Nfp Benefits Compliance Podcast

In the fourth part of this mini-series on single-payer systems, Suzanne Spradley and Chase Cannon look at four versions of single-payer system legislation introduced by the Democrats. The two walk through the four versions from least to most intrusive to the current system, which is based on employer-provided coverage. The four versions are a Medicaid buy-in (also called a “State Public Option”), Medicare buy-in (also called “Medicare for More”), Medicare-X Choice Act (which includes an expansion of the current premium tax credits administered through the state health insurance exchanges), and the full blown Bernie Sanders-style Medicare for All (true single payer, nationalized health care). Suzanne discusses the terminology, definition, structure, funding, provider impact, consequences, and potential challenges to each of the four versions. Suzanne and Chase conclude with a look at what all this could mean for the 2020 elections.

In this episode, Chase Cannon and Suzanne Spradley break down last week’s D.C. district court ruling that invalidates the DOL’s 2018 rules on association health plans (AHPs, which are also considered multiple employer welfare arrangements, or MEWAs). Chase gives a high level outline of the original and 2018 DOL AHP rules, and how the two differ. Suzanne and Chase discuss the lawsuit filed by a coalition states – led by New York and Massachusetts – and the arguments presented: That the DOL went beyond its authority be expanding access to AHPs through a loosening of ERISA’s rules on commonality of interest, primary purpose, and working owner participation. The two analyze the court’s reasoning in concluding that the 2018 rules are invalid as a regulatory overreach in conflict with ERISA’s statutory design. Chase and Suzanne prognosticate on next steps in the challenge and lawsuit, and what it all means for AHPs.

In the third part of this mini-series on single-payer systems, Suzanne Spradley and Chase Cannon focus on the challenges of funding a single-payer system, with a focus on the single-payer proposal put forth by Senator Bernie Sanders. Suzanne explains that the Sanders plan is a comprehensive first-dollar government-financed health insurance plan for all Americans, and is therefore very expensive. Suzanne outlines the taxes that would have to be raised and to what extent, and discusses studies that outline the total amounts of tax increases for both individuals and businesses. Suzanne and Chase discuss the different purported savings and efficiencies under the Sanders proposal, and how various studies dispute them. The two address different aspects of current inefficiencies in US-run programs, including waste, fraud and abuse in the current Medicare system. The two conclude that funding a single-payer system in any form will be a huge challenge; one that will be extremely difficult, if not impossible, to overco

Chase Cannon and Suzanne Spradley focus on the parts of the US system that are working well, focusing on the employer-sponsored group health insurance market. Chase orates a brief history of the employer-based insurance model, including why employer groups were originally (and still today) the ideal group market target for insurance companies. Chase explains that between 180 and 185 million people (or 55 to 60 percent of the US population) are currently covered through an employer group health plan; the vast majority of whom are happy with their plan and benefits. Chase and Suzanne outline the importance of employer engagement in employee’s health care benefit coverage, and how the employer market has seen lower cost increases than the individual market. Chase describes the built-in incentives for employers and carriers to develop innovative plan design and cost-saving strategies, and how the private market (as compared to the government) is better suited to stoke the embers of further innovation. The two con

In this episode, Suzanne Spradley and Chase Cannon announce a three-part mini-series aimed at better understanding the challenges facing a single payer system (sometimes called “Medicare for All”) in the US. In the first part, Suzanne re-sets the discussion on single payer systems and describes some of the different arrangements and titles that fall under that general term. Suzanne describes the challenges facing different single payer systems in the UK and in Canada, including information on wait times and quality of care outlined in recent studies. Chase and Suzanne discuss funding of single payer systems, and how single payer systems generally result in higher taxation across the board. Suzanne finishes with a description of the challenges facing the Veterans Affairs (VA) program, which is a version of a government-run health care system right here in the US. The two outline the next two parts to the mini-series: part two will focus on parts of the US system that are working, including the employer-sponsor

In this episode, Jill Brooking joins Chase Cannon to discuss the impact the government shutdown may have on employer group health plans, particularly for governmental contractors, whose employees may be out of work due to the shutdown. Jill breaks down the benefits issues employers should look at for employees that are out of work or on furlough as a result of the shutdown, including plan eligibility terms and carrier (or stop-loss) contracts, and the risks in covering employees outside the plan’s eligibility terms. Jill describes how the ACA’s employer mandate may impact an employer’s offer of coverage, depending on whether the employer is using measurement/stability periods for employees. Jill also discusses premium payment options for employers and employees during an unpaid leave of absence, and at what point COBRA comes into play. Lastly, Jill and Chase discuss what should happen when – if ever – the government shutdown ends, including collecting premiums in arrears and the rehire rules under both Sectio

