Spencer’s Benefits Reports NetNews – June 10, 2016

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Featured This Week


New Reports




June 10, 2016


Over two-thirds of state benchmark plans violate ACA’s addiction treatment requirements

Over two-thirds of state essential health benefits (EHB) benchmark plans violate the Affordable Care Act’s requirements for substance use disorder coverage, according to a report recently released by The National Center on Addiction and Substance Abuse (the Center). In addition, according to Lindsey Vuolo, JD,MPH, Associate Director of Health Law and Policy at the Center, a review of EHB plan addiction benefits “did not find a single state that covers all of the approved medications used to treat opioid addiction….”

(Read Intelliconnect) »

What do proposed rate hikes mean for marketplace consumers?

Once again, Avalere Health has found wide geographic variations in proposed rate hikes for individual marketplace plans as reported by the nine states for which data were available as of May 23, 2016. Average proposed rate increases across all silver-level plans for a 50 year-old nonsmoker in 2017 ranged from 5 percent to 44 percent. The proposed increases will not necessarily reflect the effect on actual consumers, Avalere says….

(Read Intelliconnect) »

June 9, 2016


Amicus brief filed concerning regulation of wellness programs

Four employer organizations—the ERISA Industry Committee (ERIC), the Chamber of Commerce, the American Benefits Council, and the HR Policy Association—have jointly filed an amicus brief with the Seventh Circuit U.S. Court of Appeals regarding
Equal Employment Opportunity Commission (EEOC) v. Flambeau, Inc. (DC WI, No. 14-cv-638-bbc). The amicus brief argues that the EEOC does not have regulatory authority over wellness programs….

(Read Intelliconnect) »

Key value of private exchange is choice, employers and employees say

Nearly three-fourths (72 percent) of U.S. employers believe that a key value of private health insurance exchanges is offering employees more choice, according to research from Willis Towers Watson. Post-enrollment surveys of employees for the plan year 2016 using private exchanges to select employer-sponsored health plans show that employees like to choose for themselves and are happy with the choices they have made. And, one in six employers are considering or have already adopted a private exchange for their full-time employees and their families….

(Read Intelliconnect) »

June 8, 2016

Health benefits are do-or-die in the war for talent, businesses and employees agree

Benefits plans at work continue to be a key consideration for companies looking to acquire and retain top talent, according to two recent surveys of businesses and employees….

(Read Intelliconnect) »

Uninsurance rates level out for 2016, newly enrolled satisfied with coverage

Following the third open enrollment period, uninsurance rates for 2016 are statistically unchanged from 2015. Still, many of those with marketplace or Medicaid coverage stated that they would not have been able to access or afford the care that they are now receiving. The Commonwealth Fund’s fourth
Affordable Care Act Tracking Survey indicated that in 2016, over 80 percent of those with marketplace or Medicaid coverage are somewhat to very satisfied with their plans….

(Read Intelliconnect) »

June 7, 2016


Ordinance gives sick and safe-time leave to employees in Minneapolis

On May 27, the Minneapolis City Council approved an ordinance under which employers with six or more employees must provide up to 48 hours (six days) of paid sick and safe time each year, or up to 80 hours when accrued leave is carried into the following year. Employers with five or less employees must provide the same amount of unpaid leave. Phased enforcement of the sick and safe-time requirements will begin July 1, 2017….

(Read Intelliconnect) »

Chamber of Commerce, other industry associations challenge DOL’s fiduciary rule

Secretary of Labor Thomas Perez and the Department of Labor are going to have to defend the controversial final rule defining “fiduciary” for ERISA purposes against a lawsuit filed on June 1 by the U.S. Chamber of Commerce and other industry associations that challenges the rule under the First Amendment and the Administrative Procedure Act. Finalized in April, the rule has sparked sharp controversy….

(Read Intelliconnect) »

June 6, 2016

EBSA’s “red flags” could mean your plan lacks parity

The Labor Department’s Employee Benefits Security Administration (EBSA) has posted information on its website with warning signs that your health plan might contain non-quantitative treatment limitations (NQTLs) that require additional analysis to determine if the plan is in compliance with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). Under the MHPAEA, group health plans and health insurance issuers must ensure that treatment limitations, including NQTLs, on their mental health or substance use disorder (MH/SUD) benefits are no more restrictive than those on the plan’s medical or surgical benefits….

(Read Intelliconnect) »

Only 10 co-ops remain after Ohio admits defeat

In news that cannot be considered surprising, Ohio’s health care co-op, InHealth Mutual, becomes the unlucky 13th out of the original 23 co-ops to close. Over 20,000 consumers must find new health care coverage within 60 days of May 26, 2016, the date of the announcement. The Ohio Department of Insurance (ODI) and the co-op have entered into an agreed order of liquidation….

(Read Intelliconnect) »

Lehman ESOP fiduciaries still in the clear after Supreme Court’s decision in
Fifth Third

For the second time, the Second Circuit U.S. Court of Appeals has upheld a dismissal of claims against the now defunct investment bank Lehman Brothers and its retirement plans. Reviewing the ERISA fiduciary case again in light of the Supreme Court’s ruling in
Fifth Third Bankcorp v. Dudenhoeffer, the court held that the plaintiffs did not make the case that the employee stock ownership plan’s (ESOP) continued investment in the failing firm amounted to a breach of fiduciary duty under ERISA….

(Read Intelliconnect) »