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IRS Offers Another Extension for 1094s and 1095s

Posted December 3, 2019 by Patrick Haynes

IRS Offers Another Extension for 1094s and 1095s

A   The IRS has, once again, come out with a holiday gift for employers. In the recently-released Notice 2019-63, the IRS provided additional reporting relief for employers for the 2019 calendar year. In short, the Notice provides:

The due date to provide Forms 1095-C or 1095-B to employees and individuals is extended 30 days from Friday, January 31, 2020 to Monday, March 2, 2020.

B  Please note:

            • This is a firm deadline. The IRS is not offering an additional 30-day extension beyond March 2, 2020.
            • All requests for an additional 30-day extension will be denied (the IRS will not even respond).

 

C  Is there relief for carriers providing coverage details?

  • New for this year, the IRS is giving carriers (aka coverage providers) a limited “pass” with providing the 1095-B statements to individuals (whereas filing must still be made to the IRS).
  • The 2019 ACA-individual mandate penalty remains zero ($0), and individuals do need to report whether they had coverage or not.
  • Carriers that wish to qualify for this relief have to post a notice on their websites that the form is still available upon request, along with the promise that they provide the form within 30 days of each

D  Does this relief apply to self-funded plans?

No.  Employers with self-funded plans must still report about their FTEs (Full-Time-Employees) on Part III of Form 1095-C, and on Part IV of Form 1095-B.

E  What if we cover folks other than FTEs?

Self-funded employers may take advantage of this relief if they are reporting on any employee who was not full-time for any part of 2019 (such as covered part-time employees, covered retirees, or COBRA QBs).

      To take advantage of this relief, the self-funded employer would need to:

  • Post a notice prominently on its website (vaguely described but not defined)that the forms are available on request; and
  • Promise to respond to the request within 30 days.
  • Generally, retirees and COBRA QB would not have access to an Employer’s website, so that may be defined further in subsequent guidance (but, savings from printing and mailing could be achieved).
  • The extreme lateness of this guidance and the possible perceived value associated with doing less work (if you can reliably separate out these populations) may be outweighed even with an extension to March 2, 2020.

F  Is there good news in this Notice?

  • Good faith penalty relief is also extended for the 2019 forms.
  • Employers/carriers who work in good faith to complete the forms will not be assessed penalties if there is missing or inaccurate information.
  • The IRS takes the employer’s (or carrier’s) efforts with its good faith compliance – reasonable efforts to prepare the reports, efforts to gather and transmit the data to appropriate parties, etc.
  • Employers should never file late with the IRS or miss the deadline to furnish forms to participants. The IRS expects timeliness but the “good faith relief” efforts permit compliance even if you aren’t perfect with your data.

G  Final reminder about 1094-C deadlines:

  • Smaller ALEs must file their paper forms with the IRS on/before February 28, 2020.
  • ALEs with 250 or more employees must file electronically by March 31, 2020.

Please consult your 1094/1095 service providers about these deadlines (as deadlines outlined in your services agreement may not change).  Finally, should you have any questions or comments, please reach out to your Account Executive or Account Manager.

 

 

 

 

Trump Administration Sets Sights on Healthcare Pricing Transparency

Posted November 25, 2019 by Patrick Haynes

Background and Goals of the Proposed Rule

A proposed rule, released jointly through the Departments of Health and Human Services (HHS), Labor, and Treasury (“The Departments”) on November 15, 2019, seeks to fulfill the Trump Administration’s Executive Order on Improving Price and Quality Transparency, first issued in June of 2019. The Executive Order directed The Departments to develop “price and quality transparency initiatives to ensure that healthcare patients can make well-informed decisions about their care” and to implement various internal strategies such as preparing reports, proposing regulations, and issuing guidance to meet that end.

The ultimate goal of the rule, if finalized, is to make the healthcare industry less opaque when it comes to providing pricing information for services to consumers on an up-front basis, effectively eliminating any potential mystery that may surround the fees associated with a medical bill. The proposed rule will require hospitals to fully disclose their fees for 300 “shoppable” services, including any rates they have negotiated with third-party payers, and will also call on most group health plans (non-grandfathered fully-insured and self-funded) and health insurers to divulge price and cost-sharing specifics to plan participants, enrollees, beneficiaries, and to the public at large. Hospitals that do not comply with the rules would in turn face fines of up to $300 per day. Smaller or more specialized hospitals would be required to disclose their fees for as many of the services that they offer within the “shoppable” category, a characterization that is inclusive of such areas as medical surgery, radiology, laboratory and pathology, and evaluation and management services. Grandfathered health plans will not be affected by the proposed rule.

