Defined Contribution Account Manager
Nova 401(k) Associates
in AZ, ID, NV, UT, Telecommute

Plan Termination Account Manager
Nova 401(k) Associates
Telecommute

ERISA / Employee Benefits Attorney
Ogletree, Deakins, Nash, Smoak & Stewart, P.C.
in AZ, CA, CO, CT, DC, FL, GA, IA, IL, IN, KS, LA, MA, MI, MN, MO, MS, NC, NJ, NV, NY, OH, OK, OR, PA, SC, TN, TX, VA, WA, WV

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Develop a Strong Parental Leave Policy
July 25, 2018 WEBCAST
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Text of IRS Rev. Proc. 2018-34: 2019 Updates for ACA Applicable Percentage Table and Employer Required Contribution Percentage (PDF)

"[This revenue procedure] updates the Applicable Percentage Table in Section 36B(b)(3)(A)(i) to provide the Applicable Percentage Table for 2019. This table is used to calculate an individual's premium tax credit. This revenue procedure also updates the required contribution percentage in Section 36B(c)(2)(C)(i)(II) ... [which] is used to determine whether an individual is eligible for affordable employer-sponsored minimum essential coverage under Section 36B.... For plan years beginning in 2019, the required contribution percentage for purposes of Section 36B(c)(2)(C)(i)(II) and Section 1.36B-2(c)(3)(v)(C) is 9.86%."
Internal Revenue Service [IRS]

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

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Text of CMS Memo: Enrollee-Level Edge Dataset for Research Requests (PDF)

"Beginning in the Fall of 2018, ... interested parties could request the 2016 benefit year dataset through the CMS research data request process. Requestors will be required to submit a research purpose statement and sign a data use agreement (DUA) to ensure that the data will be used for the stated research purpose only.... In anticipation of future data requests, this document provides a description of the 2016 enrollee-level EDGE dataset and a list of data elements that CMS will make available for research requests." [Unnumbered document, May 18, 2018] Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

GASB 74/75: OPEB Expense and Balance Sheet Items (PDF)

"The OPEB expense on the income statement now arises from changes in the Net OPEB Liability (NOL) over the measurement period, which is calculated as the Total OPEB Liability (TOL) minus the Fiduciary Net Position (FNP).... Plans that provide OPEB benefits to fewer than 100 members may use the alternative measurement method, which simplifies some assumptions and calculations.... The Required Supplementary Information (RSI) is now to include several 10-year schedules." Milliman

ACA Patient-Centered Outcomes Research Institute (PCORI) Fee Payment Is Due July 31

"If a plan is fully insured, then the health insurer is responsible for paying the fee. For self-insured plans, the plan sponsor (generally the employer) is responsible for paying the PCORI fee. For self-insured health plans, the fee is calculated using the average number of total lives covered by the plan (both employees and dependents)." Findley

IRS Issues Updated Employer's Tax Guide to Fringe Benefits

"Updates [to IRS Publication 15-B for use in 2018] include: [1] the suspension of qualified bicycle commuting reimbursements from an employee's income for any tax year after December 31, 2017 and before January 1, 2026; [2] the suspension of the exclusion for qualified moving expense reimbursements from an employee's income for tax years after December 1, 2017 and before January 1, 2026 ... [3] limits on employers' deductions for certain fringe benefits including meals and transportation commuting; and [4] the definition of items that aren't tangible personal property for purposes of employee achievement awards."
United Benefit Advisors

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 .

HHS Finalizes 2019 Out-of-Pocket Maximums

"For plan years beginning in 2019, the OOP limits will be $7,900 for self-only coverage and $15,800 for other than self-only coverage. This represents an increase of $550 for self-only coverage and $1,100 for other than self-only coverage over the 2018 OOP maximums of $7,350 and $14,700 respectively. [A table in this article] summarizes [various] ACA indexed dollar limits for 2019 and prior years." Conduent

Third Circuit: Anti-Assignment Clauses in ERISA Health Plans Are Enforceable

"The Third Circuit (Delaware, New Jersey, and Pennsylvania) here joins an expanding list of circuits that have held that anti-assignment clauses in ERISA health plans are generally enforceable -- a list that includes the First, Second, Fifth, Tenth, and Eleventh Circuits. For out-of-network providers such as the one in this case, this line of decisions limits the providers' standing to bring an ERISA suit for reimbursement -- thereby limiting their available remedies for nonpayment." [ American Orthopedic & Sports Med. v. Independence Blue Cross Blue Shield , No. 17-1663 (3d Cir. May 16, 2018)]
Thomson Reuters Practical Law

