Spencer’s Benefits Reports NetNews – February 3, 2017

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New Reports




February 3, 2017


Forecast is mixed for health benefits in 2017 and beyond

The health insurance industry can expect to see more change in 2017, and employers are concerned about how potential new healthcare legislation may affect their employee benefits programs, according to a new report issued by Wells Fargo Insurance. Well Fargo points out that health insurance premiums have increased 213% since 1999, and that trend is expected to continue. Medical and prescription drug costs will most likely continue to rise, along with prices on specialty drugs. With regard to the latter, Wells Fargo found no indications that prices for medications used to treat complex, chronic, and rare conditions will decrease….

(Read Intelliconnect) »

Consumers find incentive to switch plans when net premiums change

A greater fraction of marketplace enrollees on a county-wide scale switched plans in 2016 when average premiums increased, as well as individually switched when the net premium of their 2015 plan increased by more than the benchmark premium. The results suggested that consumer primarily responded to net premiums, rather than to gross premiums, when making plan selections in 2016, according to an HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) research brief. To explore whether consumers responded to changes in net or gross premiums when making health plan choices in the 2016 ACA marketplaces, the ASPE conducted two sets of analyses, one based on comparing counties and one based on comparing individuals….

(Read Intelliconnect) »

February 2, 2017


NBGH advocates for sustainable and affordable pricing for specialty drugs

The National Business Group on Health (NBGH), a non-profit association of 420 large U.S. employers, has released a policy issue brief intended to help stem the skyrocketing costs of specialty drugs. The 31-page report provides policy recommendations to create more sustainable and affordable pricing for specialty medications. The issue brief also outlines the challenges that large employers and their employees face in paying for expensive biologic medications, or specialty drugs, and examines initiatives employers are taking to control rising costs….

(Read Intelliconnect) »

Over half of all MHPAEA violations in 2016 concerned annual dollar limits

According to the Department of Labor’s Employee Benefits Security Administration (EBSA), 54.55 percent of Mental Health Parity and Addiction Equity Act (MHPAEA) violations in 2016 concerned the annual dollar limits. The FY 2016 MHPAEA Enforcement Fact Sheet noted that 22.73 percent of violations concerned financial limits and quantitative treatment limitations (QTLs); 13.64 percent concerned cumulative financial requirements/treatment limitations; 6.82 percent concerned benefits in all classifications; and 2.27 percent concerned nonquantitative treatment limitations (NQTLs)….

(Read Intelliconnect) »

February 1, 2017

President Trump orders two regulations repealed for each one issued

President Trump has signed an executive order that is the first step in fulfilling his campaign promise to repeal two federal regulations for every one that is issued. The temporary regulatory freeze memorandum issued by the White House on January 20, 2017, remains in effect, and this new executive order sets up the process for reducing regulations and regulatory costs going forward. The military, national security, and foreign affairs functions are exempted from the order….

(Read Intelliconnect) »

IRS proposed regs allow 401(k) plan sponsors to use forfeitures to fund QMACs and QNECs

The IRS has issued proposed regulations amending the definitions of qualified matching contributions (QMACs) and qualified nonelective contributions (QNECs) to allow employers with 40(k) plans that permit the use of amounts in plan forfeiture accounts to offset future employer contributions under the plan to use the amounts to fund QMACs and QNECs….

(Read Intelliconnect) »

“Blatant disregard” of plan terms warrants higher rate of prejudgment interest

The “blatant disregard” of the plain language of an employee stock ownership plan (ESOP) shown by plan fiduciaries who, upon plan termination, breached their fiduciary duties by distributing company stock held by the plan instead of distributing cash, warranted the use of a higher interest rate to calculate the amount prejudgment interest owed by the fiduciaries, a U.S. District Court in California has ruled….

(Read Intelliconnect) »

January 31, 2017


Administration orders regulatory freeze pending OMB review

Reince Priebus, the President’s chief of staff, has directed the heads of executive departments and agencies to institute a regulatory freeze to allow new appointees and designees to review any new or pending regulations. The directive provides exceptions for emergencies or other circumstances that affect health, safety, financial, or national security matters. The law firm Davis Polk notes, however, that in a departure from precedent, the memo freezes any guidance issued by executive agencies, in addition to rulemaking….

(Read Intelliconnect) »

DOL issues FAQs concerning implementation of conflict of interest final regs

The Department of Labor has issued a set of frequently asked questions (FAQs) regarding implementation of the conflict of interest final regulations on fiduciary investment advice. The DOL notes that, since the publication of the regulations last April, the Department has held many meetings with stakeholders to assist in their compliance efforts. Many of the questions raised in the meetings related to the various regulation provisions that draw lines between fiduciary and non-fiduciary communications….

(Read Intelliconnect) »

Even tasks performed rarely can be ‘essential’ under ADA

Although some of the many tasks set forth in the job description for a groundskeeper were only rarely, if ever, required, a federal district court did not err in finding that all of them were essential and the employer expected her to be able to perform each one as needed, concluded the Eleventh Circuit in an unpublished opinion. Due to the employee’s severe leg injury, she could not safely and consistently traverse uneven and wet surfaces or perform other essential functions, even with the use of an ATV and adaptive equipment. Consequently, she was not a “qualified individual” and summary judgment was affirmed against her ADA and Rehab Act claims….

(Read Intelliconnect) »

January 30, 2017


ACA repeal would interfere with Oregon’s universal health coverage proposals, say health policy

According to researchers at RAND Corporation and Health Management Associates (HMA), three new options from Oregon lawmakers for reforming health care would likely become more costly and difficult to implement if part or all of the federal Affordable Care Act were repealed, as is proposed by Congressional leaders and the incoming presidential administration. Researchers from RAND and HMA were asked by the Oregon Health Authority to analyze three health reform proposals and compare the likely outcomes to the existing health care system….

(Read Intelliconnect) »

PBGC issues RFI on multiemployer plan two-pool alternative withdrawal liability arrangements

The Pension Benefit Guaranty Corporation (PBGC) has issued a request for information (RFI), seeking information on proposed “two-pool” alternative withdrawal liability arrangements. These arrangements involve an alternative method for measuring the withdrawal liability amount and the annual payment amount that an employer would owe the plan. The PBGC wants input from the general public and all interested stakeholders, including multiemployer plan participants and beneficiaries, plan sponsors, and employers on these types of actions….

(Read Intelliconnect) »