The Affordable Care Act (ACA) added Section 2715A to the Public Health Service Act (PHSA), requiring fully-insured and self-insured “group” health plans to disclose, among other things, information on cost-sharing and payments with respect to any out-of-network coverage.  PHSA section 2715A also requires fully-insured and self-insured “group” plans to help their participants learn about the amount of cost-sharing the participants would be responsible for through an internet website.  In addition, PHSA section 2715A gives HHS the authority to determine “other appropriate information” that could – and should – be disclosed to “group” health plan participants through an internet website.  Note that PHSA section 2715A accomplishes all of this by cross-referencing the requirements under ACA section 1311(e)(3), which is a “certification” requirement for “individual” market plans sold through an ACA Exchange (so “individual” market plans are picked up here too).

The previous Administration never implemented these requirements but the current Administration is now using this statutory language as the basis for requiring self-insured plans, as well as fully-insured “individual” and “group” plans, to disclose to participants – through an on-line “self-service tool” – specific cost-sharing information for medical items and services covered under the plan.  In addition, in accordance with HHS’s authority to determine “other appropriate information” that could – and should – be disclosed to participants, the Departments determined that it would be appropriate to require self-insured plans, as well as fully-insured “individual” and “group” plans, to disclose their negotiated in-network rates and their historical payments to out-of-network providers on public websites.

The hope here is that consumers will no longer be surprised by the medical bill that arrives after they obtain services since they would have access to the data that they need to make an informed financial decision regarding their share of the costs at the outset. This level of consumer empowerment will also give customers the ability to shop around for the best rates, as plans and issuers would be responsible for making their negotiated rates for in-network providers and historical data showing allowed amounts paid for out-of-network providers available to the public via their websites.

HHS has also proposed a portion of the rule that seeks to “preserve the statutorily-required value that consumers receive for coverage under the MLR program, while encouraging issuers to offer new or different value-based plan designs that support competition and consumer engagement in health care.” In short, HHS intends to go about this by essentially encouraging innovation in plan design and allowing insurers to avoid paying MLR rebates if these innovative plan designs result in a “shared savings”.

Potential Legal Hurdles and the Future of the Rule

While discussing the impact of the proposed rule, HHS Secretary Alex Azar commented that this “may be a more significant change to American health care markets than any other single thing we’ve done.” Not surprisingly, a certain level of push-back from the healthcare industry against the Trump Administration is expected here, as insurers and hospitals are likely not overly eager to create such a high level of transparency when it comes to privately negotiated contracts. As such, some prominent hospital networks including the American Hospital Association, Children’s Hospital Association, Association of American Medical Colleges, and the Federation of American Hospitals, have already begun to speak out against the proposed rule, threatening lawsuits against the Administration in the process. Should legal challenges such as these ensue (from a plan, hospital, carrier, vendor, or others) it seems likely that HHS would counter with some common-sense facts and factors—namely that this information must be disclosed under the regulation, and is currently included in an Explanation of Benefits (EOB) and/or a Summary of Benefits and Coverage (SBC) that is already being distributed. HHS will likely argue that all they are doing here is merely requiring that this same information be disclosed in a different way and format.

The Trump Administration is currently seeking additional comment and has extended this period out to 60 days from the initial release of the proposed rule. Under further consideration is whether or not plans and health insurance issuers should have to make data available through a standards-based application programming interface (API) and the precise ways in which healthcare quality information can be folded into the price transparency rules.

What Disclosures are Required under the Proposed Regulations?

First content element – Estimated cost-sharing liability – all applicable forms of cost-sharing, including deductibles, coinsurance requirements, co-payments, out-of-pocket limits (the Second content element), etc.  The “types” of medical items or services mean all encounters, procedures, medical tests, supplies, drugs, durable medical equipment, and fees (including facility fees), for which a provider charges a patient in connection with the provision of health care.

