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Don't Get Bitten by COBRA Administration
October 4, 2018 WEBCAST
ConnectYourCare

Navigating Employment, Labor and Benefits Integration Issues in Media Industry Mergers and Acquisitions
October 17, 2018 WEBCAST
Jackson Lewis LLP

Spousal Rights Under ERISA Plans: Avoiding Loss of Benefits After Divorce, Ensuring Regulatory Compliance
November 15, 2018 WEBCAST
Strafford

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Display of 2018 Quality Rating System (QRS) Star Ratings and Enrollee Experience Survey Results for QHPs Offered Through the Health Insurance Exchanges (PDF)

"[CMS] will conduct a third year of consumer pilot testing during the 2019 individual market open enrollment period of the display of Qualified Health Plan (QHP) quality rating information ... The third pilot year will be conducted in the same states that displayed QRS star ratings during the 2018 individual market open enrollment period (Virginia and Wisconsin) and will expand to Michigan, Montana and New Hampshire for the 2019 individual market coverage year." Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Register for HBCE by December 19th and Save!

Join over 300 of your peers as you secure the knowledge needed to keep your plans compliant and your employees engaged. Learn from employer case studies for real-life learning and proven solutions. Act now and register today to save!

Text of IRS Publication 4885: Screening Sheet for Health Savings Accounts (HSA) (PDF)

"Only volunteers with Health Savings Account Certification may assist taxpayers with HSA issues.... This Screening Sheet will help you identify HSA issues that are within the scope of the VITA/TCE program. Use the Determine HSA Eligibility section to determine if taxpayer is eligible for an HSA; use Part I for contributions/deduction; use Part II for distributions." [Rev. 10?2018] Internal Revenue Service [IRS]

Association Health Plan Perspectives (Part 2): The Look-Through Rule and the Limits of State Regulatory Power

"According to a CMS Insurance Standards Bulletin issued on September 1, 2011, an insurance carrier underwriting an AHP must 'look-through' the group sponsoring the fully-insured AHP to the underlying size of the AHP member.... [except] where a fully-insured AHP is sponsored by a 'bona fide group or association of employers' as defined under [ERISA], an insurance carrier must treat the AHP health plan as one, single group health plan.... The final AHP regulations did not revoke or modify the look-through rule, but they did expand the universe of groups that may qualify as a bona fide group or association of employers, and by extension, the number of plans that may qualify for treatment as large groups."
Mintz

New Tax Credit for Paid Leave (Part 2): IRS Issues Helpful Guidance

"For paid leave to be eligible for the credit, the leave must be specifically designated for one or more FMLA purposes, [2]  may not be used for any other reason, and [3]  cannot be provided by a State or local government or be required by State or local law.... [ Notice 2018?17 ] also clarifies that ... the minimum paid leave requirements must be satisfied with respect to each FMLA purpose for which the employer intends to claim the credit."
Verrill Dana LLP

Results of the 2018 Employer Health Benefits Survey

"Annual premiums for employer-sponsored family health coverage reached $19,616 this year, up 5% from last year, with workers on average paying $5,547 toward the cost of their coverage. The average deductible among covered workers in a plan with a general annual deductible is $1,573 for single coverage. Fifty-six percent of small firms and 98% of large firms offer health benefits to at least some of their workers, with an overall offer rate of 57%." Henry J. Kaiser Family Foundation

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.

High-Deductible Health Plans Fall From Grace in Employer-Based Coverage

"Companies have slowed enrollment in [high-deductible health plans] and, in some cases, reinstated more traditional plans as a strong job market gives workers bargaining power over pay and benefits ... Few if any employers will return to the much more generous coverage of a decade or more ago ... But they're reassessing how much pain workers can take and whether high-deductible plans control costs as advertised." Kaiser Health News

Premiums and Worker Contributions Among Workers Covered by Employer-Sponsored Coverage, 1999-2018

"Since 1999, the Employer Health Benefits Survey has documented trends in the employer-sponsored health insurance market.... Among other topics, the survey asks firms for the premium or full per-person cost of their health coverage as well as the share that workers are responsible for. The graphing tool [in this article] allows users to look at changes in premiums and worker contributions over time for covered workers at different types of firms." Henry J. Kaiser Family Foundation

Health and Welfare Plans Under ERISA: Guidelines for State and Federal Regulation (PDF)

