Senior ERISA Attorney / Managing Partner Level
Small boutique ERISA practice
in CA, OR, WA, Telecommute

Retirement Plan Administrator
Carr, Riggs and Ingram, LLC
in NM, TX, Telecommute

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Hot Topics in Employee Benefits: What We're Seeing
December 6, 2018 WEBCAST
Morgan Lewis

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Good News on Health Coverage Reporting for 2018 Coverage

"Providing the Forms 1095-C and 1095-B to employees is only one piece of the reporting obligation and employers did NOT receive any extension on the deadlines by which they must file the Forms 1094-B, 1094-C, 1095-B or 1095-C with the Service. The deadline to file such reports with the Service for 2018 remains at February 28, 2019 for paper filers and April 1, 2019 for electronic filers." Winstead PC

IRS Extends ACA Reporting Deadline

"The due date for providing Forms 1095-C or 1095-B to employees and individuals is extended 32 days to March 4, 2019.... Good faith penalty relief is also extended for the 2018 forms.... [T]he deadline for filing the forms with the IRS is not extended. Therefore, employers filing by paper must submit their forms to the IRS by February 28, 2019. Those filing electronically have until April 1." HUB International

2018 ACA Reporting Deadline Extended by 30 Days (Again)

"As with prior years, the IRS states in the Notice that individuals may file their individual tax return (Form 1040) prior to receiving the Forms 1095-B and/or 1095-C by relying on any other information received from the employer or coverage provider (e.g., insurance carrier). Note that the Tax Cuts and Jobs Act effectively repeals the individual mandate as of 2019. Therefore, the 2018 tax filing at the beginning of 2019 will be the final return where the individual mandate will be a concern." ABD Insurance & Financial Services

Employer Options for Health Insurance May Expand with New HRA Rules

"The departments estimate that 1 million employees will enroll in individual coverage with access to an [individual coverage HRA (ICHRA)] in 2020, with that number growing to 10.3 million by 2024. About two thirds of that group are estimated to come from traditional employer-sponsored group health coverage. The departments predict 800,000 companies will offer ICHRAs in 2024, while suggesting the vast majority of adopters will be small to midsize employers." Willis Towers Watson

When Is Medicare Entitlement a COBRA Qualifying Event?

"If a COBRA triggering event, such as Medicare entitlement, does not cause loss of coverage under your plan, there is no qualifying event, and COBRA need not be offered.... [T]he Medicare Secondary Payer (MSP) rules generally prohibit group health plans from making Medicare entitlement an event that causes a loss of coverage for active employees." Thomson Reuters / EBIA

Change in Premium Payment Method Was a Loss of Coverage for COBRA Purposes

"Defining a loss of coverage for COBRA purposes as 'ceas[ing] to be covered under the same terms and conditions as in effect immediately before the qualifying event,' the court concluded that the change in her premium contribution method (i.e., from payroll deductions to payment from her workers' compensation benefits) was a change in the terms and conditions of coverage." [ Morehouse v. Steak N Shake, Inc. , No. 16-789 (S.D. Ohio Nov. 6, 2018)]
Thomson Reuters / EBIA

Text of CMS Updated Summary Report on Permanent Risk Adjustment Transfers for the 2017 Benefit Year (PDF)

9 pages. "This document updates two Tables in the 2017 Summary Report to reflect a recalculated default risk adjustment charge in the Utah small group market. The adjusted default charge allocation payments will be distributed to affected issuers in the Utah small group market after the additional default charge has been collected." Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

CMS Releases New 1332 Waiver Concepts: A Summary

"Rather than dictating state options, the goal of releasing the waiver concepts is to spur state innovation and illustrate some of the ways that states might take advantage of the flexibility offered in the new guidance on Section 1332.... The four waiver concepts are [1] account-based subsidies; [2] state-specific premium assistance; [3] adjusted plan options; and [4] risk stabilization strategies." Chris Fleming and Katie Keith, in Health Affairs

CMS Releases New 1332 Waiver Concepts: Implications

"[S]tates will still need to devote significant resources to crafting strong proposals. This will require actuarial modeling and analysis, public hearings and comment periods, and approval from the legislature and governor in many states.... At the same time, questions remain about how states could pursue some of these waiver options and continue to meet Section 1332's statutory guardrails." Katie Keith and Chris Fleming, in Health Affairs

Innovative Options to Cut Health Insurance Costs by Expanding the Circle of Coverage: A Report for State Consumer Leaders and Policymakers (PDF)

20 pages. "[1] Move toward implementing a Medicaid buy-in policy that lets consumers with incomes too high for Medicaid enroll in substantially more affordable insurance.... [2] Supplement federal financial assistance with extra help for paying premiums and lowering deductibles and other cost sharing.... [3] Implement the ACA's Basic Health Program (BHP) option ... [4] Provide more public education and hands-on assistance to help consumers obtain and retain coverage.... [5] Use state income tax filing to give the eligible uninsured opportunities to seek coverage, including by making enrollment as automatic as possible.... [6] Enact state-based individual mandates ... [7] Lower premiums by using public reinsurance dollars to pay individual market claims." Families USA

Press Releases

DataPath Receives Top Honor for Employee Engagement Program Website DataPath, Inc.

Wells Fargo Announces New Retirement Income Planning Center Wells Fargo

Zahra Ebrahimi, Ph.D. Joins Employee Benefit Research Institute EBRI [Employee Benefit Research Institute]

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Most Popular Items in the Previous Issue

Text of IRS Notice 2018-94: Extension of Due Date for Furnishing Statements and of Good-Faith Transition Relief for 2018 ACA Reporting (PDF) Internal Revenue Service [IRS]

Text of CMS FAQs for Enhanced Direct Enrollment (PDF) Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

'Tis the Season: FMLA and Holidays Jackson Lewis P.C.