Health & Welfare Plans Newsletter

October 14, 2016

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Employee Benefits Jobs

Retirement Plan Administrator
Leading Retirement Solutions
in WA

Benefits Analyst
Universal Health Services, Inc.
in PA

DC Administrator
Retirement Systems of Arizona
in AZ

Client Service Administrator - Retirement Plans
MCF Advisors, LLC
in KY

ERISA 3(16) Defined Contribution Manager
The Angell Pension Group, Inc.
Telecommute

Retirement Plan Coordinator
Summit Benefit Solutions, Inc.
in OH

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Webcasts and Conferences

ACA Check-up: What's the Prognosis for the Exchanges?
October 26, 2016 WEBCAST
National Institute for Health Care Management Foundation

Mandatory Holding Periods (After Vesting) for Equity Awards: The Intersection of Governance, Accounting, and Plan Design
November 2, 2016 WEBCAST
LRP Publications

Capital Market Update
December 14, 2016 WEBCAST
Conference of Consulting Actuaries

ERISA Fiduciary Investment Basics 2017
March 20, 2017 WEBCAST
Practising Law Institute

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[Guidance Overview]

Section 1557 Notice Requirements Become Effective October 16, 2016
"A covered entity that operates or administers a covered health plan must issue a notice stating that the covered entity does not engage in discrimination that is prohibited by Section 1557. The notice must also include information about [1] auxiliary aids or services available to individuals with disabilities; [2] language assistance services available to individuals with limited English proficiency; and [3] information about how to file a grievance with the covered entity ... or a complaint with HHS ... The notice must also include tag lines written in certain specified foreign languages."
Seyfarth Shaw LLP

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[Guidance Overview]

CMS Announces 2016 Transitional Reinsurance Fee Submission Process
"The deadlines for the 2016 transitional reinsurance fee are approaching. The process is largely unchanged from 2015. Enrollment counts for purposes of determining the 2016 reinsurance fee must be submitted by November 15. Also, the second contribution for the 2015 reinsurance fee must be made by November 15."
Xerox HR Services

[Guidance Overview]

IRS Releases Final Version of ACA Reporting Forms for 2016
"Some of the changes contained in the 2016 versions (of the forms and instructions) include: The end of certain transition relief.... The end of 'good faith' relief.... Reporting COBRA offers of coverage.... 'ALE Member' replaces 'Employer'.... Reporting Spousal Coverage.... Filing deadlines no longer extended.... Increased penalties."
The Wagner Law Group

Evidence of Insurability Requirement Does Not Bar Beneficiary's Life Insurance Claim; Premium Payments Sufficient to Establish Coverage Amount
"The Sixth Circuit has upheld a beneficiary's right to benefits under an employer's group-term life insurance plan after the insurer denied those benefits because the deceased employee failed to submit evidence of insurability.... Equating the term 'elected' with being 'covered,' the court opined, was an impermissible modification of the policy, not an interpretation ... [T]he court concluded that the increased withholding from the employee's pay was sufficient evidence of the employee's request for increased coverage[.]" [ Brown, III v. United of Omaha Life Ins. Co. , No. 15-4293 (6th Cir. Sept. 14, 2016)]
Thomson Reuters / EBIA

Practical Tips for Addressing Suspected FMLA Abuse
"[1] Conduct a thorough investigation before contacting the employee.... [2] Schedule a meeting with the suspect employee.... [3] In the event of termination, document everything."
Polsinelli PC

[Advert.]

5th Annual Telehealth and Remote Patient Monitoring Summit - Jan. 25-26, 2017 - Atlanta, GA

Sponsored by World Congress

Telehealth execs discuss engaging providers & consumers in digital health to optimize ROI & improve population health. Promo Code BLINK2 takes $200 off your registration (May not combine w any other offer. Not valid twd Govt Rate/Workshop Only/Webcast)


Address HSA Misconceptions During Open Enrollment
"[E]mployers should use open enrollment to position the HSA program as an enhancement to the benefits package.... Send the message that employees can win financially by enrolling in an HSA ... Employees often ... mistakenly apply the 'use it or lose it' feature of health care flexible savings accounts (FSAs) to an HSA ... Employees also can take their HSAs with them when they change jobs or retire."
Society for Human Resource Management [SHRM]