In this episode, Suzanne and Chase review the recent district court ruling that the individual mandate is unconstitutional and, as a result, the entire ACA is invalid. While the ACA remains in place pending appeal, Suzanne outlines the basis for the case, the reason why intervening states had to step in for the DOJ, and why the individual mandate may or may not be “inseverable” from the rest of the ACA. Suzanne gives a basic overview of civil procedure and appeals, and describes the process by which the case here will be appealed. Suzanne and Chase also discuss a bit of constitutional law and the balance of powers — the limitations on courts as they interpret and decide the constitutionality of legislation passed by Congress. The two close with important points on employer obligations while the case is appealed and the potential political fallout with a split Congress and the looming 2020 elections.

In this episode, Suzanne and Chase review the Office of Civil Rights (OCR, a subdivision of HHS) list of HIPAA violation settlements that occurred in 2018. To lead off, though, Chase breaks down the purpose of the HIPAA privacy and security rules, and what the basic HIPAA requirements are for employers. Suzanne and Chase then discuss several OCR investigations of employer HIPAA violations that eventually led to settlements. Chase breaks down HIPAA violations resulting from several situations. First: a doctor’s response to media inquiries regarding a patient’s complaint. Second: a hospital group that developed policies and procedures, but failed to implement them and later experienced a breach when unencrypted USB drives were lost and an unencrypted computer was stolen. Third: a document retention company that left a box of files containing sensitive information in an unlocked truck in its parking lot. The final case involves hospitals that failed to obtain authorization from patients while filming a TV mini-s

In this episode, Suzanne and Jill discuss year-end considerations for employer plan sponsors. Many employers are currently in or have just completed their open enrollment process. Jill and Suzanne answer the question of whether an employer should accept enrollment requests after open enrollment has ended. They also remind employers about which notices need to be distributed, including the frequently forgotten COBRA Initial Notice for employees and spouses who newly enroll during open enrollment. Lastly, they discuss how employers should prepare for upcoming reporting obligations.

In this episode, Suzanne and Chase look at the benefits compliance environment since the midterm elections. The two start off with a recap of election results and then immediately dive into the impact a divided Congress could have on the ACA. There could be bi-partisan support on simplified reporting and on repeal of the Cadillac tax. The two also discuss the Texas v. United States case involving the Republican challenge to the constitutionality of the ACA in consideration of the 2019 repeal of the ACA’s individual mandate and assess how a divided Congress might react to a loss of protections for those with pre-existing conditions. Chase outlines issues to consider post-election on prescription drug prices, medical tourism, the issues of a single-payer system (sometimes referred to as “Medicare for All”) and Medicaid expansion (and how that might interact with the employer group market). The two close with post-election impact on the court challenge of the DOL’s association health plan regulations.

In this episode, Suzanne and Chase address the advantages and disadvantages of medical tourism, and how an employer’s compliance obligations may be impacted if they incorporate some type of medical tourism into the group health plan. Suzanne leads off with a definition of ‘medical tourism,’ including travel for medical services and procedures both within and outside the US. Suzanne delves into some of the costs and coverages, including travel costs, that are generally included in medical tourism, issues regarding quality of care for treatment received in foreign countries, and how the tax consequences may play out for both the employer and the employee. Suzanne addresses transportation of foreign drugs back into the US following a foreign-performed surgery, and how the FDA may treat that drug transportation. Chase and Suzanne close with some of the practicalities in administration and compliance, including HIPAA, ERISA and vendor relations.

In this episode, Suzanne Spradley and Chase Cannon discuss different delivery methods available to employers when distributing health plan notices and disclosures to employees. The two address hand delivery, delivery by mail, email and intranet delivery, and building the notices into online enrollment systems. Chase outlines which notices are best suited for electronic delivery, and how electronic delivery requires special accommodations for some populations of employees—those who may not have phone or email access as a big part of their job. Suzanne and Chase then discuss a recent White House executive order that could impact the DOL as it formulates electronic disclosure rules, as well as industry groups that may be opposed to an all-electronic disclosure regime. They close with an overview of what it all means for employers.

