Spencer’s Benefits NetNews – April 28, 2017


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Featured This Week


New Reports



April 28, 2017

Preeclampsia screening must now be covered by group health plans

The U.S. Preventive Services Task Force (Task Force) has published a final recommendation statement and evidence summary on screening for preeclampsia. The Task Force recommends screening pregnant women for preeclampsia with blood pressure measurements throughout pregnancy. This is a B recommendation, and, as such, non-grandfathered group health plans may not impose any cost-sharing requirements (such as a copayment, coinsurance, or a deductible) and must provide coverage with respect to preeclampsia screening (ERISA Reg. Sec. 2590.715-2713(a)(1))….

(Read Intelliconnect) »

CBA’s durational clause cuts of retiree health care benefits

In retiree health benefits litigation held in abeyance for eight years while the parties tried to settle, the Sixth Circuit U.S. Court of Appeals ultimately found, on rehearing, that the series of collective bargaining agreements in issue did not provide retirees with lifetime health care benefits. Finding the case controlled by intervening U.S. Supreme Court and Sixth Circuit precedent representing a “sea change in the applicable law,” the appeals court reversed the district court judgment for the retirees and remanded the case….

(Read Intelliconnect) »


April 27, 2017

Measuring temporal proximity from last (not first) day of FMLA leave revives employee’s FMLA retaliation claim

An employee who was given extended medical leave when he was unable to return without medical restrictions at the expiration of his 12-week FMLA leave, and then fired upon his return after management discovered he had posted Facebook photos of himself on the beach and at a theme park while he was out, revived his FMLA retaliation claim. Reversing summary judgment, the Eleventh Circuit U.S. Court of Appeals announced that the temporal proximity analysis begins on the last day of the employee’s leave, and that the one-month period here suggested a retaliatory motive. However, dismissal of his interference claim was affirmed since he lost his right to be reinstated after failing to comply with his employer’s uniformly applied fitness-for-duty certification policy….

(Read Intelliconnect) »

IRS’s TE/GE provides guidance on whether cash balance plans’ benefit formulas are definitely determinable

The IRS’s Tax Exempt and Government Entities (TE/GE) has issued new internal guidance for the Employee Plans (EP) employees who are reviewing benefit formulas in cash balance defined benefit plans. The memorandum covers the analysis a Determinations specialist who is reviewing a determination letter request or an Examinations agent who is auditing a plan in which the benefit formula is not the subject of a determination letter should follow to determine whether a benefit formula based only on a portion of annual compensation, a special bonus, or other measure not based on annual compensation is “definitely determinable.” This guidance was effective April 7, 2017 and applicable to exams open then. It will be incorporated into the Internal Revenue Manual by April 7, 2019….

(Read Intelliconnect) »


April 26, 2017

Retirees of automotive manufacturer established entitlement to lifetime health benefits

A collective bargaining agreement and plant closing agreement provided retirees of an automotive parts manufacturer and their spouses with healthcare insurance benefits that survived the expiration of a collective bargaining agreement, ruled a divided Sixth Circuit. Here, the appeals court found that during the long bargaining history between the employer and union, the parties came to rely on prior judicial decisions interpreting language included in decades of CBAs. Thus, a wealth of evidence supported finding that they shared an understanding that their 1998 CBA provided lifetime health care to its retirees. Judge Gilman filed a separate dissenting opinion….

(Read Intelliconnect) »

State retirement saving payroll deduction option for political subdivisions eliminated

President Trump has signed into law H.J. Res. 67, which nullifies the Department of Labor’s regulations on Savings Arrangements Established by Qualified State Political Subdivisions for Non- Governmental Employees. The move had been signaled in a Statement of Administration Policy released on March 13, 2017….

(Read Intelliconnect) »

Employee who was ‘locked out’ over supervisor’s concerns about her gun failed to revive FMLA claim

An employee with a known anxiety disorder failed to plausibly allege that her termination was triggered by an email to her supervisor stating she’d be “out sick,” the First Circuit U.S. Court of Appeals ruled in affirming dismissal of her FMLA retaliation claim. Her pleadings had painted a picture of a longstanding and emotionally fraught dispute with her supervisor, who had encouraged her to take medical leave in the past and had recently expressed fear that she might bring a gun to work. She had also been denied entry to a work building just days before she sent the “out sick” email, causing her to fear imminent termination….

(Read Intelliconnect) »


April 25, 2017

$100K settles agency’s first challenge to an employer wellness program

In the EEOC’s first lawsuit directly challenging an employer’s wellness program-filed in 2014-Orion Energy Systems has agreed to pay $100,000 and provide other relief to resolve allegations that the Manitowoc, Wisconsin, lighting company’s program violated the ADA and the company unlawfully retaliated against an employee who objected to the program by firing her….

(Read Intelliconnect) »

Mercer shines spotlight on HSAs

Over the past decade, the percentage of employers offering high-deductible health plans (HDHPs) coupled with health savings accounts (HSAs) has grown rapidly, but enrollment in HSA-eligible plans remains a challenge….

(Read Intelliconnect) »


April 24, 2017

Employers offering benefits have competitive advantage

Even though American workers are evenly split in their satisfaction levels with employer-provided benefits, companies offering benefits have a competitive advantage over those that do not, according to recent research from the Employee Benefit Research Institute (EBRI)….

(Read Intelliconnect) »

It’s never too early to worry about next year’s subsidies

Despite urging from several industry groups to settle the question of subsidies for cost-sharing reductions (CSR) in the near future, the government remained noncommittal when meeting with insurers on the topic. The industry believes that uncertainty over the subsidies, a controversial part of the Patient Protection and Affordable Care Act (ACA) (section 1402) that Republicans from the House of Representatives successfully argued were unconstitutional, is harming market stability as insurers are nearing the deadline for finalizing 2018 plans….

(Read Intelliconnect) »