Third and Fourth content elements – Insurers and self-insured plans would also be required to disclose the “negotiated rate,” (3rd element) and in some cases the “allowed out-of-network rate,” (4th element) because these costs are necessary for determining the participant’s cost-sharing responsibilities.  The “negotiated rate” means the amount an insurer, the plan, or a third-party administrator (TPA) on behalf of a plan has contractually agreed to pay an in-network provider for a covered item or service pursuant to the terms of an agreement between the provider and the insurer, plan, or TPA.  Some provider contracts express negotiated rates as a formula (for example, 150% of Medicare), and in this case, the proposed regulation would require disclosure of the rate that results from using such a formula, which must be expressed as a dollar amount.

Fifth element – with respect to obtaining cost-sharing information for prescription drugs, participants may request this information by billing code (e.g., a CPT code) or by descriptive term (e.g., the name of the prescription drug), thus allowing the participant to learn the estimated cost of a prescription drug obtained directly through a provider, such as a pharmacy or mail order service.  Participants would also be allowed to learn about the cost of a set of items or services that include a prescription drug or drugs that is subject to a bundled payment arrangement for a treatment or procedure, although HHS recognizes that there may be some difficulties obtaining accurate cost-sharing information when prescription drugs offered outside of a bundled arrangement are based on un-discounted list prices.

The Sixth element (notice of prerequisites to coverage) and Seventh element (disclosure notices) are quite straightforward and will be the subject of future updates, regulations and guidance.

An Online Self-Service Tool

Insurers/Self-Funded plans must create their own on-line tools for participants to request the “cost sharing information” described above.  Many claims paying TPAs, carriers, vendors already offer some of these services on their sites—so wider adoption and dissemination may be required.

The Proposed Regs include an RFI (Request for Information)—seeking all comments on how the (1) cost-sharing information, (2) negotiated in-network rates, and (3) historical payments to out-of-network provider can more easily be assessed by various third parties through a API (Application Program Interface).  Patients and providers could have real-time access to data and could learn more about their potential for costs, charges and balance billing should they stay from their “in network” providers.

When will this take effect?  First, the regulations need to be finalized.  Then, they are expected to take effect 1 year after the “effective date of the final rule”.

Should you have additional questions about how this may begin to impact your plans, please contact your Sales Executive or Account Manager.

 

HRCI & SHRM Pre-Approved Webinar | Essentials of ACA Reporting Requirements & 401(k) Plan Administration

Posted November 15, 2019 by Megan DiMartino

Join us for this HRCI* and SHRM** pre-approved, complimentary, one-hour webinar as Olivia Ash, JD, MD, Compliance Consultant with ComplianceDashboard, LLC, reviews the essentials of ACA reporting requirements to help reduce feelings of compliance “unease.” She’ll also cover the “big rocks” relating to administration and operation of a 401(k) plan, including an introduction into the importance of fiduciary duties. By the hour’s end, you’ll have a basic understanding of required actions to ensure ACA regulatory compliance and avoid penalty pitfalls.

Webinar details:

  • Thursday, November 21, 2019
  • 2:00pm – 3:00 pm EST
  • No cost to attend
  • This webinar is open to all HR and Finance Professionals – but not to brokers, agents, TPAs and PEOs

Register Now


*The use of this seal confirms that this activity has met HR Certification Institute’s® (HRCI®) criteria for recertification credit pre-approval.

**AP Benefit Advisors, LLC is recognized by SHRM to offer Professional Development Credits (PDCs) for SHRM-CP or SHRM-SCP. This program is valid for 1 PDC for the SHRM-CP or SHRM-SCP. For more information about certification or recertification, please visit shrmcertification.org.


For more information, contact info@apbenefitadvisors.com. The information contained in this post, and any attachments, is not intended and should not be misconstrued as legal advice. You should contact your employment, benefits or ERISA attorney for legal direction.

AP Benefit Advisors’ webinar and website resources are designed for U.S.-based organizations. Our privacy and GDPR policy should be reviewed here. Please opt-out if you do not agree to these terms and conditions.

IRS Announces 2020 Contribution Limits for Health Care FSAs and Qualified Transportation Plans

Posted November 6, 2019 by Patrick Haynes

Today, the Internal Revenue Service announced the tax year 2020 annual inflation adjustments for more than 60 tax provisions, including the tax rate schedules and other tax changes (generally referred to as cost-of-living increases).  Revenue Procedure 2019-44 provides details about these annual adjustments.

