Health & Welfare Plans Newsletter

April 2, 2018

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Direct Primary Care Legislation Continues Its Roll Across the Country
"Direct primary care (DPC) is a style of clinical practice in which a healthcare provider ... offers primary care services to patients who pay a monthly membership fee for the provision of primary care services at no additional charge to the patient/member.... Florida Governor Rick Scott signed the 'Direct Primary Care Agreements' bill (HB 37) to amend the Florida Insurance Code and, in turn, made it clear that DPC agreements between physicians and patients do not constitute the making of insurance and therefore do not have to comply with the terms of the Florida Insurance Code."
Sheppard Mullin

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Walmart-Humana - Next Disruptor in Health Care?
"Walmart has on-site clinic experience ... Today Humana's footprint in the group market is as a regional player with strength in the southern states. At a time when the number of national group insurance options have been shrinking, could a partnership with Walmart catapult them into the arena with other national players? ... Walmart and Humana already partner on Medicare Part D drug plans."
Mercer

HIPAA in Due Diligence: Four Key Questions
"To better understand a seller's overall HIPAA compliance, there are four key diligence questions upon which buyers should focus their efforts in a transaction: [1] Does the seller have the core HIPAA documentation in place? ... [2] Is the seller complying with its policies? ... [3] How does the seller address potential HIPAA security and breach risk areas? ... [4] What is the nature of risk related to any identified gaps?"
McGuireWoods, LLP

Managing Healthcare Benefits Cost Remains Top Priority for HR Professionals
"[W]hile two-thirds of respondents say one of their 2018 goals is to better manage health benefits costs, 49% do not plan to implement any new cost management programs in the next 12 to 18 months. What's more, 54% believe they have done all they can reasonably do to control rising medical costs."
HR Daily Advisor

Employee and Employer Premiums for Medical Care Benefits in 2017
"The median monthly premium paid by employees of small (1 to 49 workers) private establishments for single coverage was $127.75 in 2017. That compares with $100.00 for single coverage in small state and local government organizations. Government employees in large organizations (500 workers or more) paid a median premium of $433.08 for family coverage, while private industry workers paid $363.00."
U.S. Bureau of Labor Statistics [BLS]

Interaction of Health FSAs and Health Savings Accounts (PDF)
"This article explains how Health FSAs and HSAs work together and provides answers to some common questions posed by employers with respect to the complex interaction between these two consumer-driven benefit designs."
EPIC

Previous Inaction on Performance Issues, Positive Reviews, Cast Doubt on Motivation for Post-FMLA Firing
"Though an employer argued that certain events during an employee's FMLA leave were the 'final' straw that led to her being terminated following her return from a six-week FMLA leave, triable issues prevented a federal court in Wisconsin from granting its motion for summary judgment on her claims of FMLA interference and retaliation. The employer would have to explain to a jury why, after years of inaction and solid reviews, it suddenly chose to act on alleged, longstanding concerns about her performance only a few days after she returned from leave." [ Degner v. Juneau County Dept. of Human Services , No. 16-674 (W.D. Wis. Mar. 5, 2018)]
Wolters Kluwer Law & Business

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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 2018 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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