Effective Benefits Communications Can Pay Off
"Benefits communications need to make the case to employees that a better understanding of their benefits can pay off in better health or financial gain. Simply providing tools without explaining their value may otherwise result in ineffective use or discouraging results.... Tools that may increase preventive care utilization include online directories to find in-network providers, preventive health schedules, and email or text message reminders to visit a provider.... More widespread use of cost calculators could make a large difference in employees' out-of-pocket health expenses due to the variation in cost among providers -- if employees are motivated to shop for health care procedures."
Marsh Consulting Group

Continuing Assaults on Surprise Out-of-Network Bills
"In September California Governor Brown signed Assembly Bill 72 requiring that policies issued on or after next July 1 provide that if an insured patient receives covered services at an in-network facility from an out-of-network provider, the patient needn't pay more than the in-network provider rate. There is an exception when the patient has specifically consented to the higher rate; that bill wouldn't be a surprise.... New York State protects patients from surprise bills not only when they are treated at an in-network facility but also when referred by an in-network physician to an out-of-network physician or service provider, including laboratory services."
Faegre Baker Daniels LLP

How Narrow Is It? HHS Begins Test of Comparison Tool for Health Plan Networks
"[HHS] recently announced that the pilot project to test the network breadth tool just got a little, well, narrower.... The new tool will designate marketplace health plan networks as 'basic,' 'standard' or 'broad' based on how they compare with other health plan networks in a county. The label will reflect the availability of three types of providers: primary care, pediatricians and hospitals. Originally, network-breadth information was going to be available for the 35 states on HealthCare.gov, the federally facilitated marketplace. But in August HHS announced it would make the tool available in just six unnamed states."
Kaiser Health News

As Costs Go Up, FEHBP Benefits Don't Keep Pace
"[OPM] recently announced that premiums under the Federal Employees Health Benefits Program [FEHBP] would go up by an average of 4.4 percent, with an increase to the employee share of the premium of 6.2 percent.... According to [HHS], prescription drug spending is projected to rise by an average of 7.3 percent annually from 2013 to 2018."
Government Executive

The ACA's Cost-Sharing Reduction Plans: A Key to Affordable Health Coverage for Millions of U.S. Workers
"Cost-sharing amounts in silver plans with [cost-sharing reductions (CSRs)] are much less than those in non-CSR base silver plans; silver plans with CSRs generally offer far better financial protection than those without. General annual deductibles range from $246 for CSR silver plans with a platinum-level actuarial value (94%) to as much as $3,063 for non-CSR silver plans. Out-of-pocket limits vary from $6,223 in base silver plans to $1,102 in silver plans with CSRs and a platinum-level actuarial level."
The Commonwealth Fund

Benefits in General

Text of IRS News Release IR 2016-132: IRS Continues to Closely Monitor Relief for Hurricane Matthew Victims as Oct. 17 Deadline Approaches (PDF)
"[T]axpayers affected by Hurricane Matthew but not yet covered by a federal disaster declaration ... may qualify for relief from penalties if they are unable to meet Monday's extended deadline for filing 2015 tax returns.... [A]dditional individual assistance areas could be added to the federal disaster area in coming days based on continuing damage assessments by [FEMA]. These additional disaster declarations will pave the way for additional extensions and other relief from the IRS.... Taxpayers affected by Hurricane Matthew ... should file when they are reasonably able. If they live outside the federally-declared disaster area ... they can request abatement of the penalties, based on reasonable cause, by replying in writing to the penalty notice and explaining that they're impacted by the hurricane."
Internal Revenue Service [IRS]

Executive Compensation and Nonqualified Plans

Hot Topics in Executive Compensation
"[1] Mandatory holding periods after vesting are growing in popularity for accounting purposes. [2] A portfolio approach (more than one vehicle) is becoming the norm for delivery of long term incentive compensation. [3] Total Shareholder Return is becoming a more popular performance metric. [4] Clawbacks are becoming more of a standard practice in executive compensation in light of upcoming Dodd-Frank regulations. [5] Use of stock options is becoming less common because of accounting issues and advisory firms' stance that they are not pay for performance."
Findley Davies

Press Releases

Sentinel Benefits Names New CEO Sentinel Benefits & Financial Group

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2016 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 that content. You may not alter or remove any trademark, copyright or other notice from copies of the content.

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