Health & Welfare Plans Newsletter

December 28, 2018

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[Official Guidance]

Text of 2018 Instructions for IRS Form 8889: Health Savings Accounts (HSAs) (PDF)

"Use Form 8889 to: [1] Report health savings account (HSA) contributions (including those made on your behalf and employer contributions), [2] Figure your HSA deduction, [3] Report distributions from HSAs, and [4] Figure amounts you must include in income and additional tax you may owe if you fail to be an eligible individual." Internal Revenue Service [IRS]

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Class Action Challenging Insurer's Denial of TMS Treatment for Depression Proceeds to Trial

"The participants assert that the insurer improperly developed and implemented a policy to deny [Transcranial Magnetic Stimulation (TMS)] coverage as an experimental and investigational treatment ... Finding the testimonial evidence sufficient to raise an issue of material fact as to whether the insurer ... [denied] TMS benefits based on requirements not found in the class members' plans, the court denied the insurer's motion for summary judgment[.]" [ Meidl v. Aetna, Inc. , No. 15-1319 (D. Conn. Oct. 11, 2018)]
Thomson Reuters / EBIA

Does Loss of Eligibility for Short-Term, Limited-Duration Health Insurance Trigger HIPAA Special Enrollment Rights?

"The preamble to the regulations indicates that loss of eligibility for short-term, limited-duration coverage gives rise to a HIPAA special enrollment right with respect to group health plan coverage ... [L]oss of eligibility does not include loss of coverage resulting from the failure to pay timely premiums or voluntarily dropping coverage. Thus, special enrollment rights under your plan will not be triggered ... solely because an employee becomes dissatisfied with the short-term, limited-duration coverage and decides to drop the coverage." Thomson Reuters / EBIA

How the DOL is Changing Association Health Plans

"Owners can now join with other small business owners to get the same type of coverage offered by larger employers.... AHPs can be formed by companies that share common geography or that work in the same industry.... [C]overage can be offered nationwide or in a specific state, city, county, or metro area.... Sole proprietors and self-employed individuals and their families are now eligible ... Consumers still enjoy protection against discrimination for pre-existing conditions." Hall Benefits Law

Five Ways Small Organizations Can Provide Better Health Benefits To Employees

"[1] Offer tax-preferred accounts (FSAs and HSAs).... [2] Offer voluntary products.... [3] Add limited purpose FSAs.... [4] Put a wellness program in place.... [5] Look into QSEHRAs." Forbes

Medical Debt and GoFundMe: Friends and Strangers Step in Where Insurance Lags

"Medical fundraisers now account for 1 in 3 of the website's campaigns, and they bring in more money than any other GoFundMe category.... Even for conventional treatments that are covered under most health plans, the copays and high deductibles have left many people with health insurance they can't afford to use." National Public Radio [NPR]

IRS Unable To Recoup Nearly $1 Billion In Obamacare Subsidies

"All told, the Treasury Department paid out roughly $27 billion in Obamacare subsidies in the 2018 tax-filing season, with overages accounting for $3.7 billion of that. Only $2.7 billion was recaptured. The $1 billion left over is small compared to the overall federal budget, but it is 20 percent of the president's border wall funding request that's spurred the current government shutdown." InsuranceNewsNet.com

[Opinion]

Effects of Weakening Safeguards in the Administration's Health Reimbursement Arrangement Proposal

"The proposed rule ... bars employers from offering this type of HRA side-by-side with a traditional health plan; it requires employers to offer this type of HRA on the same terms to all similarly situated employees; and it bars employers from using this type of HRA to subsidize short-term, limited duration coverage.... [A]bsent these safeguards, the Administration's HRA proposal would cause very large increases in individual market premiums, although the precise magnitude of those increases is uncertain." The Brookings Institution

Benefits in General

Evolving the Benefit Mindset: Aligning Employee Benefits with Organizational Purpose

"[1] Assess your current benefit strategies to determine whether they incorporate choice [and] personalization ... [2] Go beyond programs alone by aligning with the objectives of a purpose-driven organization including healthy company culture, integrated wellbeing and inclusion and diversity ... [3] [L]ook for opportunities to connect to and/or further enhance ESG commitments.... [4] Ensure that your overall benefit strategy and programs put the employee at the center of the experience[.]" Willis Towers Watson

ERISA Implications for Firing a Whistleblower

"The Court held that the whistleblower's cooperation with the DOL was quintessential protected activity, and that defendants were liable because they arranged the vote by the full board of trustees that resulted in the whistleblower's termination, they influenced the vote by recommending the whistleblower's termination, and the trustee had the authority to remove other union trustees or have their positions with the union terminated." [ Acosta v. Brain , No. 16-56529 (9th Cir. Dec. 4, 2018)]
Proskauer's ERISA Practice Center

Most Popular Items in the Previous Issue

Hospital Prices Are About to Go Public Atlanta Journal-Constitution

District Court Dismisses Wilderness Therapy Lawsuit Proskauer's ERISA Practice Center

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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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