Health & Welfare Plans Newsletter

December 26, 2018

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Leading Retirement Solutions
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Webcasts, Conferences

New Year, New Benefits Philosophy: What Employers are Looking for in 2019 & Beyond
January 9, 2019 WEBCAST
University Conference Services

Risk Mitigation Strategies for Benefit Plans
January 23, 2019 WEBCAST
Morgan Lewis

Managing Your Largest Claims
February 7, 2019 WEBCAST
University Conference Services

National Conference & Expo
February 12, 2019 in OH
Health Action Council

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[Official Guidance]

Text of CMS Guidance: Availability of Additional Special Enrollment Period for Certain Individuals Affected by Hurricane Michael in Florida and Georgia (PDF)

"Qualifying individuals in Florida counties that FEMA designated as eligible to apply for 'individual assistance' or 'public assistance' ... will have until February 16, 2019 to enroll in Exchange coverage (that is, 60 days following the end of the first SEP on December 18, 2018). Qualifying individuals in Georgia counties that FEMA designated as eligible to apply for 'individual assistance' or 'public assistance' ... will have until February 20, 2019 to enroll (60 days following the end of the first SEP on December 22, 2018)." [Unnumbered document; Dec. 21, 2018] Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

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[Guidance Overview]

Michigan Amends Recently Enacted Paid Sick Leave Law

"The revisions contained in the new Act ... restrict the paid leave mandate to significantly fewer employers than were subject to the original law, and they greatly reduce the number of paid leave hours an eligible employee can accrue. The PMLA is expected to take effect in late March or early April of 2019[.]" Epstein Becker Green

HHS Proposes to Rescind HIPAA Health Plan Identifier (HPID) Rules

"Based on both NCVHS's recommendation and 'overwhelming and persistent industry input,' HHS concluded ... that the HPID and OEID do not, and cannot, serve the purpose for which they were originally adopted."
Thompson Reuters Practical Law

All Parties in Texas v. Azar Ask for Appeal to Fifth Circuit

"On December 21, 2018, the plaintiffs in Texas v. Azar and the federal government asked Judge Reed O'Connor ... to allow for an immediate appeal to the Fifth Circuit Court of Appeals of his decision to invalidate the entire [ACA].... The federal government and intervenor states additionally encourage Judge O'Connor to confirm that his decision does nothing to disrupt the ACA and that the ACA remains the law of the land while the case proceeds."
Katie Keith, in Health Affairs

Court Rules that Payment and Acceptance of Long-Term Disability Insurance Premiums Does Not Guarantee Coverage

"The court found that Aetna did not waive its right to deny coverage by accepting premiums and failing to notify [the employee] that coverage was not in effect.... [T]he employer paid premiums under an aggregate billing method and did not provide Aetna with data at the individual employee level.... The employer is responsible for enrollment and collecting premiums." [ Ward v. Aetna Life Ins. Co. , No. 17-331 (S.D. Miss. Dec. 20, 2018)]
Kantor & Kantor

Post-TCJA Deduction Disallowance Rules for Meals: Possible 100% Deduction for Snacks Under Code Section 132

" Notice 2018-76 ... confirmed that food and beverages provided during an entertainment activity may qualify for a 50% deduction, even though the 'entertainment expenses' (apart from food and beverages) are 100% disallowed, under the TCJA's 100% disallowance for entertainment expenses (effective after 2017). However, the notice did not discuss on-premises food and beverages, nor did it address Section 132(e) de minimis fringe benefits."
Morgan Lewis

Secrets Behind Comcast's Surprising Healthcare Success

"Comcast spends about $5,800 per person enrolled in its health plan. That number ... [is] just a hair above average employer spending. What's truly eye-popping are two things Comcast gets for its money: [1] Incredibly low employee cost-sharing. Employees only pay a $250 deductible on their care, compared to a $1,500 industry average. [2] Nearly flat cost growth.... Where other large employers see 3% year-over-year healthcare cost growth, Comcast's spending only goes up 1%. Clearly, Comcast is doing something right." mpirica

The Best Health Benefits Will Keep the Best Employees in Your Ranks

"Job-hopping has become commonplace, especially in the younger generations, but the decision to move on isn't all about the money.... 50% of employees saying that if their employer did not offer adequate health benefits, they would look elsewhere. If employers want to stay competitive, they must start listening -- and responding appropriately." HR Daily Advisor

Ding Dong, the HPID Is Dead: HHS Proposes to Kill Health Plan Identifier Standard

"The employer registration process for obtaining a HPID turned out to be onerous, time-consuming and required multiple steps to complete.... Most health plans were already using the NAIC payer ID as its unique identifier and intended to continue using this identifier even if the HPID was required as well. NCVHS recommended that requiring use of the HPID would be both redundant and a significant disruption to administrative transactions." Lockton

Benefits in General

[Official Guidance]

Text of IRS Publication 15-A: Employer's Supplemental Tax Guide, for Use in 2019 (PDF)

73 pages. Topics include: [1] Who are employees? [2] Employee or independent contractor? [3] Employees of exempt organizations. [4] Religious exemptions and special rules for ministers. [5] Wages and other compensation. [6] Sick pay reporting. [7] Pensions and annuities. Internal Revenue Service [IRS]

Evolving the Benefit Mindset: Responding to the Pace of Change

"The challenge for employers is three-fold: [1] Assess the existing portfolio with a fresh perspective to determine whether longstanding legacy program designs still meet employee needs; [2] Evaluate how investments are applied via the subsidy strategy; [3] Evaluate how benefits are delivered and the employee experience it creates.... 96% of employers are making the employee experience with benefits a top priority over the next three years." Willis Towers Watson

Under ERISA, Ignorance Is Bliss in the Ninth Circuit

"[T]he Ninth Circuit concluded that the statute of limitations was not triggered when the documents were made available to the plaintiff.... [T]he plaintiff was required to have actual knowledge that Intel increased the retirement funds' alternative investments and that those investments were imprudent." [ Sulyma v. Intel Corp. Investment Policy Comm. , No. 17-15864 (9th Cir. Nov. 28, 2018)]
Ogletree Deakins

How Will the Partial Government Shutdown Affect Employers?

"Unlike other recent government shutdowns, the instant closure affects only nine federal agencies [including] the Department of the Treasury ... In addition, certain smaller independent agencies, such as the Equal Employment Opportunity Commission (EEOC), will also be impacted. It will be business as usual for other agencies, including the [DOL] ... and [HHS], which have already been funded through September 2019." Littler

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David Rhett Baker, J.D., Editor and Publisher
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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2018 BenefitsLink.com, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.

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