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Student Loans Burdening Employees: How Employers Can Help, and the New IRS Ruling
November 6, 2018 WEBCAST
HRWebAdvisor

Paid Sick Leave: Complying with the Growing Number of State and Local Requirements
November 8, 2018 WEBCAST
HRWebAdvisor

Update on HIPAA Business Associate Agreements for Employer-Sponsored Health Plans
November 15, 2018 WEBCAST
HRWebAdvisor

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DOL Confirms that Organ Donors Can Qualify for FMLA Leave

"In Opinion Letter FMLA 2018?2-A , the DOL clarified that an organ donation can qualify as an impairment or physical condition that is a serious health condition under the FMLA when it involves either 'continuing treatment' or 'inpatient care.' "
The Wagner Law Group

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

Worldwide Employee Benefits Network helps me connect with thought leaders in the Benefits Industry. Join WEB today at www.webnetwork.org .

Navigating FMLA: Can An Employee Be Entitled to Leave Beyond 12 Weeks?

"[An] employer's policies and/or practices determine whether to grant non-FMLA leave for an employee who is not yet eligible for FMLA leave (unless there is an applicable state family or medical leave law). But once an employee becomes eligible for FMLA leave, an employer may not count any non-FMLA leave taken prior to the employee's eligibility date toward the employee's guaranteed 12 weeks of FMLA leave." Polsinelli PC

Michigan Legislature Passes Law Requiring Employers to Provide Paid Sick Leave

"The new 'Earned Sick Time Act' requires the following: [1] Employees in Michigan will accrue at least one hour of paid sick time for every 30 hours worked; [2] Businesses with ten or more employees must provide at least 72 hours of paid sick time per year, while smaller employers are required to provide at least 40 hours of paid sick time; and [3] Employees who exhaust the annual minimums for paid time off are entitled to an additional 32 hours of unpaid earned sick time." Miller Johnson

ERIC and City of Seattle Agree to Temporary Non-Enforcement of Health Plan Benefits Requirement

"[T]he City of Seattle has agreed to a temporary non-enforcement of the health coverage and payment mandates in Part 3 of the Seattle Hotel Employees Health and Safety Initiative ... ERIC's lawsuit seeks to halt enforcement of Part 3 of the Initiative because it requires, uniquely for Seattle, a specified level of health plan benefits. If that level of benefits is not provided, City hotels must pay additional compensation to hotel employees." The ERISA Industry Committee [ERIC]

How to Help Your Employees Make the Most of Their Health Care Dollars

"Three simple cost savings measures you should consider communicating to your employees include: [1] Stick to your health plan's guidelines -- choose an in-network practitioner and opt for generic drugs on your plan's preferred list. [2] Visit your primary care physician or an urgent care clinic for non-emergency care instead of the emergency room. [3] Compare costs through a transparency tool before getting a non-emergency medical procedure like an MRI." Fidelity Health Marketplace

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Why Are Employer-Sponsored Health Insurance Premiums Higher in the Public Sector Than in the Private Sector?

"While there was little difference in public and private sector premiums in 2000, by 2014, public premiums had exceeded private premiums by 14 to 19 percent.... [D]ifferences in plan characteristics played a substantial role in explaining premium differences in 2014 ... Differences in worker age, gender, marital status, and educational attainment were also important factors, as was workforce unionization." U.S. Bureau of Labor Statistics [BLS]

Insurer Wins First CSR Payment Decision

"On September 4, 2018, Judge Elaine D. Kaplan of the Court of Federal Claims ... concluded that Section 1402 does indeed obligate the federal government to make CSR payments and that Congress's failure to explicitly appropriate funds for the payments did not relieve the government of that obligation." [ Montana Health Co-op v. U.S. , No. 18-143 (Fed. Cl. Sept. 4, 2018)]
Katie Keith, in Health Affairs

CMS Greenlights Indication-Based Formulary Design

"A number of important questions remain. First and foremost, what data would Part D plans use as the basis for indication-based formulary decisions? Product manufacturers are likely to be concerned about the use of data from ... entities that seek to evaluate the monetary value of therapies.... Indication-based formularies would also necessitate a change, at least in part, to existing rebate arrangements between PBMs and manufacturers if a drug will be covered differently depending upon the condition being treated." Faegre Baker Daniels

CBO Announces Members of Technical Review Panel for Its Health Insurance Simulation Model

"[A] new technical review panel that will provide feedback on the next generation of CBO's health insurance simulation model ... CBO uses the model to generate estimates of health insurance coverage and premiums for the population under age 65 and as part of a process to analyze proposed changes in policies that affect health insurance coverage.... The panel is composed of the following experts: Roger Feldman, Matthew Fiedler, Craig Garthwaite, Sherry Glied, Gautam Gowrisankaran, Kate Ho, Mark Shepard, Mark Showalter, Robert Town, and Cori Uccello. Members of the panel have been selected to provide a variety of technical perspectives." Congressional Budget Office [CBO]

More States Are Seeing Proposed ACA Premium Hikes

Infographic. "In the past two months, several states released their proposed individual market premium rates for 2019. As of mid-August, five more states published the filing details of their current exchange insurers." AISHealth

Back to School: Tuition Reimbursement Benefits for Employers

"Tuition reimbursement programs give Human Resources the ability to properly incentivize workers that already know the ins-and-outs of the company/industry and are known to have the skills that aren't necessarily taught as part of an academic education -- things like collaboration, task prioritization, organization, team management, relationship building, creative problem-solving, etc. If you have a known commodity like that, tuition reimbursement can help you develop your promising 'minor league' employees of today into your 'major league' contributors of tomorrow." Connect Your Care

Fee Awards Under ERISA: The Long and Winding Road to 'Some Success on the Merits' (PDF)

"The [Supreme Court] found that attorneys' fees may be awarded if a party obtains 'some degree of success on the merits.' As is its prerogative, the Court did little to elucidate this standard... [A recent Ninth Circuit] decision and the dis?trict court's handling of two separate fees requests by both parties demonstrates just how lenient the 'some success' standard can be when applied to plaintiffs, and how that leniency can evaporate when the party seeking fees is the defendant." [ Brasley v. Fearless Farris Service Stations, Inc. , No. 16-35519 (9th Cir. Mar. 13, 2018, unpub.)]
Jenner & Block, via Employee Relations Law Journal

Press Releases

Securian Financial Expands Its Retirement Plan Investment Solutions with Unitized Model Portfolios Securian Financial Group

OneDigital Health and Benefits Acquires Premier Benefit Solutions OneDigital Health and Benefits

Colonial Life, bswift Announce Partnership to Improve Enrollments Colonial Life

ARA Taps Daniella Moiseyev for New CMO Role American Retirement Association

Corporate Synergies Names Robert Flicker Regional Vice President of Account Management in New York Corporate Synergies

Two West Capital Advisors is Certified for Fiduciary Excellence Centre for Fiduciary Excellence [CEFEX]

CapAcuity Launches, to Address Changed Landscape in Executive Benefits CapAcuity

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Deadline for Medicare Part D Creditable/Non-Creditable Coverage Notices Nears Buck

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