The 2020 tax items of greatest interest to our clients that are employers and plans sponsors include:

  • Annual Healthcare Flexible Spending Account (FSA) contribution limits will increase $50 from the current amount of $2,700 to $2,750.
  • Monthly limit for transit and parking will increase $5 from the current amount of $265 to $270.
  • Annual maximum reimbursement for a qualified small employer health reimbursement arrangement (QSEHRA) will increase $100 for individual coverage from the current amount of $5,150 to $5,250, and the maximum reimbursement amount will increase $150 for family coverage from the current amount of $10,450 to $10,600.

Please contact your Account Manager or Sales Executive for more information.

Links: 

 

DOL – New Electronic Disclosure Guidance for Pension Plans under ERISA

Posted October 22, 2019 by Patrick Haynes

The DOL (US Department of Labor) is proposing in this document a new, additional safe harbor for the use of electronic media by Retirement plans to furnish information to participants and beneficiaries of plans subject to the Employee Retirement Income Security Act of 1974 (ERISA).  The proposal, if adopted, would allow plan administrators who satisfy specified conditions to provide participants and beneficiaries with a notice that certain disclosures will be made available on a website.  Individuals who prefer to receive these disclosures on paper will be able to request paper copies and to opt out of electronic delivery entirely.  The Department expects that the proposal, if adopted, would improve the effectiveness of the disclosures and significantly reduce the costs and burden associated with furnishing many of the recurring and most costly ERISA disclosures.  This document also contains, in section D of the preamble, a Request for Information that explores whether and how any additional changes to ERISA’s general disclosure framework, focusing on design, delivery, and content, may be made to further improve the effectiveness of ERISA disclosures.

DOL’s proposed regs will improve upon the 2002 Electronic Disclosure Safe Harbor, and the Field Assistance Bulletins (2006-03, 2008-03), Technical Release 2011-03R and their 2011 Request for Information.  While there is a comment period open for 30 days, the proposed guidance will be posted on Wednesday, October 23, 2019, and we will update this article and the links with that guidance as it is released.

Proposed guidance here:  https://s3.amazonaws.com/public-inspection.federalregister.gov/2019-22901.pdf

The DOL understands that much has changed in this area, and that their guidance has not kept pace.  They cite that evidence suggests substantial access to and use of electronic media:

  • A 2017 survey by the U.S. Census Bureau, for instance, found that 87 percent of the United States population lives in a home with a broadband internet subscription.
  • A 2018 study concluded that 93 percent of households owning defined contribution accounts had access to, and used, the internet in 2016.
  • A 2015 survey of retirement plan participants’ online habits indicated that 99 percent reported having internet access at home or work, and 88 percent of respondents reported accessing the internet on a daily basis.
  • A 2015 report observes that smartphones are used for much more than calling, texting, or basic internet browsing.  Based on surveys, the report notes that: 62 percent of smartphone owners have used their smartphones in the past year to look up information about a health condition; 57 percent to do online banking; 44 percent to look up real estate listings; 43 percent to look up information about a job; 40 percent to look up government services or information; 30 percent to take a class or find education content; and 18 percent to submit a job application.

Citing their desire to comply with Executive Order 13847 (08/31/2018) which affirmed the Federal Government’s policy to expand access to workplace retirement plans for American Workers—Federal Regulators understand that complex regulations are a hurdle and a burden for Employers, and that more needs to be done to reduce those burdens.

While current regulations and guidance may continued to be relied upon, the proposed §2520.104b-31 provides a new, optional method for compliance with ERISA’s general standard for delivery of disclosures to participants and beneficiaries.  Specifically, proposed paragraph (a) provides that the administrator of an employee benefit plan may satisfy §2520.104b-1(b)(1) with respect to covered individuals and covered documents, as described below, by complying with the notice, access, and other requirements of the proposal.

Critical Note for Health & Welfare Plan readers:On Page 32 of 115, the DOL states that these new methods apply to retirement plans only.  And, as proposed, do not apply to employee welfare benefit plansBut, they will continue to study the developments in the retirement plan disclosure arena, so change may not be too far off.

Notice & Access Method

The new method would involve the distribution of electronic NOTICES and then provide ACCESS to those Notices on a website or intranet.  The DOL is exploring email, multimedia messaging and mobile applications and their uses in this regard.  The do not wish to inhibit innovation and acknowledge that delivery methods should continue to expand as technology expands, so they will be promoting technical neutrality.  They realize that an over emphasis on technology may be counter-intuitive and possibly an impediment for a very small business, and/or require too much of an investment for others.  That’s why this guidance will offer new and optional methods to comply.

