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Sticker Shock - What is the Antidote for High Cost Drugs?
RECORDED
University Conference Services

Benefits Litigation - An Ounce of Prevention
May 4, 2018 WEBCAST
McDermott Will & Emery LLP

Employee Benefits and Executive Compensation Symposium
May 8, 2018 in AZ
Ogletree Deakins

Why are Healthcare Prices So High, and What can be Done about Them?
May 9, 2018 in DC
Kaiser Family Foundation

The Current Event: An Intimate Exchange of Current Trends in the Benefits & Insurance Space
May 17, 2018 in NY
Corporate Synergies

Benefits and Compensation: Implications of Tax Reform on Executive Compensation, Fringe Benefits, and Misconduct Settlements
May 29, 2018 WEBCAST
Morgan Lewis & Bockius LLP

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Mental Health Parity Guidance from DOL Includes Proposed FAQs and Updated Self-Compliance Tool

"The FAQs address whether specified plan designs are NQTLs and, if so, whether the plan designs are consistent with the MHPAEA.... [and] include questions involving ERISA disclosure requirements for MH/SUD benefits.... The DOL also issued an updated draft MHPAEA disclosure template ... [and] an updated MHPAEA self-compliance tool for use by plans in evaluating whether they are compliant with the MHPAEA. According to the DOL, the tool is the same audit checklist used by [EBSA] investigators in the enforcement context." Thomson Reuters Practical Law

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

Learn how to avoid common administration mistakes, implement best practices and be aware of interactions with other laws.

CMS Proposes Changes in Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System

"While hospitals are already required under guidelines developed by CMS to either make publicly available a list of their standard charges, or their policies for allowing the public to view a list of those charges upon request, CMS is updating its guidelines to specifically require that hospitals post this information. The agency is also seeking comment on what price transparency information stakeholders would find most useful and how best to help hospitals create patient-friendly interfaces to make it easier for consumers to access relevant health care data so they can more readily compare providers." [Also see a fact sheet and the CMS proposed rule .]
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Mental Health Parity: Does Your Health Plan Measure Up?

"[EBSA] provides a self-compliance tool that you can walk through answering various questions about your plan and the coverage it provides.... [T]he tool is not something you can expect to fly through on a lazy afternoon. The roadmap it provides will require some in-depth time spent reviewing your plan(s). However, the exercise it provides is a good process to help you further understand Mental Health Parity requirements." Compliance Dashboard

The Impact of Prescription Drug Rebates on Health Plans and Consumers (PDF)

37 pages. "[W]hile PBMs have undoubtedly gained financially from the rebate system, the notion that they divert a large share of rebates to excess prof its is not supported by our analysis. We estimate total PBM profits (excluding mail order) of $11 billion, compared to $89 billion in rebates passed through to payers. Even if half this total profit was 'excess,' such excess would represent a small share of rebates, and eliminating it would reduce premiums by only about 2%." Altarum

Rebates, Coupons, PBMs, and the Cost of the Prescription Drug Benefit

"We estimate that total PBM profits in 2016 were about $11 billion or 4.5 percent of PBM revenues (this excludes revenues and profits from PBM-operated mail-order and specialty pharmacies). It is difficult to judge how much of these profits might be deemed 'excessive' due to the inappropriate diversion of rebate dollars to PBM bottom lines. But even if half was found to be excessive, it would amount to less than $6 billion dollars, or roughly 10 percent of total rebates to Medicare Part D and private plans[.]" Health Affairs

What's Next for Your Benefit Plans?

Employ the right strategies to save time and money on your most important benefit plans. Attend the Chicago Mid-Sized Retirement & Healthcare Plan Management Conference, June 10-13. Register today and receive $200 off!

