Associate Director of Pension Benefits
Sheet Metal Workers' National Pension Fund
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Benefits and Breakfast: Post-Acquisition Integration of Benefit Plans
December 4, 2018 in PA
Drinker Biddle & Reath LLP

Benefits and Breakfast: Post-Acquisition Integration of Benefit Plans
December 5, 2018 in IL
Drinker Biddle & Reath LLP

Contracts 101: Creating Simple, Compliant Service Provider Agreements
December 5, 2018 WEBCAST
Compliancedashboard, LLC

Health Savings Account Basics
December 11, 2018 WEBCAST
HealthEquity

Tips to Maximize your Health Savings
December 12, 2018 WEBCAST
HealthEquity

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Proposed Regs Would Permit Employers to Reimburse an Employee's Premiums for Health Insurance Purchased in the Individual Market

"[T]he most significant conditions that an employer must satisfy in order to maintain one of these HRAs integrated with individual health coverage [ICHRA] ... [1] An employee cannot be eligible for both a group health plan and an [ICHRA].... [2] The employer must offer the [ICHRA] on the same terms for all employees in a specific class.... [3] The employer must verify that employees actually incurred expenses for individual health coverage before reimbursing such expenses.... [4] The employer must distribute a specific notice to employees eligible for the [ICHRA] ... 90 days before the beginning of each plan year." Foley & Lardner LLP

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Is Your Company Eligible for a Credit for Wages Paid under FMLA?

"The Tax Cuts and Jobs Act enacted late last year created an employer credit for paid leave provided under [FMLA]. The credit is equal to 12.5% of wages paid to a qualifying employee during any period in which he or she is on leave under FMLA, provided the employee's pay during this period is 50% of the wages normally paid to him or her." Schneider Downs

ACA Penalty Notices Are in the Mail

"Officially known as Letter 226-J, the notices inform employers of a preliminary employer mandate penalty calculation under Section 4980H. In late 2017, the IRS began mailing notices for 2015 -- with a reported 30,000 applicable large employers receiving Letter 226-J. Now the IRS has progressed to issuing Letter 226-J for 2016. The move to issuing 2016 penalty notices is significant because the pool of employers that may be subject to employer mandate penalties is much wider." Thomson Reuters / EBIA

Branded Prescription Drug Prices Continue to Rise

"Prescription drug spending among branded specialty and patent-protected drugs continues to outpace generic drugs at $79.5 billion ... Branded prescription drugs comprise only 17 percent of total prescriptions filled but account for 79 percent of overall drug spending at $79.5 billion.... While generic drug spending has declined 3 percent since 2016, it hasn't kept pace with the rapid rise in specialty branded drugs." Blue Cross and Blue Shield Association

Prescription Drug Importation: New Federal Initiatives and the Case for State Action

"While the administration recently floated the idea of Medicare using international reference pricing for drug purchasing, ... the FDA is proposing drug importation to stimulate price competition among biologics and certain small molecule generics. This is a significant development that could change decades-old federal policy, and it is predictably generating industry pushback." Health Affairs

In the Absence of Drug Rebates, New Alternatives Are Likely to Emerge

"Rebate alternative #1: Point-of-sale (POS) rebates ... generated when the consumer fills a prescription. A portion of the negotiated rebate between the manufacturer and the PBM/health plan is used to offset the consumer's out-of-pocket expense at the pharmacy.... Rebate alternative #2: Negotiated discount price ... [P]harmacies would likely continue to acquire products from wholesalers and distributors using today's list price. PBMs and plan sponsors would then pay the pharmacies based on the negotiated discount price, which would be less than their acquisition cost." Deloitte

Realizing the Promise of Telemedicine for Employers

"The high availability and low utilization of telemedicine by employees, as compared to its potential, means both employers and employees are spending far more on healthcare for non-emergency, primary care treatment and receiving that care less conveniently at a physical location.... With a minimum of 200 million visits annually capable of being diverted to telemedicine, and with First Stop Health's average savings of $216 per visit, telemedicine can deliver ever-increasing value to employers and the healthcare system as a whole." First Stop Health

What Fees Reveal About Your HSA Provider

"Friction is caused by the degree of difficulty to access HSA investments, which could be in terms of excess fees, non-integrated trading platforms, unnecessary forms, or other red tape. The easier it is for your employees to invest their HSA is an indication of a provider's understanding of and alignment with your employee's long-term HSA investment success." HealthEquity