Employers that assign an Email address to a new employee will be able to automatically enroll that employee in the “Notice & Access” method, where the employee will remain unless and until he/she opts out of that method.  The employee can also provide a different email address for this process.

This safe harbor will differ from previous efforts in that the employee need not be a specific type of employee to qualify for this method.  Anyone with a smartphone, laptop, mobile computing device, etc. will be able to receive their ERISA related retirement plan documents, notices, 5500s, SPDs, SMMs, and SARs.

Remember, these changes may be used for changes in how you communicate retirement plan notices, but will have NO effect on your health & welfare benefit compliance efforts.  Those efforts need to continue as they have.  For more information on ways that a health & welfare plan can comply with the DOL’s electronic distribution rules, please read this informative piece.  Should you have any questions, please contact your Account Manger and or Sales Executive. 

Links:

HRCI & SHRM Pre-Approved Webinar | Is Wellness Worth it? A Data-Driven Look into the World of Corporate Wellness

Posted October 10, 2019 by Megan DiMartino

For nearly a decade, the wellness industry has promised employers the outcomes of better health, prevention of large claims, and lower insurance claims costs and trend. They have also touted higher productivity, higher morale and high employee satisfaction as “soft” outcomes. Yet, who has actually taken the time to analyze the data and see if what wellness companies claim they do is actually happening?

Join us for this HRCI* and SHRM** pre-approved, complimentary, one-hour webinar as AP Benefit Advisors’ Director of Data Analytics, Scott Mayer, takes an unbiased look at claims data, historical data and independent studies to pull back on what is myth and what is reality when trying to figure out the efficacy of traditional wellness plans.

Takeaways:

  • Do wellness plans actually reduce health care claims trends?
  • What impacts do wellness plans have on a company’s population health profile?
  • How to trust, but verify, the results that the wellness vendors are showing

Webinar details:

  • Thursday, October 24, 2019
  • 1:00pm – 2:00 pm EDT
  • No cost to attend
  • This webinar is open to all HR and Finance Professionals – but not to brokers, agents, TPAs and PEOs

Register Now


*The use of this seal confirms that this activity has met HR Certification Institute’s® (HRCI®) criteria for recertification credit pre-approval.

**AP Benefit Advisors, LLC is recognized by SHRM to offer Professional Development Credits (PDCs) for SHRM-CP or SHRM-SCP. This program is valid for 1 PDC for the SHRM-CP or SHRM-SCP. For more information about certification or recertification, please visit shrmcertification.org.


For more information, contact info@apbenefitadvisors.com. The information contained in this post, and any attachments, is not intended and should not be misconstrued as legal advice. You should contact your employment, benefits or ERISA attorney for legal direction.

AP Benefit Advisors’ webinar and website resources are designed for U.S.-based organizations. Our privacy and GDPR policy should be reviewed here. Please opt-out if you do not agree to these terms and conditions.

New DOL Overtime Regulations Effective January 1, 2020

Posted September 30, 2019 by Megan DiMartino

Author: Cindy Wagner, Director of HR Professional Services at AP Benefit Advisors

On September 24, 2019, the U.S. Department of Labor (DOL) announced its plans to update the rules of the Federal Fair Labor Standards Act (FLSA) effective January 1, 2020. It is estimated that up to 1.3 million workers will become newly eligible for overtime pay due to the updates applied in the earnings thresholds necessary to exempt executive, administrative or professional employees from the FLSA’s minimum wage and overtime pay requirements.

The DOL is updating both the minimum weekly standard salary level and the total annual compensation requirement for “highly compensated employees (HCEs)” to reflect growth in wages and salaries, which were last accounted for in 2004. The DOL believes that this update will help maintain the original purpose of the salary level test and will help employers more readily identify exempt employees. The next stage of the project includes revisions to the special salary levels for employees in U.S. territories and the special base rate for employees in the motion picture producing industry.

The DOL has shared that this new rule brings a more common-sense type approach that offers consistency and certainty for employers, as well as clarify and prosperity for American workers. And, for the first time in 15 years, American workers will see an update to the FLSA overtime regulations that will in turn place overtime compensation into the pockets of more than a million working American people.

The DOL estimates this rule will transfer income from employers to employees in the form of wages by an annualized amount of $298.8 million. The majority of these transfers will be attributable to the FLSA’s overtime provision and a smaller share will be attributable to the FLSA’s minimum wage requirement.

