases |
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Steven H. Sandell Grant Program Provides Opportunities to Pursue Cutting-Edge Projects on Retirement or Disability Issues
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Dissertation Fellowship Program Provides Funding Opportunities for Doctoral Candidates to Pursue Cutting-Edge Research on Retirement or Disability Issues
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Most Popular Items in the Previous Issue |
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Large Employers and the State Paid Leave Patchwork (PDF)
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2020 Health Savings Account Landscape
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BenefitsLink.com, Inc.
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Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager
Article submission: Online form
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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