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FMLA, Disability, and Sick Leave Management: A Panel Discussion
October 17, 2018 in ME
Maine Employee Benefits Council

New Jersey's Earned Sick Leave Law Update: The Proposed Regulations are Out
October 19, 2018 WEBCAST
Littler

"Magical Mystery Tour" of Prescription Drug Rebates
November 8, 2018 WEBCAST
University Conference Services

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New Jersey Employers Are One Step Closer to Mandatory Paid Sick Leave

"The New Jersey DOL just published the New Jersey Paid Sick Leave Notice ... [Employers] must post the notice at a conspicuous place at all worksites and distribute it to all employees by November 29, and also again each time thereafter when an employee is hired or requests such a notice.... The [NJ] DOL also recently published proposed regulations to implement the requirements of the Act.... While the proposed regulations further clarify certain provisions, some questions remain unanswered."
Fisher Phillips

Sixth Circuit Finds No Breach of Fiduciary Duty When Participant Was Not Informed of Life Insurance Conversion Right

"Here, the complaint contained no factual allegations indicating that Resolute knew that Arthur's ability to convert would be important to him. Nothing required Resolute to expressly disclose the information at issue. Neither ERISA nor the DOL's regulations require SPDs to include conversion information. In addition, the SPD explains that insurance will cease upon termination of active employment, that an employee may convert the coverage, and that total disability may entitle an employee to continued coverage subject to premium payment." [ Vest v. Resolute FP US Inc. , No. 18-5046 (6th Cir. Oct. 10, 2018)]
Kantor & Kantor

Strategies for Controlling Prescription Drug Costs

"Tiered cost-sharing networks are common, offered by 92% of responding organizations.... More than seven in ten responding organizations (70.9%) use a drug formulary.... One-half of respondents use step therapy (50.0%), ... Two in five responding organizations (39.4%) promote the use of generic drugs via financial incentives.... A large majority of respondents offer a mail-order drug service (85.3%).... About two in three respondents (65.2%) utilize a pharmacy benefit manager (PBM)." International Foundation of Employee Benefit Plans [IFEBP]

Employers, Employees Striking a Balance When It Comes to Health Care Costs in 2019

"In 2018, health care premiums rose 3.5 percent. However, employers passed along a lower 2.2 percent premium increase to employees, absorbing a larger 3.9 percent increase to company costs.... [A]fter plan design changes and vendor negotiations, 2019 medical and pharmacy plans premiums are expected to increase by 3.5 percent, the same percentage as 2018.... Employers are increasingly looking to manage cost increases through means other than shifting cost onto employees." Aon Hewitt

'Virtual' Doctor Visits Are Enticing Employers. What If You're the Patient?

"About three-quarters of large firms that offer health insurance now cover such 'telemedicine,' ... up from 27 percent three years ago. And half the large employers that were surveyed by the National Business Group on Health said adopting virtual solutions was their 'top initiative' in 2019.... Fewer than 1 percent of enrollees in large employer health insurance plans used telemedicine services in 2016[.]" The New York Times; subscription may be required

Health Insurance Providers Look to Telehealth During Emergencies

"Following the devastating Hurricanes Harvey, Irma, and Maria in 2017, telehealth made it possible for patients to access care despite the inclement conditions.... Many health insurance providers connect their members with counseling and other behavioral health services via telehealth." America's Health Insurance Plans [AHIP]

Direct Primary Care: A Segue to Direct-to-Employer?

"Direct contracting between major employers and health systems can lead to savings, but it also opens providers up to financial risk -- which may be untenable for those seeking a safer bet. While many direct contracts have shown positive results, others have fallen short of expectations for at least one party." HealthLeaders Media

How Bernie Sanders' 'Medicare for All' Proposal Would Outlaw Private Healthcare Plans

"It's crystal clear the bill would eliminate every existing private insurance policy within four years, which would mean about 180 million individuals would have to give up the insurance they currently purchase on their own or through their employers.... [T]here's a limited claim that can be made that in theory, the bill, after getting rid of all existing policies, would allow private insurers to offer some supplemental benefits." Washington Examiner

The Impact of Insurance Expansions on the Already Insured: The ACA and Medicare

"Some states that have not adopted the [ACA] Medicaid expansions have stated concerns that the expansions may impair access to care and utilization for those who are already insured. [The authors] investigate such negative spillovers using a large panel of Medicare beneficiaries.... [R]esults suggest that the expansions in Medicaid did not impair access to care or utilization for the Medicare population." National Bureau of Economic Research [NBER]; purchase required for full document

Text of IRS Disaster Relief Announcement GA-2018-04, for Victims of Hurricane Michael in Georgia

"Individuals who reside or have a business in Baker, Bleckley, Burke, Calhoun, Colquitt, Crisp, Decatur, Dodge, Dooly, Dougherty, Early, Emanuel, Grady, Houston, Jefferson, Jenkins, Johnson, Laurens, Lee, Macon, Miller, Mitchell, Pulaski, Seminole, Sumter, Terrell, Thomas, Treutlen, Turner, Wilcox, and Worth counties may qualify for tax relief.... [C]ertain deadlines falling on or after Oct. 9, 2018 and before Feb. 28, 2019, are granted additional time to file through Feb. 28, 2019." Internal Revenue Service [IRS]

Text of Updated IRS Disaster Relief Announcement FL-2018-04, for Victims of Hurricane Michael in Florida

"Update 10/14 -- Added Holmes and Washington counties. Update 10/13 -- Added Calhoun, Gadsden, Hamilton, Jackson, Jefferson, Leon, Liberty, Madison and Suwannee counties.... Individuals who reside or have a business in Bay, Calhoun, Franklin, Gadsden, Gulf, Hamilton, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Suwannee, Taylor, Wakulla and Washington counties may qualify for tax relief.... [C]ertain deadlines falling on or after Oct. 7, 2018 and before Feb. 28, 2019, are granted additional time to file through Feb. 28, 2019." Internal Revenue Service [IRS]

Summary of IRS Help for Victims of Hurricane Michael

This page provides links to all IRS disaster relief notices and announcements related to Hurricane Michael, and is updated as new guidance is released. Internal Revenue Service [IRS]

In Memoriam: ERISA Attorney Nick Saakvitne Dies at 66

"Nicholas Larsen Saakvitne, 66, of Pacific Palisades, died on October 2, 2018 after suffering a ruptured cerebral aneurysm. Nick was a pension attorney and professional ERISA fiduciary and trustee in Santa Monica, California.... In 1989 with his business partner, Steven E. Rosebaugh, Nick founded his own law firm specializing in pension law and providing ERISA and ESOP fiduciary services." Los Angeles Times via Legacy.com

Late Filing of Forms 1094-C and 1095-C

Does anyone have any thoughts on what the likelihood is that the IRS will assess penalties under Code Section 6721 on a hypothetical ALE that failed (for no reason other than a lack of knowledge of the requirement) to timely file with the IRS Forms 1094-B and/or 1095-C for 2016? BenefitsLink Message Boards

Press Releases

Russell Investments Announces "Tax-Smart" Partnership with LifeYield LLC Russell Investments

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Most Popular Items in the Previous Issue

IRS Provides Tax Relief for Victims of Hurricane Michael Internal Revenue Service [IRS]

CMS Announces 2019 Medicare Parts A & B Premiums and Deductibles Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

District Court: Health Plan Could Not Use Its Interpretation of 'Reasonable and Customary' Because It Did Not Disclose Methodology Thomson Reuters / EBIA