CMS streamlines, simplifies, empowers, unburdens exchange regulations

The HHS Notice of Benefit and Payment Parameters for 2019 adopts payment parameters and provisions related to the risk adjustment and risk adjustment data validation programs, cost-sharing parameters, and user fees for federally-facilitated exchanges (FFEs) and state exchanges on the federal platform as described in the advance release and fact sheet for the final rule. […]

Benefits claim of employee who claimed prior misclassification was preempted by ERISA

Granting dismissal of an employee’s (who was a former independent contractor) claim that his prior misclassification resulted in denial of the value of the benefits plan he would have received had he been properly classified, the federal district court in Massachusetts found that this portion of his claim was preempted by ERISA. The state law […]

Many small businesses using QSEHRA to offer health benefits for first time, survey finds

More than 70 percent of small businesses that used the new qualified small employer health reimbursement arrangement (QSEHRA) in 2017 did so to offer employee health benefits for the first time, according to The QSEHRA: Annual Report 2018 from PeopleKeep. Drawing on data from more than 600 small businesses and nearly 4,000 employees, the report […]

CCIIO modifies employee counting method for MLR provision

The Center for Consumer Information and Insurance Oversight (CCIIO) has issued technical guidance regarding the employee counting method for determining market size for purposes of the Patient Protection and Affordable Care Act’s (ACA; P.L. 111-148) medical loss ratio (MLR) provision. In addition, the CCIIO has issued technical guidance on the process for a state to […]

IRS FAQs address new employer credit for paid family and medical leave

The IRS has issued a set of frequently asked questions (FAQs) that address the new employer credit under Code Sec. 45S for paid family and medical leave. The Tax Cuts and Jobs Act (P.L. 115-97) created the credit, which is generally effective for wages paid in taxable years of the employer beginning after December 31, […]

Managing health care benefits costs remains top priority for companies

Managing health care benefits costs remains employers’ top benefit priority, with 66 percent of companies with 50 to 1,000 workers ranking it as a key 2018 concern, according to recent research from Hub International. The study, Employee Benefits Barometer 2018, noted that human resource executives often turn to short-term solutions instead of the longer-term, more […]

Honeywell retirees did not have vested lifetime health care benefits

Collective bargaining agreements did not vest Honeywell International retirees with lifetime health care benefits because the CBAs contained general durational clauses, held a federal district court in Michigan. Without an express clause in the CBA vesting lifetime benefits, the right to benefits terminates with the CBA. However, the court rejected the employer’s argument that it […]

Not currently diagnosed with sleep apnea, fired dispatcher can’t show FMLA or disability bias

Affirming summary judgment against FMLA interference and retaliation and disability bias claims of a 911 dispatcher who was fired after being late repeatedly, the Seventh Circuit found it was not established that she actually suffered from sleep apnea at the time and clearly was not under continuing treatment for it to qualify as a serious […]

Iowa enacts law allowing association health plans that evade some ACA rules

Iowa Governor Kim Reynolds has signed a bill that allows associations of employers or certain agricultural organizations to offer health plans that do not comply with some of the Patient Protection and Affordable Care Act’s provisions. Senate File 2349 allows employer association health plans (AHP), a type of multiple employer welfare arrangement (MEWA), to be […]

IRS’s compliance with employer shared responsibility provision needs improvement, TIGTA says

The IRS failed to identify a substantial number of employers that were potentially liable for the Employer Shared Responsibility Payments, according to a report by the Treasury Inspector General for Tax Administration (TIGTA). The Patient Protection and Affordable Care Act’s (ACA’s) Employer Shared Responsibility Provision requires employers with an average of 50 or more full-time […]