Blog Tag: Special Bulletin
Wellness programs are subject to a variety of complex and often ambiguous federal rules and regulations that make wellness program administration a challenge for even the most astute employers.
Two recent lawsuits highlight the regulatory complexity surrounding wellness programs: AARP versus EEOC and Acosta versus Macy’s. Employers who sponsor wellness programs (or who are thinking about implementing a wellness program) and wellness program administrators should take note of these lawsuits. The AARP lawsuit could impact the future design of wellness programs that offer incentives. The Macy’s lawsuit underscores the need to pay close attention to the wellness program requirements.
In 1980, amendment to the Employee Retirement Income Security Act (ERISA) brought plans maintained by church-affiliated organizations into ERISAs church plan definition, but it left unclear whether a church-affiliated organization could establish a church plan. In several lawsuits, participants in retirement plans maintained by church-affiliated hospitals asserted that the plans did not qualify for the exemption – and thus were subject to ERISAs vesting, reporting and disclosure, funding, trust and fiduciary rules – because they had not been established by a church. The Third, Seventh and Ninth Circuits agreed with the participants and ruled that the hospital plans were subject to ERISA.
Stage two of repealing and replacing the Affordable Care Act (ACA) is now underway as focus shifts to the Senate, where significant changes are expected to be made to the American Health Care Act (AHCA) as passed by the House. Regardless of what happens next, employers need to know what is in the House-passed version in order to evaluate the potential impact if it becomes law (whether significantly revised or not).
Last week, the House of Representatives passed yet another version of healthcare reform legislation (yawn!) to which their colleagues in the U.S. Senate responded, “No thank you, we’ll start from scratch with our own reform package!” And so the saga continues: to reform or not to reform, that is the question. But on the off-chance that this latest version of reform ever sees the light of day, here is a short summary of the provisions of the American Health Care Act (AHCA).
SilverStone Group believes it is important to keep you updated on the repeal/replace activity as it evolves. House Republicans on the Energy and Commerce Committee and the Ways and Means Committee issued a proposed reconciliation “bill” late in the evening on March 6. It will be marked up this week and voted on very soon. It is slightly different than the summary provided to you last week.
Since the election of President Trump, there has been widespread speculation on just what format the long-awaited “ACA Repeal and Replace” legislation might take. In that vein, we believe it might be helpful to review some high-level thoughts on the potential impact of the draft Republican Reconciliation Bill, for which the reviewing and scoring process should begin this week.
Please keep in mind that the Bill has not yet passed, and if it passes, it is highly unlikely that it will pass in its exact current format. Again, please keep in mind that these are high-level thoughts only:
In 2013, the agencies responsible for implementing the Affordable Care Act (ACA) issued a series of notices, FAQs and other guidance addressing how the ACA applies when an employer pays or reimburses employees for the cost of buying their own individual health insurance policies. The upshot of this guidance was that it became virtually impossible for employers to pay for individual health insurance premiums, either pre tax or post tax, without violating the ACA. On December 13, President Obama signed the 21st Century Cures Act, which created Qualified Small Employer Health Reimbursement Arrangements (QSEHRA). The primary motivation behind these new QSEHRAs is to create a mechanism that would allow for the reimbursement of individual health insurance premiums — but only for certain employers.
A new regulation will require some employers to make health plan design and administrative changes. While not all employers are subject to this requirement, those who are will need to review their plans and be aware of other obligations these rules impose.
The IRS has released the 2017 cost of living adjustments affecting retirement plans. The adjustments and changes affect the limits applicable to all employees who defer salary into retirement plans, plans that are integrated with Social Security, the maximum benefit payable from defined benefit plans and the maximum annual additions for defined contribution retirement plans. For your convenience, SilverStone Group has summarized the changes as follows:
The Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) has published a final rule implementing section 1557 of the Patient Protection and Affordable Care Act (“ACA”). This section of the ACA prohibits discrimination in health programs and activities on the basis of race, color, national origin, sex, age or disability. The proposed rule (applicable to a “covered entities”) broadly prohibits discrimination on the basis of sex in health programs, and includes significant requirements related to transgender individuals and the treatments for gender dysphoria.
The rule would generally become effective July 18, 2016, however, to the extent that a group health plan or insurance carrier needs to alter its benefit design to comply with these regulations, then such plan design provisions are applicable on the first day of the plan year beginning on or after January of 2017. (But see Federal Contractor rule effective date below).