In this episode, Chase Cannon and Suzanne Spradley hit refresh on the single payer health care discussion in the US. Suzanne breaks down the different terms that are used in the discussion, including ‘single payer system,’ ‘Medicare for all,' ‘universal health coverage,' ‘national health plans’ and ‘socialized medicine.’ Chase and Suzanne describe the importance of understanding those terms and the marketing behind them during this election season as the debate marches towards November. Suzanne describes and compares legislation at the state level in California and New York, and how similar legislation has fared in other states such as Colorado and Vermont. Suzanne and Chase outline the primary barriers to single payer systems in all their forms, including increased taxes, resistance from insurance carriers and health care providers, and a Republican-led federal government. The two close discussing what it all means for employers, and how the employer-provided health insurance might have a place in a single p

In this podcast, Beth Allen and K.C. Barner discuss some of the current events on the retirement side of employee benefits. They’ll talk about the recent IRS private letter ruling that may allow employees to receive 401(k) matching contributions that coincide with their student loan payments. They’ll also review Pres. Trump’s recent executive order on retirement plans and comment on the retirement legislation that’s currently making its way through Congress.

In this episode, Podcast originals Suzanne Spradley and Chase Cannon discuss wellness and other employer programs that advertise big employment and income tax savings to employers and employees. Suzanne and Chase discuss the various names and iterations of these types of programs – including the Classic 105, Freedom Plan, Section 105 Reimbursement Plans and Premier 105 – and how they vary in plan design. Chase outlines the basic iteration: an employer takes some amount as pre-tax deduction from the employee for a type of basic wellness program, the employee participates in the wellness program (completes a health screening, sits in on educational webinars and so on), and the employer provides a tax-free wellness program “reward” that happens to be very close to the pre-tax deduction amount. Chase and Suzanne discuss the federal income and employment tax ramifications and why these types of programs don’t meet the standard tax exclusion requirements of IRC 105. The two then close with a discussion of IRS guida

In this episode, Mark Rieder, NFP’s SVP of HR Technologies and Benefit Administration Services, makes his Benefits Compliance podcast debut. He joins Suzanne Spradley to discuss various hot tech ideas and applications in the HR and benefits administration space. Mark describes NFP’s Innovation Lab and then discusses recent technology applications, including mobile apps, that are available to employers for benefits and benefits administration. Applications and other tech tools relating to group health plan data, senior care treatment, overall care and quality of care management, student loan and other financial wellness, mental wellness and more have become big for employee well-being. Mark and Suzanne also discuss employee engagement, data collection and employer strategy in the tech space for benefits administration, as well as innovation and its impact on small and large employers. They close with a discussion of tech tools for benefits compliance issues.

Join Jill Brooking and Suzanne Spradley as they discuss the new joint venture among Amazon.com Inc., Berkshire Hathaway Inc. and JP Morgan Chase & Co. — a company that was formed to develop ways to improve health care for their employees and to make those innovations available to other employers.

In this episode, Beth Allen and K.C. Barner discuss the different changes to the ACA imposed by the Trump administration, Congress and the courts. They’ll highlight the major policy shifts, like the upcoming repeal of the individual mandate and the issuance of new regulations on association health plans (AHPs). They’ll also talk about possible changes to come. By the end of the podcast, listeners should have a good understanding of where the various provisions of the ACA stand

In this episode, Suzanne Spradley and Chase Cannon work through benefits compliance issues that arise as a result of common ownership and controlled groups. Suzanne grills Chase on the different types of controlled groups under Internal Revenue Code Section 414 — and how those rules impact employers’ obligations under the ACA's employer mandate, nondiscrimination testing, Form 5500, FMLA and other federal requirements. The two also discuss mergers and acquisitions, and how the change in ownership might impact COBRA and nondiscrimination obligations. The discussion closes on common ownership and MEWAs – some employers may inadvertently create a MEWA – and how employer compliance obligations might be affected by federal and state law.

In this episode, Suzanne Spradley and K.C. Barner discuss the newly released final rule related to the creation and maintenance of association health plans (AHPs) under ERISA. The DOL’s final rule is a long-awaited response to the Oct. 12, 2017, executive order from Pres. Trump directing the DOL and other agencies to (among other things) expand the availability of AHPs. Suzanne breaks down the DOL’s final rule, which loosens restrictions on AHPs to allow more groups of employers to qualify as associations for the purpose of sponsoring group health plan benefits. The two discuss the impact on sole proprietors and other self-employed individuals, and how state and federal (including ACA) regulation of an AHP would work.