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BlueStar Retirement Services, INC. Telecommute / Jacksonville FL

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Advanced Benefits Consulting Telecommute / Saint Louis MO / AZ / IL / TX

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RFK Medical Plan/JDLC Pension Plan Keene CA

Supervisory Health Insurance Specialist

Centers for Medicare & Medicaid Services [CMS] Telecommute / Woodlawn MD

Benefits Specialist

Air Line Pilots Association Rockville Centre NY / Mc Lean VA

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Retiree Medical Trust: How Employers and Employees Can Use Pre-Tax Dollars to Create a Lifetime Medical Reimbursement Plan
October 13, 2020 WEBCAST
National Conference on Public Employee Retirement Systems [NCPERS]

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[Official Guidance]

"Form 1095-A is used to report certain information to the IRS about individuals who enroll in a qualified health plan through the Health Insurance Marketplace. Form 1095-A is also furnished to individuals to allow them to take the premium tax credit, to reconcile the credit on their returns with advance payments of the premium tax credit (advance credit payments), and to file an accurate tax return." [Also available: 2020 Form 1095-A .]

Internal Revenue Service [IRS]

[Guidance Overview]

" Notice 2020-76 states that the IRS will not impose a penalty if a coverage provider fails to distribute Form 1095-B to plan participants when the coverage provider ... [1] Posts a notice prominently on its website stating that individuals may receive a copy of their 1095-B upon request.... [2] Provides Form 1095-B to any responsible individual within 30 days of the date the request is received.... The relief only applies to the Form 1095-B, not to the requirement to provide full-time employees with Form 1095-C." 

Segal

[Guidance Overview]

"The draft guidance [issued by CMS on September 30] asks health insurers that are due the 2014-16 payments to revise affected MLR reports to include these additional payments and to determine if they owe additional premium rebates to individuals or small group customers. Health insurers that owe new premium rebates to members or small group customers would be required to submit revised MLR reports to CMS by Dec. 31 or within 60 days of receiving additional risk corridors payments from HHS, whichever is later. Health insurers also would be required to disburse additional rebates to individuals or small groups within 60 days of submitting their revised MLR reports to CMS." 

PwC

[Guidance Overview]

18 pages, revised October 8. "[This article] reflects revised temporary regulations issued after a federal district court invalidated certain portions. The revised rules narrow the definition of healthcare providers that an employer can opt to exclude from covered employees and amend the employee notice requirements. The DOL has left intact but clarified two other provisions invalidated by the court: Intermittent leave is subject to employer consent, and work must be available for an employee to take any FFCRA leave." 

Mercer

[Guidance Overview]

"Earlier this year, New York State passed its Paid Sick Leave Law, which took effect on September 30, 2020 and allows eligible employees to use sick leave beginning in January 2021. In response, New York City amended its Earned Safe and Sick Leave Law to mirror the new, more generous statewide requirements, as well as impose additional requirements on employers in New York City." 

DLA Piper

[Guidance Overview]

"Philadelphia workers who are not covered by federal sick leave laws, such as the [FFCRA], are entitled to paid sick leave benefits under the new public health emergency leave bill ... [which remains] in effect until December 31, 2020, unless renewed. Mayor Kenney signed another amendment ... to require compensation of lost wages and medical expenses for certain healthcare employees who contract a communicable disease during a pandemic or epidemic affecting the City of Philadelphia." 

Jackson Lewis P.C.

"The court concluded that [the plan's claims administrator] did not fail to consider whether the [ACA's] cost-sharing provisions supported its earlier conclusion that the plan required a plan beneficiary to meet the family, rather than individual, out-of-pocket limit before the plan would fully cover her medical expenses. The court also awarded the beneficiary some, but not all, of her requested attorney's fees and costs." [ Fisher v. Aetna Life Ins. Co. , No. 16-0144 (S.D.N.Y. Oct. 5, 2020)] 

Thomson Reuters Practical Law

"When it comes to leave, employers generally conduct the undue hardship analysis only after the employee has exhausted FMLA leave and is requesting additional leave as an accommodation. However, an employer can and should take the 12 weeks of FMLA leave already provided to the employee when considering whether additional leave would create a hardship.... it is a dangerous proposition to raise cost as a factor in an undue hardship analysis ... If employees are taking on the extended hours, projects and duties left behind by the absent employee, this is quickly going to be a problem. And it's a concept that is easily articulated to a court." 

FMLA Insights

[Opinion]

"[Of] the 48 million people who will experience job loss due to COVID-19, 32 percent of those will switch to another source of [employer-sponsored insurance (ESI)] through a family member. Researchers estimate that approximately 3.5 million (equal to 7 percent) will become uninsured. While any loss of coverage is disruptive for families, this percentage is far lower than the 21 percent estimated coverage loss suggested by groups trying to use the pandemic to showcase the 'supposed fragility' of ESI and push for a government-run system." 

U.S. Chamber of Commerce

[Opinion]

"Proponents claim that government-sponsored plans will charge lower premiums than private insurers. Yet, experience shows that, on a level playing field, they don't. All the benefits of competition begin to vanish if government tilts the scales in favor of one rival over another." 

The Heritage Foundation

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