Health & Welfare Plans Newsletter

June 27, 2017

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Regional Director, Non-Qualified
Newport Group
in AL, FL, IL, MN, NC, VA

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Actuaries Unlimited, Inc.
in CA

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Webcasts and Conferences

401(k) Investment Menu Options: Stable Value Funds vs. Money Market Funds
RECORDED
Clear Law Institute

Filling the Void in Guaranteed Retirement Income
RECORDED
fi360

Municipal Bankruptcy and Public Pensions
RECORDED
Society of Actuaries

Hot Topics and Best Practices in Employment and Benefits Law When Doing Business in California
July 11, 2017 in CA
Akerman

SEP - IRAs
July 12, 2017 WEBCAST
Collin W. Fritz & Associates, Ltd.

Understanding Transfers, Direct Rollovers and Rollovers To IRAs and From IRAs
July 12, 2017 WEBCAST
Collin W. Fritz & Associates, Ltd.

Lunch N? Learn - Update for Plan Sponsors
July 19, 2017 in NJ
WithumSmith+Brown

Transportation Fringe Benefits: Everything You Need to Know About Who, What, and How to Qualify
July 21, 2017 WEBCAST
Clear Law Institute

Nonqualified / Executive Compensation Plans
July 25, 2017 WEBCAST
ASPPA [American Society of Pension Professionals & Actuaries]

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Discussions

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New Comments and Topics

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[Guidance Overview]

Employers Offering Mental Health Benefits Should Prepare for More Scrutiny
"Only three pages long, the model form focuses on one of the more complicated aspects of the MHPAEA: its rule against applying nonquantitative treatment limitations (NQTLs), such as process or evidentiary standards, more stringently to mental health and substance use disorder benefits than they are applied to medical or surgical benefits. (The form does not cover quantitative limits such as caps on office visits or counseling sessions.) Participants could use the form before receiving treatment or as part of an effort to challenge a claim denial related to those limits."
Ogletree Deakins

[Advert.]

Online Learning Course: Family and Medical Leave Act (FMLA)

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

This course identifies coverage and eligibility requirements of employees and responsibilities of employers, and describes how to avoid common administration mistakes, implement best practices and be aware of interactions with other laws.


[Guidance Overview]

Cook County, Illinois, Issues Final Paid Sick Leave Regulations
"Although the final regulations are similar to the draft regulations, they differ in notable ways.... [S]ince the draft regulations were published, a number of additional municipalities have opted out of the Ordinance.... [T]he Commission also has issued a model posting/notice to employees regarding their right to earn and use paid sick leave, as contemplated by the Ordinance."
Jackson Lewis P.C.

Second Circuit: New York Law Prohibits Insurance Company from Offsetting Personal Injury Settlement Against Long Term Disability Benefits
"Arnone argued that, because he is a New York resident who was employed in New York and injured in New York, N.Y. Gen. Oblig. Law Section 5-335 applies to his settlement and prohibits Aetna from reducing his LTD benefit.... [T]he court found that: [1] section 5-335 would prohibit Aetna's offset action as a matter of law and, for that reason, would render its decision arbitrary and capricious; [2] section 5-335 is a law that regulates insurance and is saved from express preemption under ERISA; [3] the Plan's choice of law provision sets forth only which jurisdiction's law of contract interpretation and contract construction will be applied, it does not bind the court to apply the full breadth of Connecticut law[.]" [ Arnone v. Aetna Life Ins. Co. , No. 15-2322 (2d Cir. June 22, 2017)]
Roberts Bartolic

Health Savings Account Landscape 2017
46 pages. "Out of the 10 plans [the authors] evaluated, only one looks compelling for use as a spending vehicle and an investment vehicle, suggesting there is much room for improvement across the industry ... Account maintenance fees represent the most important consideration for accountholders intending to use their HSAs as a spending vehicle. The current low-interest-rate environment means accountholders will generate little income from the checking accounts offered by HSAs ... As compared with retail mutual funds, the all-in cost of investing in the HSA plans ... ranges from cheap to expensive."
Morningstar

First Comprehensive Look at Multiemployer Health Plans
"The total number of plans in the study was 1,823 for the 2005 plan year, declined steadily to 1,595 in 2013, and then increased slightly to 1,602 for the 2014 plan year.... The 1,602 health plans in the study had more than five million covered participants.... The plans in the study reported more than 209,000 contributing employers.... One in seven plans (14.7%) have costs above $14,000 per participant per year (PPPY), while one in seven (15.4%) have PPPY costs below $6,000."
International Foundation of Employee Benefit Plans [IFEBP]

[Advert.]

Now is a great time to join Worldwide Employee Benefits Network (WEB)

Sponsored by WEB - Worldwide Employee Benefits Network

WEB members represent more than 25 professions and 30 areas of expertise within the pension and benefits industry -- administrators, consultants, attorneys, accountants, investment managers, communications experts and benefits managers. Join today .


