Health & Welfare Plans Newsletter

June 14, 2018

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401(k) Pension Administrator
Legacy Retirement Solutions, LLC
in PA

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Kraw Law Group, APC
in CA

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Nationwide
in CA

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Prime Benefits Inc.
in MD, Telecommute

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U-Haul International
in AZ

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[Guidance Overview]

Repeal of the Michigan Health Insurance Claims Tax

"On June 11, 2018, Governor Snyder signed a series of bills that repeal the Michigan Health Insurance Claims Assessment (HICA) tax. But the repeal is conditioned on federal approval of the HICA tax's replacement.While all employer-sponsored group health plans benefit from HICA tax repeal, the true winners will be self-funded group health plans and their third-party administrators (TPAs)." Miller Johnson

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New Jersey Adopts Individual Health Insurance Mandate

"The New Jersey law simply imposes the same obligation on New Jersey residents that the ACA's individual mandate does (i.e., have at least 'minimum essential coverage,' or MEC) and levies the same penalties for noncompliance, except the penalties are payable to the state." Lockton

IRS Releases More Details on Letter 227 -- Response to Appeal on Employer Shared Responsibility Payment (PDF)

"Different versions of Letter 227 will either close the Shared Responsibility penalty issue or prompt employers to take additional steps. Such steps may include paying the penalty or following the instructions provided in Letter 227 or Publication 5 to request a pre-assessment conference with the IRS Office of Appeals. A conference should be requested in writing by the response date shown in Letter 227, which will generally be 30 days from the date of Letter 227." Marsh & McLennan Agency LLC

PCORI Fee Due July 31, 2018

"The PCORI fee for a plan year is due by July 31 of the calendar year immediately following the last day of such plan year. Because the PCORI fee only applies to plan years (and policy years) ending before October 1, 2019, the final PCORI fee payment for sponsors of calendar year plans (for the 2018 plan year) will be due by July 31, 2019." Conduent

Who Must Get a Medicare Part D Disclosure Notice?

"A 'Part D eligible individual' is an individual who [1] is entitled to benefits under Medicare Part A or enrolled in Medicare Part B; and [2] lives in the service area of a Part D plan. Part D eligible individuals could include active employees, disabled employees, COBRA participants, retirees, and, importantly, covered spouses and dependents of any of the above." Thomson Reuters / EBIA

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Trending: Fewer Spouses Covered on Employee Benefit Plans

"In 2016, ... 15.7% of responding health plan sponsors imposed spousal surcharges or exclusions. Data from the 2018 survey, not yet released, shows 20.1% impose a surcharge or exclusion.... [A 2017 survey] shows 27% of companies used a spousal surcharge in 2017, with an additional 5% planning to do so in 2018 and another 14% considering a surcharge for 2019.... [In December 2017 a third survey] reported nearly 30% of its survey participants are imposing a spousal surcharge in 2018, up almost 10% from the previous year." International Foundation of Employee Benefit Plans [IFEBP]

Get Health Coverage at Work? Lawsuit Against ACA Could Affect You, Too

"Tens of millions of people who get health insurance through their job could face waiting periods for coverage or find that specific medical conditions aren't immediately covered if the courts back a request by the Trump administration ... If the courts toss some ACA provisions linked to the insurance-coverage mandate, elements of the requirements that also apply to employer plans would likely be halted or reversed as well[.]" The Wall Street Journal; subscription may be required

Insurers Can Continue Silver Loading for 2019

"[I]nsurers will not be prohibited from using silver loading to make up for the loss of cost-sharing reduction (CSR) payments -- at least for 2019. [HHS] Secretary Azar made these remarks during a hearing before the House Education and Workforce Committee. These comments resolve at least one point of uncertainty for 2019, but Secretary Azar did not rule out banning silver loading in the future." Health Affairs

The Effects of Actuarial Value Changes on New Yorkers with High-Cost Medical Needs

"Under the expanded AV threshold, insurers could sell plans with lower premiums but with higher cost sharing to compensate.... In New York, ... the AV threshold change did not adversely affect individuals with high-cost conditions. However, ... other factors such as New York's unique Marketplace requirements, the state's basic health plan and Medicaid expansion, and drug pricing and coverage changes may have mitigated the impact of the new AV threshold flexibility." Health Affairs

Administering Employee Benefits Coverage During a Leave of Absence

"[An] employer's policy needs to address what types of leaves of absence are permitted.... For each type of permitted leave under an employer's policy, specific issues related to the provision of benefits need to be addressed.... What benefits are continued and for how long? ... Has the insurance/stop loss carrier agreed to the continuation of coverage? ... What do the applicable plan documents say? ... How will benefits be paid for during the leave? ... When are COBRA requirements implicated?" Fraser Trebilcock

Benefits in General

The New Rx for Retirement: Maximizing Retirement and Health Savings (PDF)

16 pages. "[This paper] presents a savings optimization model to help determine how to allocate funds between retirement plans and HSAs for maximum spending power in retirement.... [1] The relevance of HSAs; [2] The retirement savings optimization model; [3] The savings optimization model in action; [4] Putting it all together." Great-West Financial and Empower Retirement

Executive Compensationand Nonqualified Plans

#MeToo: Sexual Harassment and Executive Compensation (PDF)

10 pages. "Whether ... 2017 was a harbinger of an enduring change in employers' attitudes towards, and approaches in addressing, allegations of sexual harassment relating to key executives remains to be seen. If it is true that #TimesUp, and in particular if customers (and members of the public more generally) favor harsher treatment of executives engaged in sexual harassment or assault, compensation committees may find value in reflecting this new attitude in the structure of their companies' executive compensation programs and agreements." Utz & Lattan, LLC

Press Releases

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David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager

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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