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Scholz & Friends Enlightened Retirement Group, Inc.
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Nicholas Pension Consultants
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PCS, LLC
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Top Health and Welfare Compliance Mistakes
January 9, 2019 in TX
Worldwide Employee Benefits Network [WEB] - Houston Chapter

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March 24, 2019 in CA
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Text of HHS RFI on Modifying HIPAA Rules to Improve Coordinated Care

"The Office for Civil Rights (OCR) is issuing this Request for Information (RFI) to assist OCR in identifying provisions of the [HIPAA] privacy and security regulations that may impede the transformation to value-based health care or that limit or discourage coordinated care among individuals and covered entities (including hospitals, physicians, and other providers, payors, and insurers), without meaningfully contributing to the protection of the privacy or security of individuals' protected health information. This RFI requests information on whether and how the rules could be revised to promote these goals, while preserving and protecting the privacy and security of such information and individuals' rights with respect to it." Office for Civil Rights [OCR], U.S. Department of Health and Human Services [HHS]

25% off Employee Benefits E-Learning Courses Until 12/31

Enroll today and make your education a priority in the new year! Enroll in any of these online courses and get instant access to interactive, self-paced online training. E-learning courses are the online training solution that fits into your schedule

IRS Guidance Addresses Parking Fringe Expenses and UBTI, Provides Penalty Relief to Tax-Exempt Organizations

"A key part of this guidance is a special rule, enabling many employers to retroactively reduce the amount of their nondeductible parking expenses. Under this rule, employers will have until March 31, 2019, to change their parking arrangements to reduce or eliminate the number of parking spots they reserve for their employees. By making this change, many churches, schools, hospitals and other tax-exempt organizations may be able to reduce their associated UBTI." Bryan Cave Leighton Paisner

Agencies Propose HRA Expansion

"Large employers, as well as employers of any size that deploy group health coverage for recruiting and retention purposes will not likely have much interest. But because individual coverage HRAs are themselves group health plans that provide MEC, they might find purchase in industries with large cohorts of contingent and variable workers -- e.g., restaurants, retail, staffing, and hospitality -- that currently offer so-called preventive-services-only plans." Mintz

HHS Seeks Public Input on Improving Care Coordination and Reducing the Regulatory Burdens of the HIPAA Rules

"HHS developed the HIPAA Rules to protect individuals' health information privacy and security interests, while permitting information sharing needed for important purposes. However, in recent years, OCR has heard calls to revisit aspects of the Rules that may limit or discourage information sharing needed for coordinated care or to facilitate the transformation to value-based health care. The RFI requests information on any provisions of the HIPAA Rules that may present obstacles to these goals without meaningfully contributing to the privacy and security of protected health information (PHI) and/or patients' ability to exercise their rights with respect to their PHI." U.S. Department of Health and Human Services [HHS]

IRS Explains Disallowance of Qualified Transportation Fringe Benefits for Parking

"[ Notice 2018?99 ] provides a four-step method that will be considered reasonable and states that using the value of employee parking to determine expenses allocable to employee parking in a parking facility owned or leased by the taxpayer is not a reasonable method because Sec. 274(a)(4) disallows a deduction for the expense of providing a QTF, regardless of its value.... [F]or tax years beginning on or after Jan. 1, 2019, a method that fails to allocate expenses to reserved employee spots cannot be a reasonable method."
Journal of Accountancy

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ERISA Class Action Litigation over Fees in Health and Welfare Plans

"Although the primary issue is whether these plans were improperly designated as governmental entity plans ... the key issue for health-plan fiduciaries is whether Atrium retained a costly, affiliated entity as a third-party administrator for its health plan and failed to ensure that participants paid only 'reasonable' fees for services, co-insurance and deductibles." [Shore v. Charlotte-Mecklenburg Hospital Authority (d/b/a Atrium, f/k/a Carolinas Healthcare System), No. 18-961 (M.D.N.C. complaint filed Nov. 19, 2018)]
McDermott Will & Emery

Michigan HICA Tax Officially Repealed

"Michigan officially repealed the Health Insurance Claims Assessment (HICA) tax on June 11, 2018. However, that repeal was conditioned on the approval of its replacement -- the Investment Provider Assessment (IPA) -- by [CMS]. On December 11, 2018, CMS ... approved the IPA.... [S]elf-funded group health plans are not subject to the IPA. On the other hand, fully insured group health plans are subject to the IPA." Miller Johnson

