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OneDigital Health and Benefits

Health Care in Retirement: The Trends & Implications for Retirees
November 15, 2018 WEBCAST
EBRI [Employee Benefit Research Institute]

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Text of CMS Notice of Proposed Rulemaking: International Pricing Index Model for Medicare Part B Drugs

59 pages. "CMS intends to test whether [1] phasing down the Medicare payment amount for selected Part B drugs to more closely align with international prices; [2] allowing private-sector vendors to negotiate prices for drugs, take title to drugs, and compete for physician and hospital business; and [3] changing the 4.3 percent (post-sequester) drug add-on payment in the model to reflect 6 percent of historical drug costs translated into a set payment amount, would lead to higher quality of care for beneficiaries and reduced expenditures to the Medicare program." Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

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CMS Proposes International Pricing Index Model for Medicare Part B Drugs

"CMS is considering issuing a proposed rule in the spring of 2019 on the potential model, called the International Pricing Index (IPI) Model. The potential IPI Model would start in spring 2020 and operate for five years, until the spring of 2025. Over the course of the model, CMS would monitor and evaluate the impact of the model on beneficiary access to drugs, program costs, and the quality of care for beneficiaries.... CMS is seeking feedback on the potential parameters of the IPI Model."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

A New Direction for Health Reimbursement Arrangements

"Under the proposed rules, differences in the amount of HRA contributions can be based on an employee's work location. However, availability of individual Exchange coverage is based on an individual's place of residence. Employees at the same work location could live in multiple rating areas. Therefore, the employer's HRA contribution would buy varying amounts of coverage for its employees, even if the employer makes adjustments for age and family size, because of differences in individual insurance coverage options and costs." Winston & Strawn LLP

Paid Sick Leave Changes in New York City and Westchester County

"[For NYC, revised FAQs provide that] ... [E]mployers must maintain sick and safe time policies in a single writing.... Employers are now expressly forbidden from maintaining or applying absence control policies that count time off protected by the ESSTA as absence(s) that may lead to disciplinary action.... [J]oint employers cannot allocate responsibility for compliance with the law among themselves.... Westchester County, New York, enacted a new ordinance called the Earned Sick Leave Law (ESLL). For most employees in Westchester County, the ESLL will take effect on April 10, 2019." Littler

New Jersey FAQs Clarify Requirements of Paid Sick Leave Law

"An employer cannot use an employee's anniversary year as its designated benefit year for paid sick time.... An out-of-state employer must provide paid sick leave to employees who perform all work in New Jersey.... The 120-day waiting period does not restart for reinstated employees.... An employee may use sick leave during overtime that they were required to work but employer is not required to pay sick leave at overtime rate." Fisher Phillips

NYC Council Passes Bills Expanding Lactation Room Requirements for Employers

"The first bill ... would require covered employers to provide employees needing to express breast milk with access to a lactation room, as well as to a refrigerator suitable for breast milk storage, 'in reasonable proximity' to the employee's work area.... The second bill ... would require covered employers to develop and implement a written policy regarding the provision of a lactation room, to be distributed to all new employees upon hire. The policy would be required to ... identify a process by which employees could request a lactation room." Proskauer

Want to Crack Down on FMLA Abuse? Try the Chicago Way

"[T]wo years ago, nearly 50 percent of the center's call takers were on some type of absence tied to the FMLA.... [T]he call center has reduced FMLA use by 4,000 hours ... and lowered overtime costs by nearly $1 million.... [T]he City has ... [1] Conducted FMLA training for all managers ... [2] Empowered managers to ask their employees questions about their leave 'without fear'. [3] Initiated meetings with employees when they recognized a pattern of absenteeism ... [4] Those who have abused FMLA leave have been shown the door. Lawfully. Shown. The. Door." FMLA Insights

Make Sure Your Health Plan is Affordable When Setting Premiums for 2019

"[F]or 2019 the cost of single coverage must be less than 9.86% of an employee's household income in order to be affordable. The 9.86% is also the percentage that employers can rely on for 2019 under either the federal poverty limit, rate of pay or Form W-2 safe harbor. If you wish to rely on the federal poverty level safe harbor, ... you must charge less than $99.76/month for single coverage." Graydon

Choosing the Right Flexible Benefit for Employees

"Trying to decide which of the many employer-sponsored benefits out there to offer employees can leave an employer feeling lost in a confusing bowl of alphabet soup -- HSA? FSA? DCAP? HRA? ... While there are many details to cover for each of these benefit options, perhaps the first and most important question to answer is: which of these benefits is going to best suit the needs of both my business and my employees?" United Benefit Advisors

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

Nov. 28 webinar. Although HSAs have numerous tax advantages, it is easy to inadvertently fail to satisfy the requirements. This webinar will help health plan administrators navigate this sometimes treacherous terrain. BenefitsLink discount .

