Friday, November 11, 2016

Friday Benefit Clips: Obamacare on the Ropes; Election Impact on Employment Law Issues; FMLA and Overtime Updates

Health Care Reform News:

Election Results Likely to Result in the End of the ACA as We Know It, But Employers and Plan Sponsors Should Stay the Course for Now
November 10, 2016 – Proskauer Rose LLP
Excerpt: “This is not a novel approach to effect healthcare legislation – the ACA itself was a product of budget reconciliation legislation passed after Democrats lost their Senate supermajority in 2010. Budget reconciliation legislation cannot be held-up by filibuster, but the subject of the legislation must be related to revenue. Non-revenue related provisions can be struck from this type of legislation.”

2016 Election – Impact on Compliance Issues
November 9, 2016 – BB&T Insurance Services
Excerpt: “Regardless of any future changes that may be made, employers that provide group health coverage for their employees must prepare for upcoming ACA deadlines. These may include…”

2016 End of Year Plan Sponsor “To Do” List Health & Welfare
November 9, 2016 – Snell & Wilmer
Excerpt: “The Health Care Reform Act created the transitional reinsurance program, which requires most self-insured health plans to make contributions to HHS for the 2014, 2015, and 2016 calendar years. The contribution amount is determined by the number of covered lives under each plan. The number of covered lives must be calculated and submitted to HHS by November 15 of each year. The third and final filing is due November 15, 2016 for the 2016 calendar year.”

2016 Reinsurance Contributions Review and Discussion Session
November 7, 2016 – The Centers for Medicare and Medicaid Services
Excerpt: “Notable Changes for the 2016 Benefit Year…File no later than November 15, 2016 (to) submit the Form and schedule payment.”

Donald Trump Wins Presidential Election, Total Rewards & Business Changes Expected in New Administration
November 9, 2016 – World at Work
Excerpt: “Trump's positions on total rewards issues include a mix of traditional pro-business positions and some novel approaches to policy changes…”

ColoradoCare measure Amendment 69 defeated soundly
November 9, 2016 – The Denver Post
Excerpt: “Amendment 69, the ballot measure known as ColoradoCare that would have created a universal health care system in Colorado, was soundly defeated Tuesday night…Amendment 69 would have eliminated most private health insurance in the state and replace it with a taxpayer-funded cooperative known as ColoradoCare, which would have provided coverage to every single Colorado resident. It would have been paid for, largely, through a 10 percent payroll tax — workers at businesses would have been responsible for a third of the tax, while their employers would have picked up the rest; the self-employed would have paid the full 10 percent.”

ACA Compliance Alert: "Opt-Out Payments" to Employees Who Decline Employer Health Coverage
November 9, 2016 – Frost Brown Todd LLC
Excerpt: “The employee's "tax family" consists of the employee and all individuals the employee is reasonably expected to claim as a personal exemption on his or her individual tax return. One thing to note - this term can include individuals that are not eligible under the employer plan (e.g., dependents who are age 26 or older). When the requirements of an eligible opt-out arrangement are met, the opt-out payment is not considered for affordability purposes for the entire period of coverage to which the payment applies, even if the other coverage subsequently terminates for the employee or a member of the employee’s expected tax family.”

Hospital and Health System Health Benefit Plan Obligations Under New Nondiscrimination Rules: ACA Section 1557 and Requirements for Federal Contractors
November 7, 2016 – Alston & Bird LLP
Excerpt: “This impacts any entity (or health benefit plan) that receives federal financial assistance, including Medicare or Medicaid reimbursements. Two new regulations require some employers to make health plan design and administrative changes. While not all employers are subject to these requirements, those who are will need to review their plans and be aware of other obligations these rules impose…The Section 1557 regulations will impact employer-sponsored plans in several ways. Employers looking to assess application of Section 1557 to themselves or their health plan should determine whether they fit into any of these categories…”

NOT-130248-16: Sections 4375 & 4376 – Insured and Self-Insured Health Plans, Adjusted Applicable Dollar Amount for Fee Imposed by §§ 4375 and 4376
November 4, 2016 – The Internal Revenue Service
Excerpt: “The fee imposed by §§ 4375 and 4376 helps to fund the Patient-Centered Outcomes Research Institute (PCORI) and is calculated using the average number of lives covered under the policy or plan and the applicable dollar amount for that policy year or plan year…The applicable dollar amount that must be used to calculate the fee imposed by §§ 4375 and 4376 for policy years and plan years that end on or after October 1, 2016, and before October 1, 2017, is $2.26.”

In Other News:

Can an Employer Require That an Employee Submit FMLA Certification from a Specialist to Support the Need for FMLA Leave?
November 4, 2016 – Franczek Radelet
Excerpt: “Therefore, a generic note even from the psychiatrist stating that the employee can return to work is not good enough. As the court also affirmed here, the employer has the right to insist that the health care provider review the job description for the position and confirm that the employee can perform those job duties. And, according to this court, the employer can require that this information be provided by the psychiatrist, as opposed to a primary care doctor.”

Overtime Changes Take Effect December 1, 2016
November 3, 2016 – BB&T Insurance Services
Excerpt: “A Department of Labor (DOL) final rule is set to increase the salary threshold for the “white collar overtime exemptions” to $47,476 per year. Recent challenges to the rule have left some questioning whether it will take effect on Dec. 1, 2016 as scheduled.”

FMLA Fraud Finding Leads To Employer Court Victory
November 3, 2016 – Fisher Phillips
Excerpt: “Further, the court noted that United showed no signs of bias against employees who took FMLA leave. In fact, in the two years prior to the investigation, the employer approved 56 days’ worth of intermittent leave requested by Sharif, never once rejecting his requests. “This is not the record of a company that is historically hostile to FMLA leave in any discernable way,” the court said.”