Health & Welfare Plans Newsletter

September 27, 2018

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Defined Benefit Plan Administrator
Pension Investors Corporation of Orlando, Inc.
in FL

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Bertelsmann, Inc.
in NY

Defined Benefits / Cash Balance Analyst
Retirement Planning Services
in CO, Telecommute

Sr. Relationship Manager - Retirement Plan Solutions
TD Ameritrade
in CO

Associate Attorney - Employee Benefits
FordHarrison LLP
in GA

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[Guidance Overview]

IRS Allows Tax-Free Payment of Moving Expenses Paid in 2018 If Incurred in 2017

"The IRS has now indicated an employer can directly pay or reimburse an employee's qualified moving expenses in 2018 if the expenses were incurred prior to Jan. 1, 2018. In other words, in determining whether employer-paid moving expenses are nontaxable, the IRS will look to the date the expenses are incurred, not when the amounts are paid or reimbursed by the employer." Lockton

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[Guidance Overview]

The ACA Blindspot: Many Employers Caught Off Guard Because of Inaccurate Advice

"[T]wo major blind spots ... have generated countless IRS penalty letters and significant potential penalties to employers across the country.... [1] A payroll vendor offered to provide ACA reporting to an existing client, but the payroll company did not realize it may not store all the proper data needed to complete all the requirements and underestimated how complicated the Forms 1094-C and 1095-C were to complete accurately.... [2] The second common scenario is occurring with fully insured employers who were under the impression or were advised that an insurance carrier would provide ACA reporting on their behalf using the Forms 1094-B and 1095-B." Accord

Individual Disability Insurance Policies May Create ERISA-Covered Plan

"The owner, as employer, had signed a form specifying the eligible class of employees, and stating that the employer would pay all or part of the premium, as well as recommend the individual LTD polices to eligible employees through an endorsement letter. Also, although individual policies were involved, the employer had made initial contact with the insurer and had facilitated discounted premiums which meant it had 'contributed' to the program, regardless of whether it actually paid the premiums or not." [ Bommarito v. The Northwestern Mut. Life Ins. Co. , No. 15-1187 (E.D. Cal. July 23, 2018)
The Wagner Law Group

Can Equitable Defenses Defeat Subrogation Claims for Overpayment After Tort Settlement?

"To seek reformation it is not necessary to suggest specific contract language.... No unclean hands.... No waiver.... No laches.... The make whole rule -- remand for further proceedings." [ Jalali v. Unum Life Ins. Co. of America , No. 16-512 (S.D. Ohio Sept. 18, 2018)]
Lane Powell PC

Employee Healthcare Cost-Shifting Is So Last Year

"Fewer than half of employers are changing cost-sharing features ... The out-of-pocket pain point is high, and employers are balking at pushing it higher.... For 2019, with underlying trend down, employers are deciding to pass up deeper short-term (next year) savings for an investment in the future of cost control -- addressing underlying use of care and management of health." Mercer

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Health Savings Accounts (HSAs): Compliance Obligations Under the Internal Revenue Code and ERISA

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Amid Rise in Healthcare Costs, Employers Focus on Clinical Conditions and Integrated Wellbeing

"When seeking to manage rising health care costs, the top priorities for employers are zeroed in on clinical conditions (85%) and investing in employee wellbeing (82%) over the next three years -- two strategies to contain health care expenses longer term and ultimately improve workforce performance. Employers report that little progress has been made in these areas in the past three years. Fewer than one-third (30%) say they have made advancements in clinical conditions, and only 41% say the same for employee wellbeing." Willis Towers Watson

Will Congress Bring Sky-High Air Ambulance Bills Down to Earth?

"Kaiser Health News and NPR received more than a dozen bills from people around the country on the hook for medevac helicopter rides that ranged from $28,000 to $97,000.... If an air ambulance service is not part of a patient's insurance network, the operator can charge the patient for the portion of the bill the insurance company won't cover ... [Air ambulance companies] are regulated by the Federal Aviation Administration. By law, states cannot set rules for them. That has meant they haven't been required to participate in insurance networks, their prices are not capped, and they can charge patients the balance of the bills even after insurance has paid." Kaiser Health News

On-Demand Health Insurance Shows Promise, But Can It Deliver?

"As insurers introduce their plans for the 2019 enrollment period, one health technology company is entering the space with a disruptive strategy in mind. Bind is a healthcare startup aimed at providing 'on-demand health insurance' for consumers to pay for the coverage plan they want. Bind has been utilized by several business organizations primarily in the Minneapolis-St. Paul market, but they have plans to expand operations." HealthLeaders Media

Onsite Clinics and HSAs: Convenient, High Value Health Care or Taxable Income?

"[An] onsite clinic can provide free or reduced services such as physicals and immunizations, administration of prescription drugs provided by the employees, nonprescription pain relievers and treatment for on-the-job accidents. If more 'significant benefits' are provided, current IRS guidance provides that the employee may lose eligibility for his or her HSA." The Alliance

Crafting Quality Fringe Benefit Language in Your CBA

"Developing clear, consistent and concise CBA language aligned with Plan rules is critical to minimizing legal and audit costs, safeguarding member benefits and preserving bargaining party relationships. The bargaining process is a complex beast, and opposite sides of the table may have different objectives. The first step in getting the language right is finding common ground." Lindquist LLP

Aetna to Sell Medicare Part D Drug Business to WellCare Health

"Aetna Inc. said [on September 27] it agreed to sell its Medicare Part D prescription business to a WellCare Health Plans Inc. subsidiary ... The deal with the WellCare subsidiary will be effective at the end of this year ... The announcement marks a major step forward for CVS's planned acquisition of Aetna, a nearly $70 billion deal that will unite the third-biggest health insurer with the huge drugstore and pharmacy-benefit company." The Wall Street Journal; subscription may be required

Benefits in General

[Official Guidance]

Text of IRS Disaster Relief Notice SC-2018-01, for Victims of Hurricane Florence in South Carolina

"Victims of Hurricane Florence that took place beginning on Sept. 8, 2018 in South Carolina may qualify for tax relief ... Individuals who reside or have a business in Chesterfield, Dillon, Horry, Marion and Marlboro counties may qualify for tax relief.... [C]ertain deadlines falling on or after Sept. 8, 2018 and before Jan. 31, 2019, are granted additional time to file through Jan. 31, 2019." Internal Revenue Service [IRS]

[Official Guidance]

Text of IRS Notice 2018-77: 2018-2019 Special Per Diem Rates (PDF)

"This annual notice provides the 2018?2019 special per diem rates for taxpayers to use in substantiating the amount of ordinary and necessary business expenses incurred while traveling away from home, specifically [1] the special transportation industry meal and incidental expenses (M&IE) rates, [2] the rate for the incidental expenses only deduction, and [3] the rates and list of high-cost localities for purposes of the high-low substantiation method." Internal Revenue Service [IRS]

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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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