Health & Welfare Plans Newsletter

November 12, 2020

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[Official Guidance]

Text of IRS Pub. 5165: Guide for Electronically Filing ACA Information Returns for Software Developers and Transmitters, Processing Year 2021 (PDF)

72 pages. "[This publication] outlines the communication procedures, transmission formats, business rules and validation procedures for information returns transmitted electronically through the AIR System.... The procedures in this publication should be used when the following information returns are transmitted electronically for Tax Year (TY) 2015, TY2016, TY2017, TY2018, TY2019 and TY2020 in PY2021: [1] Form 1094-B, Transmittal of Health Coverage Information Returns; [2] Form 1095-B, Health Coverage; [3] Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns; [4] Form 1095-C, Employer-Provided Health Insurance Offer and Coverage. This publication does not contain information or procedures for filing Form 1095-A." Icon to read more

Internal Revenue Service [IRS]

[Guidance Overview]

Colorado Voters Approve Paid Family and Medical Leave Law

"Colorado must launch a paid family and medical leave insurance (PFMLI) program, with contributions beginning in 2023 and benefits available in 2024.... The PFMLI program will provide partial wage replacement for 12–16 weeks of leave, depending on the circumstances. Employees will be able to take paid leave for many of the same reasons permitted under the federal [FMLA]. The program also will extend paid leave so victims of domestic violence, sexual assault or stalking can handle related issues." Icon to read more

Mercer

Furloughs, Layoffs, ACA Measurement Periods and Next Year’s Medical Plan Eligibility: Chaos Gives Way to Confusion

"As if 2020 has not already wrought enough chaos, many employers are finding that their medical plan eligibility rules are about to add insult to their employees' injuries triggered by furloughs, layoffs or reduced work hours in 2020. Those reduced hours in 2020 may cause a loss of medical plan eligibility for those employees in 2021. There are ways out of the bind but avoiding that bind will often require agreement of the medical plan's insurer or stop-loss carrier." Icon to read more

Lockton

Supreme Court Arguments: Even If Mandate Falls, Rest of ACA Looks Likely to Be Upheld

"The argument touched on all three core issues of the litigation: whether the plaintiffs have standing to sue, the continued constitutionality (or not) of the individual mandate, and whether the rest of the ACA can be severed if the mandate is unconstitutional.... There was virtually no discussion of the ACA's substantive provisions beyond the mandate and the preexisting condition protections[.]" [California v. Texas, No. 19-840; Texas v. California, No. 19-1019 (cert. pet. granted Mar. 2, 2020; oral arg. Nov. 10, 2020)] Icon to read more

Health Affairs Blog

Well Beyond Work: Strengthening Your Health, Disability, and Workers' Compensation Benefit Plans

"Employers can build strategies to control health care, absenteeism, and lost productivity costs by adopting a company-wide culture of integrated benefits that promote employee safety, health, and overall well-being around the clock. An approach for consideration is through a comprehensive approach and integration of three core areas: [1] Employee safety and preventive health care ... [2] Health care management ... [3] Recovery and continued health promotion." Icon to read more

ABD Insurance & Financial Services

Court Advances Title VII Case Challenging Health Plan’s Exclusion of Same-Sex Spouses

"While this case was brought against a labor union and welfare fund, the underlying principles apply equally to employers and employer-sponsored health plans, which are clearly subject to Title VII. As this case illustrates, the full implications of Bostock—including its application to employee benefit plans—are evolving in the courts." [Jimenez v. Laborer’s Welfare Fund, No. 18-7886 (N.D. Ill. Oct. 8, 2020)] Icon to read more

Thomson Reuters / EBIA

[Opinion]

After Taking the Bait, the Chief Justice Prepares to Switch on the ACA

"[Chief Justice Roberts] suggested that he would again save the ACA through severance but do so by recognizing that the basis of his earlier opinion is now invalid. Indeed, Roberts himself could find the individual mandate unconstitutional. So, Roberts could create a curious precedent: he saved the ACA in 2012 by declaring the individual mandate essential to the survival of Act and then may save the ACA again in 2020 by declaring that the individual mandate is not essential to the survival of the Act." [California v. Texas, No. 19-840; Texas v. California, No. 19-1019 (cert. pet. granted Mar. 2, 2020; oral arg. Nov. 10, 2020)] Icon to read more

Prof. Jonathan Turley

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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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