A review of the key provisions:

  1. Raising the “standard salary level” from the currently enforced level of $455 to $684 per week (equivalent of $35,568 per year (full year)/per worker);
  2. Raising the total annual compensation level for HCEs from the currently enforced level of $100,000 to $107,432 per year;
  3. Allowing employers to utilize non-discretionary bonuses and incentive payments (including commissions) paid at least annually to satisfy up to 10% of the standard salary level, in recognition of evolving pay practices; and
  4. Revising the special salary levels for workers in U.S. territories and in the motion picture industry (rules under development).

In addition, the DOL has announced their intention to continue routine updates of the standard salary and HCEs total annual compensation levels more regularly in the future through notice-and-comment rulemaking.

A breakdown of the final rule by the numbers:

  • $684 per week – new salary requirement. This amount was increased from $455 per week. The new equivalent level is $35,568 per year.
  • $107,432 – total HCE compensation threshold. This amount was increased from $100,000 annually.
  • 10% – amount of the standard salary level of final rule allows employers to cover with non-discretionary bonuses and incentive payments that are paid annually or more frequently.
  • $1.3 million – estimated number of current exempt workers the DOL estimates will potentially become eligible for overtime.
  • $298.8 million – estimated amount of extra pay workers may receive each year.
  • $455 per week – special salary level for workers in Puerto Rico, U.S. Virgin Islands, Guam, and the Commonwealth of the Northern Mariana Islands.
  • $380 per week – special salary level for workers in American Samoa.
  • $1,043 per week – “base rate” threshold for employees in the motion picture industry.

What comes next?

Employers need to do their homework – as the new rules have been released and the fourth quarter is upon us, it is highly recommended that HR and/or Payroll Professionals immediately begin pulling data for exempt workers earning below the new threshold level. Upon review of budget, consideration should be given for which positions may need to be reclassified, restructured, and where salary adjustments should be applied, if applicable. In addition, timing and communications should be considered and defined. For compliance purposes, the appropriate testing criteria should be applied. And, of course, document your process and results in case of an audit. It is also recommended that you seek guidance from your legal counsel and/or HR Consultant should you require any assistance with this project.

Areas of focus to help ensure a successful action plan:

  • Review job descriptions
  • Review budgets
  • Develop training materials
  • Define communications strategy
  • Document action plan
  • Review compliance requirements
  • Seek legal guidance/HR consultant support

Lastly, don’t forget to update your Employee Handbooks and Policies and Procedures to reflect any changes made regarding these new regulations.

Also, continue to monitor information shared by the DOL for updated clarification and guidance on these final rules. AP Benefit Advisors will continue to keep you informed as we become aware of any new and breaking information.

Links: U.S. Department of Labor | Final Rule: Overtime Update


For more information, contact info@apbenefitadvisors.com. The information contained in this post, and any attachments, is not intended and should not be misconstrued as legal advice. You should contact your employment, benefits or ERISA attorney for legal direction.

AP Benefit Advisors’ webinar and website resources are designed for U.S.-based organizations. Our privacy and GDPR policy should be reviewed here. Please opt-out if you do not agree to these terms and conditions.

2019 3rd Quarter Compliance Update

Posted September 27, 2019 by Megan DiMartino

Topics include:

  • Medicare Part D Notices
  • Rx Plans May Exclude Value of Drug Manufacturers’ Coupons Until Further Notice
  • Summary Annual Reports
  • Agencies Finalize Mental Health Parity Resources
  • Affordable Coverage
  • MLR Rebates
  • ACA Pay or Play Still Applies
  • ACA Reporting 2019
  • And more!

Read Now


For more information, contact info@apbenefitadvisors.com. The information contained in this post, and any attachments, is not intended and should not be misconstrued as legal advice. You should contact your employment, benefits or ERISA attorney for legal direction.

AP Benefit Advisors’ webinar and website resources are designed for U.S.-based organizations. Our privacy and GDPR policy should be reviewed here. Please opt-out if you do not agree to these terms and conditions.

HRCI & SHRM Pre-Approved Webinar | Retirement Plans – The Four “Fs” Retirement Plan Administrators Need to Know

Posted September 17, 2019 by Megan DiMartino

In the face of multiple fiduciary breach lawsuits, plan sponsors need to be on their game to protect themselves from the real liability that exists with group retirement plans. Pricing on group retirement plans has become incredibly competitive, and if any plan sponsors haven’t benchmarked their plans to the open market in the past 24 months, there is likely some great opportunity to improve plan pricing.

