Health & Welfare Plans Newsletter

June 19, 2018

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[Official Guidance]

Text of DOL Final Regs: Definition of Employer Under ERISA -- Association Health Plans (PDF)

198 pages. "By establishing a more flexible 'commonality of interest' test for the employer members than the [DOL] had adopted in sub-regulatory interpretive rulings under ERISA section 3(5), and otherwise removing undue restrictions on the establishment and maintenance of Association Health Plans (AHPs) under ERISA, the regulation facilitates the adoption and administration of AHPs and expands access to affordable health coverage, especially for employees of small employers and certain self-employed individuals.... The final rule also sets out the criteria that would permit, solely for purposes of Title I of ERISA, certain working owners of an incorporated or unincorporated trade or business, including partners in a partnership, without any common law employees, to qualify as employers for purposes of participating in a bona fide group or association of employers sponsoring an AHP and also to be treated as employees with respect to a trade, business or partnership for purposes of being covered by the AHP."
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

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[Official Guidance]

CSR Reconciliation Discrepancy Resolution Inbound Specification (PDF)

12 pages; version 3.0. "The purpose of this document is to provide details on cost-sharing reduction (CSR) reconciliation discrepancy files that issuers will send to CMS.... CMS will only accept discrepancy files through Enterprise File Transfer (EFT)." Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

President Donald J. Trump Helps Millions of Americans Employed by Small Businesses Gain Access to Quality, Affordable Health Coverage

DOL press release."Under the Department's new rule, AHPs can serve employers in a city, county, state, or a multi-state metropolitan area, or a particular industry nationwide. Sole proprietors as well as their families will be permitted to join such plans.... [The] Employee Benefits Security Administration will monitor these new plans to ensure compliance with the law and protect consumers. Additionally, States will continue to share enforcement authority with the Federal Government.... The new rule does not affect previously existing AHPs, which were allowed under prior guidance. Such plans can continue to operate as before, or elect to follow the new requirements if they want to expand within a geographic area, regardless of industry, or to cover the self-employed. New plans can also form and elect to follow either the old guidance or the new rules." Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

Association Health Plan Expansion Sparks Fraud Concerns

"Without effective state oversight, fake association health plans could saddle patients with large and unpaid medical bills and even threaten their health ... [T]he final rule has to be clear that states have broad authority to regulate association health plans in tandem with the federal government." Bloomberg BNA

Make Benefits Consulting Easier -- Through Data Solutions

"[T]he very best [data solutions] have three things in common: ... [1] they use objective, observable data-points; ... [2] their analysis is informed by a sound methodology; ... [3] their conclusions are both meaningful and easy to understand.... Well-honed analysis, with communication aids to support it, can clarify employee choices, and improve their engagement with employer benefits tools." mpirica

[Advert.]

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Construction Industry's Ongoing Labor Shortage: Consider Implementing Non-Monetary Benefits

"Studies show that employers that devote just one-to-two percent of their payroll to an employee recognition program can improve retention. While working on a jobsite might not lend itself toward traditional notions of employee recognition, recognition does not have to take place in an office. Contractors can offer meals, snacks, coffee, a new training course, and positive reinforcement as part of an employee recognition program." Jackson Lewis P.C.

HSA Eligibility for Retirement-Age Individuals

"[W]hen an individual who is 65 commences Social Security benefits, that individual is automatically enrolled in Medicare Part A.... [O]nce an employee or spouse is enrolled in Medicare Part A, they are no longer eligible to make contributions to an HSA. To complicate the contribution calculation, in the year an employee turns age 65 and commences Social Security benefits, enrollment in Medicare Part A will apply retroactively up to six months." Benefits Bryan Cave

Court Requires Texas Cancer Center to Pay $4.3 Million in Penalties for HIPAA Violations

"MD Anderson had written encryption policies going as far back as 2006 [and] MD Anderson's own risk analyses had found that the lack of device-level encryption posed a high risk to the security of ePHI. Despite the encryption policies and high risk findings, MD Anderson did not begin to adopt an enterprise-wide solution to implement encryption of ePHI until 2011, and even then it failed to encrypt its inventory of electronic devices containing ePHI between March 24, 2011 and January 25, 2013." U.S. Department of Health and Human Services [HHS]

Questions to Ask When Creating a Paid-Sick-Leave Policy

"[1] Is my business covered? ... [2] Which employees are eligible? ... [3] Who is a 'family member' under paid-sick-leave laws? ... [4] What is safe time? ... [5] How much paid time off must be provided? ... [6] Does more than one law apply?" Society for Human Resource Management [SHRM]

How Managers Can Drop the Ball and Get Into FMLA Trouble

"[1] They are 'space cases' and fail to recognize the need for FMLA leave. [2] They are 'lazybones'; they are aware that there is a need for FMLA leave but don't alert HR. [3] They are 'oversharers,' telling employees why they think it isn't a good time for leave to be taken. [4] They are jerks to workers who are on FMLA leave. [5] They badger employees on FMLA leave with work concerns. [6] They are trouble-makers, such as managers who bully employees for taking FMLA leave." Society for Human Resource Management [SHRM]

How Advisers Can Help Employers Navigate Paid Family Leave

"With a strong push for PFL legislation at the national level, state-mandated employee benefits offerings may change drastically in the next few years. Proactively taking the lead on monitoring and updating clients on new regulations passed and providing recommendations on how to remain compliant could help set you apart from the competition." Employee Benefit News

Benefits in General

[Official Guidance]

Text of IRS Disaster Relief Notice HI-2018-02, for Victims of Volcanic Eruptions and Earthquakes in Hawaii

"Victims of volcanic eruptions and earthquakes that occurred starting on May 3, 2018 in Hawaii may qualify for tax relief from the [IRS].... [C]ertain deadlines falling on or after May 3, 2018, and ending Sept. 17, 2018, are granted additional time to file through Sept. 17, 2018. In addition, penalties on employment and excise tax deposits due on or after May 3, 2018, and ending May 18, 2018, will be abated as long as the deposits were made by May 18, 2018." Internal Revenue Service [IRS]

Planning for Health Care Costs in Retirement (PDF)

24 pages. "Some research on health care costs in retirement estimates these expenses as a lifetime lump sum.... [A] better planning framework considers these costs as annual expenses personalized to an individual's health status, coverage choices, retirement age, and loss of any employer subsidies. For a typical 65-year-old woman, the Mercer-Vanguard model predicts an annual health care expense of $5,200 in 2018.... Half of individuals will incur no long-term care costs -- but there is a small but meaningful risk that costly care will be required for multiple years[.]" Vanguard

Press Releases

ARA Opens Board Nomination Period American Retirement Association

BrightDime

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Lois Baker, J.D., President
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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