"The principal purpose of this handbook is to provide state insurance regulators with a resource guide to help them through the labyrinth of ERISA preemption analysis.... [T]his handbook focuses exclusively on health-related employee welfare benefit plans.... [It] discusses the scope of ERISA preemption ... highlights the general characteristics of an ERISA plan and reviews the specific types of employee welfare benefit plans governed by ERISA.... [and] explores in a question and answer format a number of timely topics of interest to state insurance regulators." [Redlined draft dated July 20, 2018, with corrections to footnotes on Aug. 16, 2018, would update an existing NAIC publication. Submitted comments on the draft are online (tab labeled Exposure Drafts).]
National Association of Insurance Commissioners [NAIC]

More Courts Rule on Section 1557 as HHS Reconsiders Regulation

"In late September, two new federal district courts ruled that Section 1557 -- the [ACA's] chief nondiscrimination provision -- prohibits discrimination against transgender people.... HHS is reconsidering the regulation in light of a nationwide injunction issued in Texas in 2016 against portions of an earlier version of the rule barring discrimination on the basis of gender identity or termination of pregnancy." Katie Keith, in Health Affairs

How Do Providers Respond to Reference Pricing?

"There was no evidence that providers responded to the changing incentives by lowering prices only for patients facing reference pricing.... There also was no evidence that providers attempted to compensate for lower facility prices by raising other fees, by charging higher prices to other insurers for these services or by letting quality decline.... Significant changes in provider pricing behavior in response to reference pricing are unlikely unless these programs are coordinated across many large employers and purchasers." National Institute for Health Care Management [NIHCM]

Sixth Circuit Rules That Employees Need Not Return Severance Pay Before Suing

"This decision means that notwithstanding the fact that the employee signed a severance agreement and accepted severance pay upon leaving the company, the employee may still be able to sue and keep the severance money -- if the employee claims she was coerced into signing the agreement.... [T]he Sixth Circuit's decision only relates to whether employees must return severance pay; it does not address whether employees can disclaim and void the actual severance agreement itself. " [ McClellan v. Midwest Machining, Inc. , No. 17-1992 (6th Cir. Aug. 16, 2018)]
Seyfarth Shaw LLP

Patient-Centered, Value-Based Health Care Is Incompatible with the Current Climate of Excessive Regulation

"Although still a subject of debate, the fee-for-service health care payment system that reimburses providers for individual services is widely indicted for promoting care that is inefficient, uncoordinated, and too often fails to meet the needs of patients.... Unfortunately, many well-intentioned efforts to move to a more effective system are adding to the already substantial administrative and regulatory burden on physicians, hospitals, and other providers. In turn, these cumbersome new initiatives stifle innovation and obstruct meaningful payment and delivery reform." John O'Shea, in Health Affairs

Text of IRS Notice 2018-76: Deductibility of Expenses for Business Meals under Code Section 274 (PDF)

"This notice provides transitional guidance on the deductibility of expenses for certain business meals ... As amended by the [Tax Cuts and Jobs Act], Section 274 generally disallows a deduction for expenses with respect to entertainment, amusement, or recreation. However, the Act does not specifically address the deductibility of expenses for business meals. This notice also announces that the [Treasury Department] and the [IRS] intend to publish proposed regulations under Section 274, which will include guidance on the deductibility of expenses for certain business meals. Until the proposed regulations are effective, taxpayers may rely on the guidance in this notice for the treatment under Section 274 of expenses for certain business meals." Internal Revenue Service [IRS]

Are You 'Doing Enough' to Avoid ERISA Statutory Penalties?

"Many employers, by handing off plan administration to an insurer or other third-party administrator -- arrangements usually handled by their insurance broker, assume they have what amounts to a 'turnkey' plan, and that mundane plan chores, such as responding to participant document requests, are not any concern of theirs. Members of the ERISA plaintiff's bar are well aware of this dangerous complacency among many uninformed employers and are ready, willing, and able to take advantage of it." Jackson Lewis P.C.

Press Releases

Fiduciary Retirement Plan Services Announces New Employer-Sponsored Retirement Plan Consulting Services Fiduciary Retirement Plan Services

Compliance Assistance for Association Health Plans Now Available at Employer.gov Employee Benefits Security Administration [EBSA], U.S. Department of Labor

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Most Popular Items in the Previous Issue

Health Savings Accounts: Some Frequently Asked Questions and Answers (PDF) EPIC

Employee Benefits in the Supreme Court: October 2018 Update (PDF) Eversheds Sutherland

DOL Rules Time Spent on Wellness Activities Not Compensable Under the FLSA Kilpatrick Townsend