Nfp Benefits Compliance Podcast

In this episode, Chase Cannon and Suzanne Spradley recap the 10-year extension of the Patient-Centered Outcomes Research (PCOR) fee, which is now set to run through 2029. Chase digs into the background of the PCOR Institute, the non-profit organization funded by the PCOR fee, which supports clinical effectiveness research, including studies on treatments and outcomes for a wide variety of conditions and illnesses. Chase and Suzanne discuss several examples of studies and spotlights on the PCOR Institute webpage, including several studies relating to diabetes treatments. The two also discuss the revival of the PCOR fee and the IRS’s recent announcement of the adjusted fee amount, and then close by addressing several questions that have arisen from employer failures to pay the fee in past years.

We all agree that our greatest assets are our people. So, are you providing the value-creators in your organization with the programs that will keep them coming back? Are you ensuring that you can recruit top talent? Are you helping your highly-compensated population prepare for a successful retirement? Are you providing them with benefits that are proportional to the compensation they earn? Learn how to build programs that help lock in the key talent your company needs to weather the current storm and thrive in the future.

In this episode, Suzanne Spradley and Chase Cannon revisit the single payer debate in the context of the COVID-19 pandemic. Suzanne starts by exploring whether support for a single payer system in the US has waxed or waned during the pandemic. Chase and Suzanne then discuss articles from experts, and comparisons across different countries, regarding governmental versus private company response to the pandemic. Suzanne dives into the history behind US governmental stockpiles of protective gear and ventilators, and draws comparisons between the US and other countries in pandemic preparedness. Suzanne and Chase close with a review of presidential nominee Joe Biden’s views towards single payer system and how Congress’s potential Phase Four legislation might impact access to coverage.

FDA Commissioner Stephen Hahn was quoted at a recent White House Coronavirus Task Force press briefing emphasizing that in the “sea of new treatments” we need to connect “the right drug to the right patient at the right dosage at the right time. As an example, we may have the right drug, but it may not be in the appropriate dosage form right now, and that may do more harm than good. Those are the things that that’s our job to look at.” In our latest Insight from the Experts podcast, NFP's Head of Innovation Mark Rieder sits down with Joe Spinelli, chief marketing officer of MedTek21, to discuss how risk management using genomics can bring personalized medicine to every patient.

In this episode, special guest Geoff Seibel, VP of NFP Actuarial Services, joins Chase Cannon to discuss the impact of COVID-19 on fully and self-insured plan costs. Geoff starts by addressing the cost impact for fully insured plans, including differences for small and large group markets. Chase and Geoff then discuss actual COVID-19-related costs, including the difference in costs for COVID-19 patients who are hospitalized, and those who are placed in the ICU. Geoff explains the differences in averages across the general populations versus employer groups, and the differences between explicit and implicit costs (and how both impact overall costs). Geoff and Chase close by discussing best methods for tracking changes (since models and costs change daily) and how modeling tools and other resources can help employers better understand impacts on their own populations and plans.

Employers across the country are busy crafting their Return to Work strategies. Strategies which include things like PPE, office spacing, testing, assessments and vital sign monitoring. But what about planning for an increase in workplace violence? These are unprecedented times and “business as usual” has been replaced by fear, uncertainty and doubt. In our latest Insight from the Experts podcast, NFP's Head of Innovation, Mark Rieder, sits down with Ty Smith, founder and CEO (and Retired Navy SEAL) of Vigilance Risk Solutions, to discuss how fear, uncertainty and doubt could lead to violence in the workplace, and what VSR is doing to help organizations ensure the safety of their employees as they return to work.

In this episode, Suzanne Spradley and Chase Cannon look at benefits issues relating to returning to work, as companies begin mulling reopening and bringing back employees. The two start with a discussion of benefit eligibility, COBRA and premium payments relating to furloughs and layoffs, as the employer’s decisions then impact issues to consider upon returning to work. Suzanne then outlines some issues employers should consider when collecting premium payment from employees in arrears, how to handle waiting periods for rehires and what to do with employee FSA (both health and dependent care) elections upon return. The two close with a short discussion on plan amendments and employee communications.

One Key Takeaway: Status matters when deciding whether to furlough or terminate employees during this pandemic. SME/Speaker: Chase Cannon and Kyle Healy

futureWork captures and interprets the data that surrounds every worker to improve health and safety. And now with COVID-19 they are now helping companies record and report employee temperatures. Join us for this episode as Head of Innovation Mark Rieder, sits down with Lars Skari, cofounder of futureWork, to discuss how wearables can help Americans get back to work.

In this episode, Chase Cannon and Suzanne Spradley dive back into common COVID-19 questions. The two start with process and documentation of employee leave requests under the FFCRA, including recordkeeping for employers to claim the FFCRA tax credits. Chase then outlines several different buckets of developments at the state level, including paid sick, family, and medical leave changes on account of COVID-19. The two close with a look ahead at potential additional changes Congress could introduce in so-called “Phase 4 Legislation”, including COBRA subsidies and mandates for group health plan coverage of COVID-19 treatment.

In this episode, Suzanne Spradley and Chase Cannon discuss recent questions popping up from employers regarding the FFCRA, COVID-19 and furlough situations. Suzanne outlines the issues to consider in determining if FFCRA applies, including factors in employee counts to determine if an employer is above or below the 500-employee threshold and whether the 50-employee small exception is automatic. Suzanne and Chase discuss furloughs, and whether FFCRA applies to furloughed employees. The two then discuss unemployment insurance, and whether furloughed or laid off employees might qualify for unemployment benefits (and how the newly enacted CARES Act expands unemployment benefits). The two close with a discussion on the P&C side — business interruption insurance, and how state and federal legislation might impact how business interruption insurance works in the COVID-19 environment.

