Health & Welfare Plans Newsletter

August 23, 2018

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[Guidance Overview]

San Antonio Enacts Paid Sick Leave Law: Will It Live to Go Into Effect?

"The Ordinance will require paid sick leave for all employees who work at least 80 hours per year within the City of San Antonio, including work performed through the services of a temporary or employment agency.... Covered employees will be entitled to accrue one hour of paid sick leave for every 30 hours worked within the city.... [A] number of Texas state representatives have announced plans to introduce a law that would expressly prohibit local governments from enacting paid sick leave laws." Proskauer

Employer Didn't Violate FMLA by Not Reducing Employee's Absences While on Leave

"An employee who was fired for excessive absences could not claim FMLA interference because his employer did not reduce his accumulated absences under its absence reduction policy while the employee was on FMLA leave ... [T]he court found that the employer's absence reduction policy, predicated on 30 days of perfect attendance, which did not include time spent on FMLA leave, was a benefit to which the employee was not entitled while on FMLA leave." [ Dyer v. Ventra Sandusky, L.L.C. , No. 16-2817 (N.D. Ohio Aug. 6, 2018)]
Wolters Kluwer Law & Business

Changes in NY Paid Leave Law, On-Call Rule Could Cost Employers

"The two changes come from different areas of workplace policy, but they could intersect in a way that puts the onus on employers in a financial Catch-22 by requiring them to provide leave that workers can take without notice, but then adding a financial penalty when a substitute worker is called in without notice." Bloomberg BNA

Major Employers Save Money -- While Hospitals Win Patients -- with On-Site Clinics

"Some of South Carolina's largest employers -- Volvo, Mercedes-Benz and others -- are cutting deals with the region's leading health care systems to make it easier for workers to access health care on the job site. Such partnerships have become more common as employers search for novel ways to minimize how much they spend on their employees' health. They are also strategic for hospital systems looking to expand their network of patients." The Post and Courier

After Years of Erosion, More Employers are Offering Health Coverage (PDF)

"Since 2008, the percentage of employers with 1,000 or more employees offering health benefits to workers has been consistently near or above 99 percent -- it reached 99.8 percent in 2016 -- but smaller firms have shown a steady, though not precipitous, decline in offer rates. For the smallest employers, those with fewer than 10 employees, the offer rate declined from 22.7 percent in 2015 to 21.7 percent in 2016. This changed in 2017.... Between 2008 and 2016, the percentage of private-sector employers offering health benefits declined 11.1 percentage points, from 56.4 percent to 45.3 percent. However, it then increased to 46.9 percent in 2017." Employee Benefit Research Institute [EBRI]

Blue Cross, UNC to Reduce Some ACA Health Insurance Premiums in North Carolina

"Blue Cross and Blue Shield of North Carolina says premiums paid by [ACA] customers in the Triangle will decrease more than 21 percent on average next year because of a new partnership with UNC Health Care.... Under the partnership, the two companies plan to eventually move to a model where Blue Cross will pay UNC Health Care's physician network, UNC Health Alliance, a set amount to care for a patient or a family over a year, with adjustments for patients with serious health issues." The News and Observer

AHIP, State Attorneys General Urge Appeals Court to Rehear Risk-Corridor Payment Case

"The briefs -- including those filed on behalf of AHIP, attorneys general in 18 states, Blue Cross Blue Shield and the National Association of Insurance Commissioners -- argue that the court's June decision will wreak havoc on ACA marketplaces if allowed to stand." FierceHealthcare

Limited-Duration Health Insurance: Short-Term Gain, Long-Term Pain?

"Expanded access to short-term, limited-duration insurance coverage -- which could lead to adverse selection in the [ACA's] individual market -- may also result in consumer confusion over coverage, a rise in the number of uninsured and underinsured individuals, and bad debt incurred in paying for coverage." Morgan Lewis

GAO Report on Health Insurance Exchanges: HHS Should Enhance Its Management of Open Enrollment Performance

"About 8.7 million people bought insurance in 2018 through the federal website (healthcare.gov), 5% less than in 2017. Health and Human Services reduced its advertising and other consumer outreach. The 23 stakeholders we interviewed had mixed views about the effects of these reductions on enrollment. HHS did not set enrollment targets for 2018, but reported meeting its goal of enhancing specific aspects of consumer experience. We recommended that HHS take steps to better manage its performance." [GAO-18-565, published Jul. 24, 2018, released Aug. 23, 2018] U.S. Government Accountability Office [GAO]

Executive Compensationand Nonqualified Plans

[Guidance Overview]

New IRS Guidance Regarding Expanded 162(m) Rules

"Companies subject to the deduction limitation should act now: [1] to confirm that the list of individuals that they have identified as subject to the deduction limitation comply with this methodology, [2] to determine what portion, if any, of current compensation arrangements would be able to be grandfathered, and [3] consider methods to maximize the deductibility of current and future compensation." Vorys

[Guidance Overview]

More Details on the IRS Guidance on the 162(m) Grandfathering Rules

"One thing the guidance does make absolutely clear is that the first step in determining whether any payment to any person in any year after 2017 is subject to the draconian limits of Section 162(m) is to determine whether there was a written binding contract in effect on November 2, 2017, which created a legal obligation on the company under any applicable law (e.g., state contract law) to pay the compensation under such contract if the employee performs services or satisfies the applicable vesting conditions. Every one of the many examples provided in the guidance begins with a determination of whether the plan or agreement created a legal obligation on the company. In the examples, some do and some do not." Winston & Strawn LLP

[Guidance Overview]

IRS Clarifies Grandfather Rule and Other Code Section 162(m) Issues

"[ Notice 2018-68 ] indicates that compensation will not be considered payable under a written binding contract if the employer is not obligated to pay it under applicable law. Thus, it appears that plans that provide the employer with discretion to reduce or eliminate an employee's compensation (i.e., negative discretion) will fail to satisfy the 'written binding contract' standard to the extent the compensation can be reduced or eliminated."
Groom Law Group

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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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