Ten Essential Contract Provisions for Service Provider Agreements

"Common service provider agreements include those with: an insurance company; TPA; claims & billing administrator; COBRA partner; stop loss carrier; financial institutions; and vendors who provide software services that handle Protected Health Information 'PHI'.... Whether your existing agreements are up for negotiation or you're on the threshold of signing a new one, ... consider including these provisions in your agreements." Compliance Dashboard

The New California Regulatory Scheme for Pharmacy Benefit Managers

"PBMs will have to register with the California Department of Managed Health Care (DMHC) and provide new disclosures to the purchasers of their services. The bill will also establish a new pilot project and task force run by the DMHC to analyze how PBMs are affecting the pharmaceutical market." Sheppard Mullin

Some Are Skeptical of North Carolina's Reference-Pricing Move

"North Carolina is shifting its health plan for state employees and teachers to a reference-pricing model that ties payments for health care services to Medicare rates. The new rates for various categories of services will average out to 177% of Medicare's fees, down from a current average of 213%[.]" AISHealth

ERIC Remains Confident in Lawsuit Against City of Seattle

"Seattle hotels with at least 100 rooms must offer the affected employees (even if they have other coverage) coverage in an employer-sponsored group health plan with benefits that are the equivalent of gold-level medical policy on the Washington State insurance exchange at a cost of no more than five percent of their monthly gross taxable earnings or else provide additional compensation based, in part, on the cost of such coverage. ERIC's lawsuit seeks to halt enforcement of Part 3 of the Initiative because it requires, uniquely for Seattle, a specified level of health plan benefits and precludes uniform plan administration governed by federal law." The ERISA Industry Committee [ERIC]

Hot Topics in Total Rewards

"Finding the right recognition vendor, solving the pay gap, working with compensation committees, and finding the right performance management are all challenging puzzles but solving them will reap great rewards for the company." Findley

Agencies Release Advance Copies of Form 5500 Annual Return/Report for 2018

"[EBSA, IRS and PBGC have] released advance informational copies of the 2018 Form 5500 Annual Return/Report and related instructions . The 'Changes to Note' section of the 2018 instructions highlights important modifications to the Form 5500 and Form 5500-SF, and their schedules and instructions.... The advance copies of the 2018 Form 5500 are for informational purposes only and cannot be used to file a 2018 Form 5500 Annual Return/Report."

Schedule A -- Insurance Information
Schedule C -- Service Provider Information
Schedule D -- DFE/Participating Plan Information
Schedule G -- Financial Transaction Schedules
Schedule H -- Financial Information
Schedule I -- Financial Information -- Small Plan
Schedule MB -- Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information
Schedule R -- Retirement Plan Information
Schedule SB -- Single-Employer Defined Benefit Plan Actuarial Information

Form 5500-SF Annual Return/Report of Small Employee Benefit Plan, and Instructions .

Text of IRS Disaster Relief Notice CA-2018-13, for Victims of November 8 Wildfires in California

"Victims of Wildfires that took place beginning on Nov. 8, 2018 in California may qualify for tax relief ... Individuals who reside or have a business in Butte, Los Angeles and Ventura counties may qualify ... [C]ertain deadlines falling on or after Nov. 8, 2018 and before April 30, 2019, are granted additional time to file through April 30, 2019." Internal Revenue Service [IRS]

Planning for 2019: Year-End Deadlines and Considerations for Employee Retirement, Health & Welfare Plans

"As the end of the year approaches, employers should be aware of important year-end deadlines and considerations related to their retirement, health and welfare plans. [The authors] have compiled a list of these deadlines and provide guidance on how to comply with recent changes." Husch Blackwell

Press Releases

Lex Machina Expands Employment Litigation Analytics with Launch of ERISA Module Lex Machina

Russell Investments Delivers New Income Model Portfolio Strategies via Envestnet, Baird & TD Ameritrade Russell Investments

Walmart Honored by National Alliance of Healthcare Purchaser Coalitions for Efforts to Improve Healthcare Delivery System National Alliance of Healthcare Purchaser Coalitions

Fidelity Introduces Industry-First Global Retirement Savings Guidelines Fidelity Investments

Transamerica Unveils New Suite of Tools to Help Patients and Financial Professionals Navigate Family Finances Following a Cancer Diagnosis Transamerica

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Most Popular Items in the Previous Issue

Beyond Words: Engaging Consumers in Changing Health Behaviors (PDF) Buck

Proposed Regs Would Permit Employers to Reimburse Employee Premiums for Health Insurance Purchased in the Individual Market Foley & Lardner LLP

Employers Face Increased Litigation Over Plan Coverage of Residential Treatment and Wilderness Therapy Frost Brown Todd LLC