FAQs About Prescription Drug Pricing and Policy (PDF)

38 pages. "This report will address frequently asked questions about government and private-sector policies that affect drug prices and availability. Among the prescription drug topics covered are federally funded research and development, regulation of direct-to-consumer advertising, legal restrictions on reimportation, and federal price negotiation. The report provides a broad overview of the issue s as well as references to more in-depth CRS products. The appendices provide references to relevant congressional hearings and documents and a directory of CRS prescription drug experts." [Report R44832, Apr. 24, 2018] Congressional Research Service [CRS]

AHIP Sees SCOTUS Ruling as a Win for Generic Drugs

"A U.S. Supreme Court ruling this week that upholds the constitutionality of a patent review process is being hailed as a win for consumers by the health insurance industry. America's Health Insurance Plans says the high court's 7-2 decision in Oil States Energy Services v. Greene's Energy Group upheld the inter partes review process as a way to prevent drug manufacturers from inappropriately prolonging patent monopolies past the time intended by Congress."
HealthLeaders Media

The HSA in Your Future: Defined Contribution Retiree Medical

"This variant will ... likely be limited to Medicare-eligible retirees, using a Medicare Advantage or Medigap exchange, where coverage is retiree pay all -- financed by accumulated Health Savings Account assets.... [T]his alternative is all about reducing expense while improving both the real and perceived value of the Total Rewards Package." Plan Sponsor Council of America [PSCA]

Ideas for Funding Your HSA

"Currently, you cannot transfer money from a 401(k), 457 or other type of retirement plan. However, if you have a 401(k) from a former employer, you may be able to roll those funds into a traditional IRA and then transfer it to your HSA. You can also transfer funds from a SEP (self-employed plan) or Simple IRA as long as the plan is no longer considered ongoing." DataPath

GAO Report: CMS Innovation Center -- Model Implementation and Center Performance

"To assess the center's overall performance, the Innovation Center established performance goals and related measures and reported meeting its targets for some goals in 2015, the latest year for which data were available ... Innovation Center officials told GAO that the center also recently developed a methodology to estimate a forecasted return on investment for its model portfolio. The center is in the early stages of refining the methodology and applying it broadly across its models." [GAO-18-302, published Mar. 26, 2018, released Apr. 25, 2018] U.S. Government Accountability Office [GAO]

Lobbyist Attention Spikes on Small Business Health Plans

"The increase in lobbying related to small business health plans came as the [DOL] ... introduced a proposed rule that would expand access to ... association health plans.... At least 84 lobbying disclosures filed on behalf of 75 organizations included association health plans or related legislation as an issue between Jan. 1 and March 31." Bloomberg BNA

Letter from Trade Groups to Congress on Proposal for Mental Health Parity Penalty Rules

"On behalf of the employer community, we write to urge you to reject proposals to create a new civil monetary penalty regime pursuant to mental health parity (MHP) rules. Employers continue to be committed to providing quality benefits -- both medical/surgical and mental health benefits.... [C]reating a new penalty regime at this time is unwarranted, and may in fact result in a decline in, rather than an improvement in, mental health benefi ts for patients." American Benefits Council and six employer and insurance industry organzations

QSEHRA and Medicare

Can a small business employer with less than 20 employees, who offers group health insurance, sponsor a section 105 Health Reimbursement Plan to reimburse employees who opt out of the group offering and enroll in Medicare Part B, D and supplement? BenefitsLink Message Boards

HSA/FSA Benefit Year vs. Calendar Year

The IRS sets FSA and HSA limits based on calendar year. Our benefit year is 10/1 to 9/30. Can we set up our plans so the limits follow the benefit year rather than the calendar year? I've not seen this done but I've been told that our legal department has approved this process if we stay consistent. BenefitsLink Message Boards

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Press Releases

Ascensus Continues to Expand Retirement and Consumer-Directed Healthcare Capabilities with Agreement to Acquire Benefit Planning Consultants, Inc. Ascensus

Lisa S. Boehm Named Employee Benefits Lawyer of the Year Verrill Dana LLP

Findley Davies | BPS&M Rebrands as Findley Findley

Former Lexington Resident Sentenced to 41 Months for Theft from Pension Plans Employee Benefits Security Administration [EBSA], U.S. Department of Labor

HERO Announces Board of Directors, Adds Three New Members Health Enhancement Research Organization [HERO]

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