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20th Annual EBIA Advanced Cafeteria Plans and Benefits Conference
July 10, 2018 in WA
Thomson Reuters / EBIA

Employee Benefit Plans of Tax-Exempt and Governmental Employers 2018
September 24, 2018 in DC
American Law Institute Continuing Legal Education Group [ALI CLE]

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New York City Employers Must Take Immediate Steps to Comply with Expanded Sick Leave Law

"The recent amendments to the Act give employees the right to take safe leave, which can be used to seek assistance or take other safety measures if the employee or a family member is the victim of domestic violence, unwanted sexual contact, stalking or human trafficking. Additionally, the Act broadens the definition of a covered family member." Fisher Phillips

Employee Health, Benefits, & Well-Being Congress | July 30-31

Who is moving the needle on employee health care? This event convenes HR, benefits, and wellness executives, TPAs, Brokers, Payers, and Providers to learn and discuss strategies to enhance employee health and improve outcomes while reducing costs.

How Yearlong Paid Leave Works

"The Bill & Melinda Gates Foundation's benefit for new parents -- 52 weeks of paid leave ... has been a resounding success from a retention and recruiting standpoint, with only two of the 222 participants deciding to leave the foundation to be at-home parents.... Filling the job of someone on parental leave may involve an employee making a lateral move or several people taking on parts of a role." Society for Human Resource Management [SHRM]

New Hampshire Employers, Are You Ready for Potential Paid Family Leave Law?

"The bill would set up a trust fund with the New Hampshire Department of Employment Security into which employees (not employers) could pay a small portion of their wages. Employees would then be eligible to apply for funds to cover 60% of their pay when they are on FMLA leave." HR Daily Advisor

Fiduciary Responsibility in Healthcare Plans: Best Practices for Healthcare Plan Management

"[1] [A]ctively manage ... plans like a business.... [2] [I]nsist on openness and transparency in ... dealings with service providers ... [3] [C]ontract with primary care providers whose focus is on the wellbeing of the patient ... [4] [S]eek out centers of excellence for the provision of medical services.... [5] [S]eek to manage end of life costs and the costs of chronic disease.... [6] [Help] employees intelligently manage their use of plan benefits with access to data, concierge services, and other resources." Fiduciary Plan Governance, LLC

Majority of Small Business Owners Are Worried About Cost of Health Coverage for Workers

"Nearly 80 percent of small business owners are worried about the cost of health insurance coverage, and 62 percent said that a 15 percent increase in premiums would make their current group health insurance coverage unaffordable ... Sixty-four percent of survey respondents said that they offered small business coverage because it helps them hire and retain the best workers. And nearly half (47 percent) show this commitment by covering 75 percent or more of employee health insurance premiums." Wolters Kluwer Law & Business

Health Savings Accounts (HSAs): Compliance Obligations Under the Internal Revenue Code and ERISA

May 30 webinar. Complex employer health care offerings can make it difficult to determine HSA eligibility. This webinar will help health plan administrators navigate this sometimes treacherous terrain. Discount for BenefitsLink readers .

Building a Better Health Plan Network

"Most employers still use a national strategy to select provider networks, but some are beginning to quilt together the best options by location and even using incentives to steer to these options.... Use your in/out-of-network utilization, center of excellence penetration, total cost of care trend, accountable care organization (ACO) attribution and other metrics to establish a baseline comparison to what is available in the market.... For each alternative, understand the financial, quality, member and administrative impact." Mercer

The New Drug Blueprint: What's In It for Employer Plans?