Why Do I Keep Getting Billed for Preventive Health Services?

"[T]he U.S. Preventative Care Guidelines outline what services should be considered as preventative and what frequency is recommended.... These guidelines ... do not include common procedural terminology (CPT codes) to clearly state what services are recommended as preventative.... This has left administrators to establish clinical and administrative policies, resulting in inconsistencies between commercial insurers and government and commercial payers." Mercer

Employers Concerned About Cost of Waste and Inappropriate Healthcare

"Employers perceive healthcare waste to be a problem, with majority (57%) indicating up to 25% of treatments their employees and dependents receive are wasteful. Most employers don't collect or analyze data to track waste (59%), and those that do rely on their vendors (34%).... Most employers don't report significant success in managing healthcare waste, their efforts have generally only been somewhat effective (e.g. 25% effective for medical imaging, 12% physician referrals)." National Alliance of Healthcare Purchaser Coalitions

Trump Administration Outlines Plan to Lower Pharmaceutical Prices in Medicare Part B

"The plan contains three key elements: substituting private-sector pharmaceutical vendors for the current Part B 'buy and bill' practice, changing the Part B Average Sales Price plus 6 percent reimbursement system to a flat fee, and implementing international reference pricing. The first two of these were attempted -- and failed -- in previous administrations." Health Affairs

Health Plan Choice and Premiums in the 2019 Federal Health Insurance Exchange (PDF)

44 pages. "This brief presents information on qualified health plans (QHPs) available in the Exchange for states that use the HealthCare.gov platform, including estimates for issuer participation, health plan options, premiums, and subsidies in the upcoming open enrollment period (OEP), and trends since the first OEP. National estimates and summary tables are presented in each section of the text." Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS]

CBO's Health Insurance Simulation Model: Overview of Planned Updates

30 presentation slides. "Currently, CBO is developing and testing a new version of HISIM to respond to continued Congressional interest in understanding the effects of legislative proposals that significantly affect health insurance coverage. The new model will be used to help develop CBO's spring 2019 baseline projections and subsequent cost estimates." Congressional Budget Office [CBO]

The Health of the Small-Group Insurance Market

"Enrollment has declined in the small-group market, although this is largely a continuation of a trend in place prior to the ACA. Substantially more small-business owners and workers now have coverage than prior to the ACA because many have been able to take advantage of subsidized individual plans through the marketplaces. For those who remain in the small-group market, price increases have been similar to those in the large-group market." The Commonwealth Fund

IRS and DOL Audit Focus Points (PDF)

25 presentation slides. Topics include: [1] Agencies conducting audits; [2] Plans being audited; [3] Drivers of audit activity; [4] The audit process: IRS examination process and areas of focus; [5] Best practices/life before an audit; [6] IRS and DOL sample request letters; and [7] Know your compliance requirements. McDermott Will & Emery

U.S. Employers Taking Measures to Modernize Total Rewards Programs

"Nearly two-thirds of employers (66%) have made at least one change to their Total Rewards program; of those who haven't, two out of three are considering doing so this year, with the other third considering changes over the next three years. These changes include: Greater flexibility.... Health and wellbeing benefits.... Personalized communication.... Technology.... Transparency." Willis Towers Watson

Press Releases

Fidelity's New Financial Wellness Platform Provides 20 Million Workers with a Solution Targeted to Their Top Financial Needs Fidelity Investments

DataPath Adds Podcasts to Employee Engagement Program DataPath, Inc.

Dietrich Growth Continues to Evolve Dietrich

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Most Popular Items in the Previous Issue

Text of CMS HIOS Portal User Manual (PDF) Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

2018 End of Year Health and Welfare Plan Sponsor 'To Do' List Snell & Wilmer

Employer-Provided HRAs for Individuals to Purchase Health Insurance -- A Remedy for High Health Benefit Costs? Winstead PC