Ninth Circuit Holds That Substantial Contribution Standard Applies to AD&D Policy Exclusion

"[T]he court held that the substantial contribution standard applies in interpreting the concepts of cause and contribution in the exclusion for 'any loss caused or contributed to by illness or infirmity.' Applying this standard, the court found that diabetes did not substantially cause or contribute to the amputation where Dowdy suffered a deep infection related to the original injury and the fracture itself was slow to heal. For these reasons, the court found that Plaintiff is entitled to benefits." [ Dowdy v. Metropolitan Life Ins. Co. , No. 16-15824 (9th Cir. May 16, 2018)]
Kantor & Kantor

Overcoming Common Barriers to Implementing an Onsite Clinic

"[S]mall to medium organizations ... may choose to share their onsite services with nearby employers and operate on a cohesive schedule.... Employers also consider launching a clinic with part-time hours while building participation, then expand as demand increases.... [E]mployees are not only accepting of clinics but have even grown to expect them in the business environment." Healthstat

Once a Vision for the Future, Virtual Health Is a Reality of the Present

"Virtual health led to a 15 percent reduction in length of patient stays, and improved the experience of chronically ill patients, and remote monitoring of patients once they leave the hospital can cut readmission rates. It is estimated that $7 billion a year (average of $126 per visit) would be saved if annual face-to-face doctor visits moved to virtual visits.... There are now about 200 telemedicine networks and 3,500 service sites in the U.S.... Virtual health can help improve medication adherence, health tracking, and patient accountability." Deloitte

The Relationship Between the Minimum Wage, Fringe Benefits, and Worker Welfare

"This paper explores the relationship between the minimum wage, the structure of employee compensation, and worker welfare.... Using American Community Survey data from 2011-2016, [the authors] find robust evidence that state-level minimum wage changes decreased the likelihood that individuals report having employer-sponsored health insurance. Effects are largest among workers in very low-paying occupations, for whom coverage declines offset 9 percent of the wage gains associated with minimum wage hikes." National Bureau of Economic Research [NBER]; purchase required for full document

Text of GASB Implementation Guide No. 2018-1: Implementation Guidance Update, 2018

This 25-page Implementation Guide addresses new questions about application of the Board's standards on pensions, other postemployment benefits, the statistical section, regulatory reporting, and tax abatement disclosures. The Implementation Guide also includes amendments to previously issued implementation guidance on relevant topics. Governmental Accounting Standards Board [GASB]

Disability Benefits Claims May Settle Faster Under New Claims Procedures Regs

"If the plan administrator fails to strictly comply with the new rules, then the Labor Department has strongly suggested that any court review of a disability claim denial should be under a de novo standard.... In California, de novo review always will occur for litigated insured disability benefit claims. This is the case even if the new Labor Department rules are precisely followed by the plan administrator and if the plan is well drafted to give decision discretion to the plan administrator." Bob Blum Mediation

How Does Your Pay Compare to the Bottom Half of Your Company?

"This is the first year that publicly traded companies are required to tell investors how their CEO pay compares to the rest of the work force with ... the CEO pay ratio. Some companies braced for backlash as they revealed headline-grabbing numbers: Toy maker Mattel Inc. paid its CEO 4,987 times the median of all pay packages in the company.... [T]his is the first time people can see how pay disparity looks inside an individual company. More importantly, employees can now see for the first time how close their pay is to the bottom half of their own organization." WCPO

Reimbursement of Medicare Premiums

We have a small business with 10 employees. The business offers health insurance. So the QSEHRA is not available. Two employees have chosen Medicare instead of the employer health plan. The employer pays 75% of the health insurance premium and employee 25%. The employer wishes to reimburse the Medicare-covered employees 75% of the Medicare premium they incur. There appears to have been a pronouncement in 2015 which allows for this provided certain conditions have been met which they have in this case. So it appears to be allowable. Is this still an allowable benefit? Does there need to be a written plan? BenefitsLink Message Boards

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