"Revisiting how rebates are handled won't necessarily lower drug prices and we think it's fair to assume that PBMs/insurers will make up any lost revenue in a different way. Check your PBM contract -- PBMs/insurers frequently include a provision that allows them to re-rate the contract in the event of a change in the laws and regulations around rebates.... If PBMs were identified as plan fiduciaries, they would be accountable for negotiating in the best interest of the plan and its members. This could certainly change the dynamics of current PBM relationships and, if adopted, keep PBMs from accepting certain types of payments from both manufacturers and health plans." Mercer

Ninth Circuit Determines 'Direct and Sole Cause' Doesn't Mean What It Says under 'Accidental' Injury Plan

"[T]he Ninth Circuit ruled that an accident plan that covers 'accidental injury that is the Direct and Sole Cause of a Covered Loss' really covers many losses that have causes other than the accidental injury. And the court held that an illness does not 'contribute to' a loss unless it is a 'substantial cause' of the loss. In so holding, the Court: relied on some Congressional policies underlying ERISA while ignoring others; and read language into a Plan that was not there." [ Dowdy v. Metropolitan Life Ins. Co. , No. 16-15824 (9th Cir. May 16, 2018)]
Robinson & Cole LLP

Tax Court Denies Mileage Deduction and Penalizes Tax Attorney for Inadequate Substantiation

"Even though the regulations under Code Section 274(d) allow vehicle expense deductions to be established by testimony and 'other corroborative evidence,' that form of substantiation will often be found inadequate. This also affects employers that provide company cars, or reimburse employees for business use of employees' personal vehicles, because the income exclusions for those fringe benefits rely on either the working condition fringe rules or the accountable plan rules, both of which incorporate the strict substantiation requirements of Code Section 274(d) when applied to vehicle expenses." [ Velez v. Comm'r , T.C. Memo. 2018-46 (Apr. 5, 2018)]
Thomson Reuters / EBIA

CMS Sends Clear Message to Plans: Stop Hiding Information from Patients

"[On May 17, CMS] sent a letter to companies that provide Medicare prescription drug coverage in Part D explaining that so-called 'gag clauses' are unacceptable, as part of the Administration-wide 'American Patients First' initiative to lower prescription drug costs."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Democratic Attorneys Generals Allowed to Intervene in Individual Mandate Litigation

"The 17 intervenor states will now be able to defend the ACA and represent their interests alongside the Trump administration. Although there is nothing to suggest that the Trump administration will not defend the ACA, the federal government has not yet filed a substantive response in the litigation." Health Affairs

Trump Administration's Rx 'Blueprint' Will Need More Action Steps to Tackle Prices

"Despite its length, the blueprint does not address the main culprits driving U.S. drug prices. To start with, drug manufacturers too often game the system by filing frivolous patents to create 'thickets' around their products or by paying generic companies not to manufacturer cheaper versions.... In addition, the blueprint does not identify some of the most effective tools for improved competition and negotiation.... Many have pointed to the president's campaign promises, which called for allowing Medicare to negotiate drug prices and the importation of drugs from other countries. These ideas are notably missing from the blueprint." The Commonwealth Fund

State-By-State Estimated Premium Increases Due to Individual Mandate Repeal and Short-Term Plan Rule

"Given the mandate's important role in encouraging healthier people to enroll in the marketplaces, the Congressional Budget Office estimates that, in 2019, this will increase average premiums in the individual market by 10 percent. Furthermore, in February 2018, the Trump administration proposed a rule to expand short-term health insurance plans.... Using estimates from the Urban Institute, this column projects average state-by-state premium increases for 2019, in dollars. Estimated premium increases ... average $1,013 nationally for benchmark premiums for a 40-year-old individual." Center for American Progress

Financial Stability Board Consults on Compensation Data Reporting to Address Misconduct Risk

"As part of its 2015 workplan to reduce misconduct risk in financial institutions, the Financial Stability Board ... published a public consultation on [May 7] on recommendations for consistent national reporting of data on the use of compensation tools to address misconduct risk. The recommendations are intended to enhance the capacity of financial supervisory authorities to monitor the effectiveness of compensation tools and other mechanisms in promoting good conduct." Morgan Lewis

Press Releases

Susan Neely Named President and CEO of the American Council of Life Insurers American Council of Life Insurers

BPAS Joins LPL Financial Retirement Partner Program BPAS

OneAmerica Unveils Innovative Profit-Sharing Retirement Plan Design OneAmerica

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