Welfare Benefit Plan ERISA News
April 2017

 
Invisible High-Risk Pools: How Congress Can Lower Premiums And Deal With Pre-Existing Conditions

"Maine faced similar challenges in 2011 as it sought to unwind failed experiments that pushed its market into a long-term death spiral. But by creating an invisible high-risk pool and relaxing its premium rating bands, Maine policymakers were able to cut premiums in half while still guaranteeing those with pre-existing conditions access to plans.... Maine's experience provides federal policymakers with key lessons as they work to repeal and replace the ACA." (Health Affairs) Joel Allumbaugh, Tarren Bragdon, and Josh Archambault

Why COBRA Might Be Making a Comeback
"We're facing a landscape where the complexity of COBRA remains a part of every employer's benefits program while the ACA gets a makeover from the Republican White House.... Most likely, it just means that the majority of employers will continue to outsource COBRA administration. It also could mean eligible employees go back to just having COBRA as their only choice for 'transitional' coverage. But even if the option remains to enroll in Obamacare plans, COBRA could still win as the most attractive option for employees who qualify." (Benefitfocus)

IRS Clarifies the Rules for Disposal of Cafeteria
Plan Forfeitures

The IRS has issued guidance on the rules for disposing of unused funds in a cafeteria plan where the plan's sponsor discontinues its business operations. In Information Letter 2016-0077, the IRS responds to a taxpayer's inquiry by confirming that the unused funds will not revert to the U.S. Treasury but are instead disposed of in accordance with the plan document. (Wagner Law Group)

Anxiety Disorders: Why They Matter and What Employers Can Do

"Anxiety disorders lead to an average of 4.6 work days lost to disability per month and 18.1 work days lost to disability per 3 months, as well as an average of 5.5 work days of reduced productivity per month ... For every $1 invested in treating depression and anxiety, there is a $4 return for the economy. While scaling up treatment for depression and anxiety would cost $147 billion over the next 15 years, it would yield a 5% improvement in workforce participation -- representing a $399 billion return on investment." (Partnership for Workplace Mental Health)

Massive Medicare Fraud by UnitedHealth Uncovered

"The Justice Department has joined a California whistleblower's lawsuit that accuses insurance giant UnitedHealth Group of fraud in its popular Medicare Advantage health plans .... The whistleblower has accused the insurer of 'gaming' the Medicare Advantage payment system by 'making patients look sicker than they are' said his attorney ... The attorney said the combined cases could prove to be among the 'larger frauds' ever against Medicare, with damages that he speculates could top $1 billion."
(Kaiser Health News)
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© 2017 ERISAPros, LLC, All rights reserved. Information on ERISAPros' website, its newsletter, “News & Views,” and its blog, “ERISA Wonk,” is published as a general informational source. Information and articles are general in nature and are not intended to constitute legal or tax advice in any particular matter. Blog posts and comments reflect the personal views of their respective authors - not those of ERISAPros. Transmission of this information does not create an attorney-client relationship. ERISAPros, LLC is not a law firm and is not giving legal or tax advice. It does not warrant and is not responsible for errors or omissions in the content on its website or in its newsletters. ERISA is a complicated and confusing law. Summary Plan Descriptions (SPDs), Wrap Plan Documents, and Form 5500s require review and updating by qualified ERISA compliance professionals.

 

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