Spencer’s Benefits NetNews – October 13, 2017


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Featured This Week


New Reports




October 13, 2017


EBSA proposes to postpone final rules on new disability benefits claims procedures

The Employee Benefit Security Administration (EBSA) has proposed to delay the applicability of final regulations revising the claims procedures for employee benefit plans providing disability benefits, which were originally published on December 19, 2016 (see “Final rules on claims procedures for disability benefits parallel ACA rules,” Employee Benefits Management Newsletter, January 11, 2017). The final rules had adopted certain procedural protections and safeguards for disability benefit claims that were already applicable to claims for group health benefits under the Patient Protection and Affordable Care Act (ACA)….

        (Read Intelliconnect) »

Half of business owners plan to increase their 401(k) matches

Fifty percent of business owners plan to increase their 401(k) matches, with 55 percent of this group saying it is because of rising revenue, Nationwide found in an online survey of 1,069 business owners with up to 299 employees….

        (Read Intelliconnect) »

October 12, 2017


IRS encourages leave-based donations due to Maria

The IRS has provided special relief designed to support leave-based donation programs to aid victims of Hurricane Maria. Under these programs, employees forgo their vacation, sick or personal leave in exchange for cash payments the employer makes to charitable organizations providing relief for the victims of this disaster….

        (Read Intelliconnect) »

Out-of-pocket spending increased for employees in large group plans

About one in four people (24 percent) covered by large employer plans spent more than $1,000 out-of-pocket on health care in 2015, an increase of seven percentage points from 17 percent in 2005, according to a recent Kaiser Family Foundation analysis….

        (Read Intelliconnect) »

October 11, 2017


Employee fired days after receiving VA letter rating PTSD as 70 percent disabling advances FMLA, ADA claims

A veteran fired from his job at a car dealership just days after he received a letter from the VA rating his post-traumatic stress disorder as 70 percent disabling can proceed to trial on his FMLA interference and retaliation claims as well as his claims under the ADA. Citing evidence he was told “[W]e’re going to have to part ways…. due to you not being a hundred percent while you’re here, being on the medications that you’re on and missing work for appointments at the VA, we need to let you go,” a federal district court in Illinois denied his employer’s summary judgment motion in large part….

        (Read Intelliconnect) »

CMS is failing its oversight responsibilities for ACA eligibility determinations

The Centers for Medicare and Medicaid Services (CMS) has generally failed to ensure that state health insurance marketplaces are properly verifying individuals’ eligibility under the Patient Protection and Affordable Care Act (ACA), a report from the HHS Office of Inspector General (OIG) has found. Whereas a previous report had discovered that the states themselves were doing a poor job of verifying eligibility, this new report found that CMS was not fulfilling its oversight role to ensure that states had systems in place, and were using them, to determine eligibility….

        (Read Intelliconnect) »

October 10, 2017


Adjusted applicable dollar amount for fee imposed on health insurance plans announced

The IRS has announced that the applicable dollar amount used to calculate the fees imposed by Code Secs. 4375 and 4376 for policy and plan years that end on or after October 1, 2017, and before October 1, 2018, is $2.39. This figure is based on the percentage increase in the projected per capita amount of the National Health Expenditures published by HHS on February 14, 2017….

        (Read Intelliconnect) »

SEC urged to adopt a ‘best interest’ standard for broker-dealers

The Investment Adviser Association has responded to SEC Chairman Jay Clayton’s request for comments on the standards of conduct for investment advisers and broker-dealers by recommending that the Commission develop a best interest standard for brokers that is as robust as the fiduciary standard with which investment advisers comply. IAA urged the SEC to preserve the fiduciary duty standard of care under the Investment Advisers Act, affirm that all who provide discretionary investment advice to clients are subject to the “fiduciary duty” standard with respect to that advice, and adopt a new best interest standard for broker-dealers when making nondiscretionary investment recommendations to retail customers that is no less stringent than the fiduciary standard. If the SEC does not adopt an equally stringent standard for broker-dealers, it should prohibit those who are not subject to the Advisers Act from holding themselves out in a manner that implies a fiduciary relationship, IAA advised….

        (Read Intelliconnect) »

October 9, 2017


New regulations provide opportunity for moral objection to contraceptive coverage

Two new interim final rules from the IRS, the Labor Department, and the HHS, effective October 6, 2017, have sliced through the Patient Protection and Affordable Care Act’s (ACA) (P.L. 111-148) contraception mandate by providing additional exemptions for objecting employers and insurers. In addition to religious organizations objecting on grounds of religious beliefs, non-religious groups may now decline to cover contraceptives based on “sincerely held moral convictions.” The Health Resources & Services Administration (HRSA) retains discretion to continue to require coverage where no regulatory objections apply….

        (Read Intelliconnect) »

Lower prescription drug costs predicted for 2018

The increase in prescription drug benefit cost trends will be lower in 2018 than in 2017, according to the 2018 Segal Health Plan Cost Trend Survey. The survey found that outpatient prescription coverage for active employees and retirees under age 65 will be 10.3 percent in 2018, down from 11.6 percent in 2017. And, the projected increase for specialty drugs/biologics also is projected to decrease in 2018, from 18.7 percent down to 17.7 percent….

        (Read Intelliconnect) »