Changing Retiree Medical Plan Benefits to Reduce OPEB Liabilities Under Governmental Accounting Rules (PDF)
"GASB 74 became effective for financial statements for fiscal years beginning after June 15, 2016. As governmental employers have begun to determine and report OPEB liabilities, a question has arise n similar to a question that had earlier arisen in the context of reporting pension liabilities -- whether the governmental employer can make changes to the plan to reduce the amount of liabilities."
Groom Law Group

CBO Presentation: An Analysis of Private-Sector Prices for Physician Services
"Physicians' services account for a substantial portion of health care spending in the United States, but research on the prices private insurers pay for those services has been limited. Using 2014 claims data from three major insurers, we analyzed the prices paid for 21 common services and compared them with the estimated amounts that Medicare's fee-for-service (FFS) program would pay. Consistent with other studies, our results showed that commercial prices were higher than Medicare FFS prices, on average, and that prices for a given service varied as much as twofold across areas and providers, even after adjusting for differences in input costs. Out-of-network prices that insurers paid in commercial plans were as much as three times their in-network prices."
Congressional Budget Office [CBO]

CBO and JCT Cost Estimate for Senate's 'Better Care Reconciliation Act of 2017'
"CBO and JCT estimate that enacting this legislation would reduce the cumulative federal deficit over the 2017-2026 period by $321 billion. That amount is $202 billion more than the estimated net savings for the version of H.R. 1628 that was passed by the House of Representatives. The Senate bill would increase the number of people who are uninsured by 22 million in 2026 relative to the number under current law, slightly fewer than the increase in the number of uninsured estimated for the House-passed legislation. By 2026, an estimated 49 million people would be uninsured, compared with 28 million who would lack insurance that year under current law."
Congressional Budget Office [CBO]

Amended Senate Bill Includes Waiting Period for Those Who Let Coverage Lapse
"The new Senate amendment would allow an insurer in the individual market to impose a waiting period of six months on an enrollee who had had a gap in coverage of 63 days or more during the preceding 12 months.... An individual who lost employer coverage on March 31 -- who would under the ACA be able to get coverage effective April 1 under a special enrollment period for loss of employer-sponsored coverage -- would have to wait until October if he or she had experienced a 63-day gap in coverage during the preceding year prior to getting employer coverage."
Timothy Jost, in Health Affairs

Comparison of Proposals to Replace the Affordable Care Act
"President Donald Trump and Republicans in Congress have committed to repealing and replacing the [ACA]. How do their replacement proposals compare to the ACA? How do they compare to each other? Plans available for comparison: [1] The Better Care Reconciliation Act of 2017 -- Updated 6.26.2017; [2] The American Health Care Act, as passed by the House of Representatives on May 4, 2017; [3] The [ACA], 2010."
Henry J. Kaiser Family Foundation

[Opinion]

The Senate Should Offer a Range of Options to Encourage Continuous Insurance Coverage
"The most effective approach would be to apply the prohibition on pre-existing condition exclusions to only those individuals who can demonstrate continuous coverage during the prior year. This would be the same as the federal rule for employer-group plans that was in place before Obamacare. Other, somewhat less effective alternatives, have also been proposed, such as imposing on those without continuous coverage a premium surcharge, a risk-rated premium or higher deductibles for one year. The goal of all these mechanisms is the same: Return to states authority over insurance market regulation that was pre-empted by Obamacare."
The Heritage Foundation

[Opinion]

Senate Bill Would Raise Premiums, Deductibles, or Both for Most Marketplace Consumers
"[T]he bill's defenders are either mischaracterizing or misunderstanding what CBO says -- which is that most marketplace consumers would pay more in premiums, deductibles, or both, with older consumers facing the highest cost increases. And in many cases, they'd be buying insurance that covered fewer benefits and offered fewer protections."
Center on Budget and Policy Priorities

[Opinion]

Senate Republicans' Obamacare Repeal and Replace Bill Will Not Reduce the Cost of Health Insurance
"Here's the key question: Given that only 40% of the subsidy eligible signed up under Obamacare, will the proposed Senate actions make that 40% take-up rate better or worse? For the life of me, I can't see how it can't be a lot worse. And, if we have an even worse sign-up rate than 40% we can only have relatively fewer healthy people in the pool to pay the claims of the sick. That means costs would be even higher under the proposed Senate bill than what we now have in Obamacare."
Bob Laszewski's Health Care Policy and Marketplace Review

Executive Compensationand Nonqualified Plans

New York Appellate Court Issues Decision on Executive Compensation Order and Regs
"[T]he four-Justice majority concluded that 'limit on administrative costs and executive compensation paid for by state funds and state-authorized payments, [does not] violate the separation of powers doctrine.' In contrast, the Court said that DOH exceeded its authority by imposing the soft cap and restricting executive compensation paid from non-state dollars.... As a result, there is now a conflict between the Appellate Division's Third Department and Second Department, which previously upheld Governor Cuomo's Executive Order and DOH's implementing regulations." [ LeadingAge New York, Inc. v. Shah No. 523308 (N.Y. App. Div. June 22, 2017)]
Greenberg Traurig

Discussions onthe BenefitsLink Message Boards

Handling VEBA Assets When No Employees Are Left After Multiple Acquisitions
"The company that originally set up a VEBA was sold to another company several years later and amended the VEBA's trust. In 2016, that company was acquired by another company. The VEBA has less than $100,000 (all employer- contributed), but there are no employee members and no way to find out who was a member. Can the new company transfer the assets to a charity without being subject to the tax benefit rule? Also, can the company amend the VEBA to include only the new company's medical plan and use the assets for current employee health coverage?"
BenefitsLink Message Boards

Press Releases

PSCA 60th Annual Survey Open PSCA [Plan Sponsor Council of America]

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David Rhett Baker, J.D., Editor and Publisher
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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2017 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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