In this episode, Elizabeth Allen and Patrick Myers address some of the benefits compliance questions swirling around the issue of the coronavirus pandemic. The two briefly discuss the virus and go into more detail on the employee benefits laws that employers must consider as they make business decisions concerning the virus. Specifically, they discuss the coronavirus and its implications under the HSA rules, HIPAA, FMLA, ACA, Section 125 and COBRA.

In this episode, Suzanne Spradley and Chase Cannon address the hot issue of surprise medical billing. Suzanne outlines what is a surprise medical bill and how common of an issue it is to receive one. Suzanne and Chase discuss the challenges for patients that receive out-of-network provider services and bills at in-network facilities. Suzanne outlines three different bills that address surprise medical billing that have been discussed by Congress at the federal level, as well as state legislative action. Suzanne and Chase round out the podcast by talking about different approaches in each proposal, and what to expect down the road in 2020 from states and Congress.

In this episode, Chase Cannon and Suzanne Spradley address two lawsuits, and discuss some new state employer reporting obligations. The first lawsuit relates to one covered in Episode 66 on COBRA notice failures—the Sixth Circuit weighed in and overturned the District Court on whether a change in the premium payment turns constitutes a COBRA triggering event. The second lawsuit relates to the ACA’s employer mandate. A court recently approved a settlement in a case where the employer intentionally reduced hours for employees who were previously eligible for or enrolled in the company’s group health plan; the employer’s intent was to avoid offering those employees affordable coverage under the mandate. Chase outlines the settlement, and the reasons why the employees in the case were able to assert an ERISA 510 claim against the employer to the point of a settlement, even if the court did not ultimately resolve the 510 legal issue. Chase and Suzanne discuss the importance of continued compliance with the mandate

In this episode, Suzanne Spradley and Chase Cannon look at three recent lawsuits, two of which are class action suits, against employers relating to COBRA notice failures. Suzanne describes the lawsuits, and explains that the failures related to the content of the notices themselves, rather than the more common issue of failure to send COBRA notices. Suzanne outlines the particular failures, and how the employer could’ve avoided the issue. The two discuss the importance of using model notices and things to consider when working with a third party vendor for COBRA administration

In this episode, Chase Cannon and Suzanne Spradley review the end-of-2019 spending bill, which includes several provisions relating to employee benefits and group health plan/employer compliance. Chase starts by describing the bill, and then jumping in on a discussion relating to the full repeal of the Cadillac Tax. The two then discuss the health insurance tax (HIT), and the impact of its repeal beginning in 2021. Chase outlines three other provisions that are less directly impactful — the repeal of the medical device tax, the repeal of a commuter benefit tax for tax-exempt organizations, and a one-year extension of the tax credit for employers that provide paid medical and family leave. Chase and Suzanne then turn their attention to a surprise in the bill: A 10-year extension of the PCOR fee. The two close with a discussion of things employer might’ve wanted in the bill, and a look at what’s ahead in 2020.

In this episode, Suzanne Spradley and Chase Cannon dig in to the issue of health care costs in the U.S. as compared to other countries. Suzanne begins the discussion by outlining the Organization for Economic Cooperation and Development (OECD) data that has been tracking the cost of health systems in the world since 1986. Suzanne explains the different factors and variances, and the importance of defining terms when it comes to making such comparisons. Suzanne and Chase discuss the OECD findings that the U.S. spends far more than other countries, and they outline the exact dollar numbers and percentages. Suzanne digs in on the different areas where the U.S. spends more, and the two conclude the episode discussing the relationship between health care spend, health care resources, and health care outcomes.

In a welcome turn of events, the DOL has proposed a new rule that would allow for electronic disclosure of many retirement plan documents. Beth Allen and Carol Wood discuss the proposed rule — beginning with how the DOL got to this point, explaining the details of the rule, and highlighting the rule’s limited application. Ultimately, the discussion will give retirement plan sponsors a better idea of how they may be able to distribute documents, should this rule be adopted.

In this episode, Chase Cannon and Suzanne highlight four considerations to help avoid compliance issues resulting from open enrollment periods. First, Chase outlines the importance of documenting offers and waivers of coverage, and how that can help employers avoid IRS scrutiny and employee misunderstandings. Second, Chase and Suzanne discuss challenges that can arise during open enrollment on HSA eligibility, and how employees can easily step into excess contribution issues when enrolling in benefits. Third, Chase describes challenges in open enrollment relating to absent and remote employees, including those out on FMLA or state-protected leave, and those that are working from different locations or from home. Chase and Suzanne close with a discussion of important notices that must go out during open enrollment, and how to distribute those notices.

In this episode, Suzanne Spradley and Chase Cannon dig in to a trending topic, particularly for self-insured plans: reference-based pricing (RBP). Suzanne begins with a description of RPB, including an example to help illustrate how it works. Next, Suzanne explains the process and the pros and cons of RBP, which leads to a discussion on pricing and billing, including balance billing to unsuspecting plan participants. Suzanne outlines employer considerations when implementing an RBP design, including several issues with respect to the ACA and out-of-pocket maximums, and lessons learned from litigation relating to RBP strategies (including one case that made it to court with over $300K in claims at stake). The two close by discussing related ERISA fiduciary issues and administrative practicalities for employers to consider when adopting an RBP design.