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T. Rowe Price
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Kraw Law Group, APC
in CA

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2018 Draft IRS Instructions for Form 1095-A: Health Insurance Marketplace Statement (PDF)

Sept. 17, 2018. "Form 1095-A is used to report certain information to the IRS about individuals who enroll in a qualified health plan through the Health Insurance Marketplace. Form 1095-A also is furnished to individuals to allow them to take the premium tax credit, to reconcile the credit on their returns with advance payments of the premium tax credit (advance credit payments), and to file an accurate tax return." Internal Revenue Service [IRS]

ftwilliam.com -- Enhanced Welfare Documents Module!

Recent enhancements to our Welfare Plan Documents package provide additional features to our Cafeteria and POP Plan Docs. This includes extensive new options and a new Individually Designed Plan formatted version of the Cafeteria Plan. Learn more!

Text of IRS Publication 5164: Test Package for Electronic Filers of ACA Information Returns (PDF)

24 pages. "[This publication] contains general and program specific testing information for use with ACA Assurance Testing System (AATS).... Software Developers must pass IRS AATS test scenarios for the forms and tax years that the software package will support.... Transmitters and Issuers must pass a one?time communication test for the forms they will file." [Rev. Oct. 2018, though formally entitled "Version 1.0, Sept. 14, 2018."] Internal Revenue Service [IRS]

Proposed Regs Issued for New Jersey Paid Sick Leave Law

"[T]he required notice may be provided by email, and the required posting may be posted via 'an internet site or intranet site for exclusive use by its employees and to which all employees have access.' ...[T]he employer must establish a single benefit year for all employees. If the employer wishes to change the benefit year, the employer must supply the NJDOL with specified, detailed information, and the NJDOL can refuse the change if it determines the change is intended to prevent use or accrual of PSL." Ogletree Deakins

Senate Votes 98-2 to Ban Pharmacist Gag Clauses

"The Senate [on Sept. 17] passed [ S.2553 , which] would put an end to gag clauses that bar pharmacists from telling consumers when it would cost less to pay cash for a prescription than to shell out the copayment under their health plan.... The National Community Pharmacists Association has said that gag clauses interfere in their relationships with their patients."
American Journal of Managed Care

Senators Unveil Legislation to Protect Patients Against Surprise Medical Bills

"The draft legislation, which sponsors said is designed to prevent medical bankruptcies, targets three key consumer concerns: [1] Treatment for an emergency by a doctor who is not part of the patient's insurance network at a hospital that is also outside that network.... [2] Treatment by an out-of-network doctor or other provider at a hospital that is in the patient's insurance network.... [3] Mandated notification to emergency patients, once they are stabilized, that they could run up excess charges if they are in an out-of-network hospital." Kaiser Health News

2019 Onsite Employee Health Clinics Summit - Jan. 28-29 - Scottsdale, AZ

Perspectives from Disney, Boeing, Harley-Davidson, Procter & Gamble, Cisco Systems, & More! Register now for this event hosted by World Conference Forum.

Senate HELP Committee Hearing on Reducing Health Care Costs: Examining How Transparency Can Lower Spending and Empower Patients

Hearing was held Tuesday, Sept. 18, 2018; video recording is online. Testimony by: [1]  Leah Binder , The Leapfrog Group; [2]  Bill Kampine , Healthcare Bluebook; [3]  Nancy A. Giunto , Washington Health Alliance; and [4]  Ty Tippets , St. George Surgical Center.
Committee on Health, Education, Labor and Pensions, U.S. Senate

Specialty Drugs, Biosimilars and Your Health Benefit Plan

"[A] biosimilar action plan for self-funded employers: [1] Quantify the opportunity.... [2] Identify a biosimilar strategy for your self-funded health benefit plan and consider carving coverage out of medical and moving it to pharmacy. [3] Incentivize patients to use biosimilars instead of biologic reference drugs, where appropriate (e.g. lower co-pays, co-insurance or other out-of-pocket expenses). [4] Educate your employees, once you incentivize." The Alliance

New Employee Benefit Plan Auditing Standard Now Final

"After years of debate, deliberation and revision, it appears the Auditing Standards Board (ASB) is finally set to issue Statement on Auditing Standards (SAS) Forming an Opinion and Reporting on Financial Statements of Employee Benefit Plans Subject to ERISA as a final standard. The ASB has not yet announced when the final standard will be available nor has it determined the effective date." Schneider Downs

Evaluating Service Provider Data Security

"[T]ake the time to understand the standards the provider holds themselves to. In other words: when they make any claim about the strength of their security, what criteria is this based upon? ... [H]ow frequently does the provider assess the strength of their system's security? ... [W]hat method does the provider use to evaluate their security: internal assessments or assessments done by a reputable third-party? ...Has the provider prepared for the worst?" bswift

Benefit Gains Exceed Wage Growth

"The value of benefits -- including bonuses and vacation time -- grew at a faster rate in the 12 months ended in June than wages and salaries ... That extended a long-running but slow shift in compensation toward benefits and away from wages. The cost of benefits for private-sector employers rose 3% in June from a year earlier, while the cost of wages and salaries advanced 2.7%." The Wall Street Journal; subscription may be required

Do Employers Really Know What Employees Want?

"Eighty-one percent of employees value retirement plans, but only 60 percent of employers offer it. While 60 percent of employees say it's important to have life insurance available to them at work, only 48 percent of employers offer it. When looking at critical illness coverage, 44 percent of employees view it as important but just 24 percent of employers offer this benefit. Only 21 percent of employers offer long-term care insurance but almost half, 46 percent, of employees feel the benefit is important." LIMRA

Press Releases

NAPA Announces the Retirement Industry's Top 10 DC Wholesalers National Association of Plan Advisors [NAPA]

Fitbit and Humana Expand Strategic Partnership to Drive Healthy Habits and Prevent and Manage Chronic Disease Fitbit, Inc.

Fitbit Launches Fitbit Care, A Powerful New Enterprise Health Platform for Wellness and Prevention and Disease Management Fitbit, Inc.

VALIC Named Exclusive Retirement Program Provider for PGA of America Golf Retirement Plus Program VALIC

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Most Popular Items in the Previous Issue

Behind Your Rising Health Care Bills: Secret Hospital Deals That Squelch Competition The Wall Street Journal; subscription may be required

IRS Releases Early Drafts of ACA Employer Reporting Forms and Instructions Fraser Trebilcock

Parental Leave Benefits Are Under Scrutiny -- Be Sure Yours Don't Discriminate! Foley & Lardner LLP