Health & Welfare Plans Newsletter

August 15, 2018

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Legislation Would Expand HSAs and Repeal or Delay ACA Taxes

"The House bills would increase HSA contribution limits, expand HSA eligibility and provide more flexibility for using HSA funds. Other proposals would repeal the ACA medical device excise tax, suspend the health insurance issuer tax and more. Two provisions from the House Ways and Means Committee -- further delay of the Cadillac tax and suspension of the employer mandate -- did not make it into the House package." Willis Towers Watson

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Unum Must Revise Benefit Denial in Opioid Overdose Death

"Unum Life Insurance Co. of America will have a second chance to provide more information about its denial of accidental death benefits to the widower of a woman who died of prescription drug overdose.... Unum's denial, which was based on its finding that death from multiple drug toxicity wasn't a covered accident, was considered in a 'conclusory fashion,' [the judge held]." [ McCusker v. Unum Life Ins. Co. of Am. , No. 17-1214 (E.D. La. Aug. 13, 2018)]
Bloomberg BNA

Beware of Health Care Consultants' Preferred Partnerships

"Consulting firms and brokers have preferred relationships with insurance carriers, enrollment firms, pharmacy benefit managers (PBMs), and others. Insurance carriers and third-party administrators (TPAs) have preferred relationships with PBMs, stop-loss carriers, price-transparency vendors, and others. To best serve clients, it's often necessary to integrate these relationships." CFO

The ERISA Industry Committee Files Lawsuit Against City of Seattle

"In its lawsuit, ERIC argues that the health benefit plans of large employers are regulated by [ERISA, which] contains a broad federal preemption provision that invalidates any state and local law that relates to employee benefit plans, including health benefit plans. This broad standard has consistently been upheld by the U.S. Supreme Court."
The ERISA Industry Committee [ERIC]

Seattle Faces Legal Test Over Hotel Worker Insurance Mandate

"Seattle is facing a new lawsuit over its initiative that requires large hotels in the city to pay workers additional compensation if they don't get a specified level of health insurance coverage. The lawsuit, filed Aug. 14 by the ERISA Industry Committee [ERIC], seeks to bar the city from enforcing the health insurance sections of Seattle's Hotel Employees Health & Safety Initiative, a labor regulation voters approved in 2016 that seeks to protect the health and safety of hotel employees." Bloomberg BNA

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Editor's Pick NCSL Prescription Drug Policy Resource Center

"Prescription drugs account for 10 percent of overall health spending in the U.S.... State and federal governments have focused on successfully managing these costs through a variety of approaches. These include widespread use of increased manufacturer rebates, use of preferred drug lists, prior authorization, state-initiated bulk purchasing and large retailers' competition to offer $4-$10 prescriptions for many widely used drugs." National Conference of State Legislatures [NCSL]

States Leverage Federal Funds to Help Insurers Lower Premiums

"A provision in the ACA allows states to experiment with their marketplaces as long as they honor ACA requirements and don't cost the federal government more money. (Federal reinsurance funding for high-cost patients reduces premium subsidies, which are fully paid by the federal government.) Notably, even as the Trump administration has blocked other provisions of the ACA and pushed Congress to repeal the law, it has encouraged states to establish reinsurance programs and seek federal funding." Kaiser Health News

Executive Compensationand Nonqualified Plans

The Reach and Breadth of Your Clawback Policy Matter

"[A recent study] discovered companies with stronger clawbacks had a modest decrease in CEO turnover ... [W]hile imposition of any clawback would cause CEO pay to rise (to provide a hedge against the additional risk to the CEO of losing pay), CEO pay in fact rose less when a more robust clawback was adopted. A number of factors might mitigate the pay increases required for the adoption of strong clawbacks relative to weaker clawbacks[.]" Willis Towers Watson

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David Rhett Baker, J.D., Editor and Publisher
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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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