The Four “Fs”:

  • How we can help with plan fees
  • How we can help with fiduciary responsibilities
  • How we can help with fund selection and monitoring
  • How we can help to finally provide that financial wellness program that all plan sponsors need

Please join us for this HRCI* and SHRM** pre-approved, complimentary, one-hour webinar as Chris Strother, SVP of Retirement Plan Services, and Bryan Wright, Principal at AP Colorado, cover the four “Fs” above in this educational retirement plan webinar.

Webinar details:

  • Wednesday, September 25, 2019
  • 2:00pm – 3:00 pm EDT
  • No cost to attend
  • This webinar is open to all HR and Finance Professionals – but not to brokers, agents, TPAs and PEOs

Register Now


*The use of this seal confirms that this activity has met HR Certification Institute’s® (HRCI®) criteria for recertification credit pre-approval.

**AP Benefit Advisors, LLC is recognized by SHRM to offer Professional Development Credits (PDCs) for SHRM-CP or SHRM-SCP. This program is valid for 1 PDC for the SHRM-CP or SHRM-SCP. For more information about certification or recertification, please visit shrmcertification.org.


For more information, contact info@apbenefitadvisors.com. The information contained in this post, and any attachments, is not intended and should not be misconstrued as legal advice. You should contact your employment, benefits or ERISA attorney for legal direction.

AP Benefit Advisors’ webinar and website resources are designed for U.S.-based organizations. Our privacy and GDPR policy should be reviewed here. Please opt-out if you do not agree to these terms and conditions.

CVS-Aetna Merger Finalized

Posted September 13, 2019 by Megan DiMartino

We expect to see the ongoing consolidation of our industry stakeholders. The CVS/Aetna plays with the recent CIGNA/ESI deal that also aligns in the integrated medical/Rx delivery model with UHC/Optum. With this alignment between CVS and Aetna and the continued move towards an integrated care model, it is more imperative than ever for employers to carve out their Pharmacy benefit to have maximum disclosure and savings for their drug spend.

– Howard Mazzafro, VP Business Development at Keenan Pharmacy (An AssuredPartners Company)

Dive Brief:

  1. District Court Judge Richard Leon has approved the settlement agreement CVS and Aetna reached with the U.S. Department of Justice to allay antitrust concerns
  2. Leon gave his blessing grudgingly. He had been highly critical of the settlement that called for Aetna to divest its Medicare Part D business to WellCare, noting the agreement addressed just a sliver of the nearly $70 billion deal. His order, however, imposes no further conditions.
  3. The American Medical Association, which argued in court the agreement did not go far enough to address market concentration concerns, spoke out against Wednesday’s ruling.

Dive Insight:

The review by Leon was unprecedented, spanning nearly a year as he decided whether the agreement was in the public interest.

Under federal law, judges have the power to review DOJ settlement agreements and the risk was whether Leon would send the DOJ and CVS-Aetna back to the negotiating table.

“Indeed, if the Tunney Act is to mean anything, it surely must mean that no court should rubberstamp a consent decree approving the merger of ‘one of the largest companies in the United States’ and ‘the nation’s third largest health-insurance company,’ simply because the Government requests it!” Leon wrote in an accompanying opinion.

Leon even held a hearing, letting others besides CVS-Aetna and the DOJ testify on the merits of the merger and the potential harm to competition.

“Obviously we’re disappointed, but I think we’ve established a precedent for the future for the enforcement of the Tunney Act in antitrust cases,” David Balto, a lawyer who testified at the evidentiary hearings on behalf of U.S. PIRG and Consumer Action, told Healthcare Dive. “I think the judge demonstrated why the Tunney Act is important in the oversight of antitrust actions.”

The American Medical Association has been critical of the deal and also had their own experts testify during the hearing.

“Nothing in the deal guarantees reductions on insurance premiums or prescription drug costs. As for promised efficiency savings, that money will likely go straight to CVS’ bottom line. CVS made no commitment to pass much-hyped savings onto consumers through lower premiums or drug costs,” the AMA said in a statement.

CVS, which previously closed on its deal with Aetna, said – “CVS Health and Aetna have been one company since November 2018, and today’s action by the district court makes that 100 percent clear.”

Source: Healthcare Dive | Judge finally blesses CVS-Aetna merger settlement


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