Health & Welfare Plans Newsletter

July 14, 2017

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[Official Guidance]

Text of Draft 2017 IRS Form 1095-A (PDF)
"This Form 1095-A provides information you need to complete Form 8962, Premium Tax Credit (PTC). You must complete Form 8962 and file it with your tax return (Form 1040, Form 1040A, or Form 1040NR) if any amount other than zero is shown in Part III, column C, of this Form 1095-A (meaning that you received premium assistance through advance credit payments) or if you want to take the premium tax credit."
Internal Revenue Service [IRS]

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New York Sets Paid Family Leave Contribution Rate
"[F]or those employees earning less than the New York average weekly wage, the contribution will be 0.126% of the weekly income they earn. For those earning more than the New York average weekly wage, the contribution amount will be capped at 0.126% of that state average weekly wage. Currently, the New York average weekly wage is set at $1,305.92. So ... the maximum contribution rate ... is $1.65 per week per employee."
Corporate Synergies

Oregon Clarifies Paid Sick Leave Law
"Foremost among the changes was the addition of language in the statute that permits employers to limit the accrual of paid or unpaid sick time of their employees to 40 hours per year.... This change brings greater clarity to the law and its application for employers following the 'accrual' method of calculating time for their employees."
Littler

People Don't Take Full Advantage of Health Savings Accounts
"A recent report ... indicates that account holders appear to be using HSAs as a special checking account instead of an investment vehicle, despite tax incentives offered to participants that wish to set aside money for future medical expenses.... While employers hope that these account-based plans will encourage employees to shop around for the most cost-effective health care, [another] study indicates employers may also want to do their own shopping when deciding which HSAs to offer."
Bloomberg BNA

Medicare Trustees: Fund Is Solvent Through 2029
"[The 2017 Medicare Trustees report projects] that the trust fund financing Medicare's hospital insurance coverage will be depleted in 2029, one year later than projected in last year's report. Lower spending in 2016, lower projected inpatient hospital utilization and slightly better projected hospital insurance deficit in 2017 than in 2016 were the contributing factors ... [B]ecause spending levels in Medicare did not exceed its targets, the Independent Payment Advisory Board (IPAB), set up by the (ACA), was not triggered."
U.S. Department of Health and Human Services [HHS]

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Senate GOP Leadership Unveils Latest Version of Health Reform Legislation
"The Cruz amendment provides that an insurer could offer 'skinny' plans that do not comply with ACA requirements in a rating area for a plan year, as long as the insurer certified to HHS that it would make available at least one gold plan (80 percent actuarial value), one silver plan (70 percent actuarial value), and one plan with an actuarial value of 58 percent (the new benchmark level for determining premium tax credits) in the entire rating period for the plan year.... The July 13 amendment provides $70 billion for state stability funds. For the years 2020 to 2026, the Cruz amendment would require HHS to pay these funds to insurers that offer ACA compliant plans ... States with skinny plans could use money they receive under the stability fund to reduce premiums for ACA compliant plans."
Health Affairs

GAO Report: Improvements Needed in CMS and IRS Controls over Health Insurance Premium Tax Credit
"Although CMS properly designed and implemented control activities related to the accuracy of advance PTC payments, it did not properly design control activities related to preventing and detecting improper payments of advance PTC, such as verifying individuals' eligibility. As a result, CMS is at increased risk of making improper payments of advance PTC to issuers on behalf of individuals." [GAO-17-467, published and released July 13, 2017]
U.S. Government Accountability Office [GAO]

Uneven Playing Field: Senate Bill Would Apply Different Rules to Competing Health Plans
"[An] amendment to the BCRA, suggested by Senator Ted Cruz (R-TX), reportedly would allow insurers in the non-group market to also sell some policies that would not be required to follow all of the ACA market rules.... This brief examines the likely impact of such a change on the stability of coverage offered through non-group markets and on the number of individuals who might be affected."
Henry J. Kaiser Family Foundation

[Opinion]

No 'Freedom Option' in the Revised Senate Health Care Bill
"This draft imposes ObamaCare's 'single risk pool' price controls on 'freedom option' plans. Long story short, that means there is no 'freedom option' in this bill. Insurers probably would not even offer non-compliant plans. If they did, ObamaCare's 'single risk pool' price controls would make secure, guaranteed-renewable health insurance impossible by taxing such plans to death."
Cato Institute

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[Opinion]

American Benefits Council Letter to CMS on Reducing Regulatory Burdens Imposed by the ACA
"Specific solutions for reducing regulatory burden for employers include: Facilitating electronic disclosure ... Minimizing unnecessary and duplicative notices and disclosures ... Reducing regulatory burden for HIPAA administrative simplification ... Allowing for centralized employer exchange notice administration and requiring use of uniform forms[.]"
American Benefits Council

[Opinion]

U.S. Chamber of Commerce Comment Letter to HHS on Reducing Regulatory Burdens Imposed by the ACA
"[The Chamber has] identified a series of legislative and regulatory changes that could provide significant assistance to businesses that offer health insurance products in the individual and small group markets, as well as businesses that offer health coverage to their employees and their employees' families as an employment benefit.... [T]hree other items submitted with this comment letter: [1] 5-page chart on 'Health Care Regulatory Work'; [2] 10-page chart on 'Important Regulatory Steps;' and [3] 21-page document on '2017 Health Care Policy Recommendations.'"
U.S. Chamber of Commerce

Benefits in General

The Rise of the Mobile Devices: Putting Benefit Communication in Your Participants' Hands (PDF)
"Because the vast majority of us expect access to information anywhere from any device 24/7, it makes sense that we should consider a commitment to incorporate mobile devices, particularly smartphones, to provide benefits information to our audiences.... The thinking around creating a communications plan that uses smartphones is different from other media you may use."
International Foundation of Employee Benefit Plans [IFEBP]

Press Releases

National Alliance Elects New Board Leadership; Adds New Members National Alliance of Healthcare Purchaser Coalitions

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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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