Reimbursement Barriers Still Plague Telemental Health Expansion

"Federal and state efforts to boost telemental health may be blossoming -- in particular for students, seniors and veterans -- but 'a lack of meaningful coverage and reimbursement rules' means the telemedicine specialty is still struggling for sustainability.... And while [there is] a lot to like in new connected health programs and policies, [there are still] significant barriers in how these programs are supported." mHealthIntelligence

CMS Announces 2019 Pass-Through Funding For State Waivers

"CMS posted letters for Alaska , Hawaii , Maine , Maryland , Minnesota , and Oregon . Based on these letters, the estimated total pass-through funding for 2019 so far is about $634 million, more than half of which will go to Maryland. All these states except Hawaii used a Section 1332 waiver to adopt a state-based reinsurance program."
Katie Keith, in Health Affairs

New Rules for Section 1332 Waivers: Changes and Implications

"State waiver programs could reduce health insurance premiums for some, even many, state residents.... Parallel markets could divide the risk pool, isolating people with pre-existing conditions.... Shifting ACA subsidies to medically underwritten policies could destabilize ACA-compliant markets.... New counting rules could reduce protection for people with pre-existing conditions.... Other marketplace services and protections could be weakened under 1332 waiver programs." Henry J. Kaiser Family Foundation

Evaluating the Administration's Health Reimbursement Arrangement Proposal

"[T]his new option would likely be particularly appealing to large employers with sicker workforces.... [S]ubsidizing community-rated individual market coverage could allow them to offer similar coverage at lower cost.... [T]he influx of sicker workers into the individual market would increase premiums, thereby increasing subsidy costs for the federal government and premiums for unsubsidized enrollees." The Brookings Institution

Prescription Drugs and Price Controls: What the Debate Gets Wrong

Podcast with transcript. "America has been called the 'Pharmacy to the World' because it's where more than half of new drugs get developed and tested in clinical trials. Patients in Europe and elsewhere enjoy the benefits of these breakthrough drugs. Price controls in the U.S. would significantly curtail new research and development project s-- resulting in a net loss for everyone." City Journal, published by the Manhattan Institute for Policy Research

DOL and (Some) IRS Relief for Recent Hurricane and Fire Victims

"DOL will not pursue ERISA violations against plans for transactions involving hardship withdrawals, loans, and blackout notices for victims of Hurricanes Florence and Michael and the 2018 California wildfires. DOL has not mandated any additional COBRA deadline extension, as it did with hurricane Maria in 2017. Additionally, for victims of these hurricanes, the IRS has offered relief from a number of the usual distribution restrictions so that participants can quickly access their retirement plan funds for disaster-related needs." Buck

2019 Health and Retirement Plans Reporting and Disclosure Calendar: Single Employer Plans (PDF)

"[This 24-page calendar summarizes] the annual compliance requirements and disclosure obligations that health and retirement plan sponsors need to know. The content in these calendars raise issues that may cause plan sponsors to check, change or consider their current approaches." Sibson Consulting

2019 Health and Retirement Plans Reporting and Disclosure Calendar: Multiemployer Plans (PDF)

"[This 25-page calendar summarizes] the annual compliance requirements and disclosure obligations that health and retirement plan sponsors need to know. The content in these calendars raise issues that may cause plan sponsors to check, change or consider their current approaches." Segal Consulting

Press Releases

Global IQX API Unleashes Wealth of Data for Employee Benefits Insurers Global IQX, Inc.

The Retirement Advantage Acquires The Condon Company The Retirement Advantage [TRA]

Cowden Associates, Inc. Hires Top Talent for Health and Benefits, Retirement / Actuarial and Compensation Practices Cowden Associates, Inc.

Alegeus Announces Multi-Phased Innovation Initiative to Deliver the Industry's First "Smart HSA" Alegeus

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Most Popular Items in the Previous Issue

Recent Development on Wilderness Therapy Treatment Winston & Strawn LLP

Tweaked Year-End Tax Relief Package Includes Retirement and Health Care Provisions Committee on Ways and Means, U.S. House of Representatives

Ninth Circuit Recognizes Cat's Paw Liability in ERISA Retaliation Case; Fiduciary Claims Fail Thomson Reuters Practical Law