Podcasts

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.

In this episode, with mental health trending as a national discussion, Chase Cannon and Suzanne Spradley discuss mental health parity in health insurance coverage. As background, the federal Mental Health Parity and Addiction Equity Act (MHPAEA) requires that the financial requirements and treatment limitations imposed on mental health and substance abuse disorder benefits be no more restrictive than the predominant financial requirements and treatment limitations that apply to substantially all medical and surgical benefits. Chase quizzes Suzanne on some details relating to quantitative treatment limits (dollar and limit visits) and non-quantitative treatment limits (pre-authorization, reimbursement rates, cost sharing, etc.), including some examples outlined in recent federal guidance on MHPAEA. Suzanne outlines several examples of NQTL treatment limits. The two then discuss two recent cases involving mental health coverage issues, one of which ends in favor of the plan and one of which ends in favor of a participant.

In this episode, K.C. Barner and Beth Allen discuss the status of the DOL’s Fiduciary Rule. Since the U.S. Court of Appeals for the Fifth Circuit vacated the Rule, there’s been some action on the part of the DOL, the states and the SEC. Specifically, the DOL has indicated that it won’t enforce the Rule, while the SEC has proposed its own rule. The states are even joining the party, through litigation and regulation. The two discuss what all this action ultimately means for employer retirement plan sponsors.

In this episode, Chase Cannon and K.C. Barner – in his podcast debut – discuss some recent announcements and adjustments from the #IRS on #HSA contribution limits. The two discuss the mid-year changes to the 2018 maximum family HSA contribution limits — and what employers and HSA account holders should do in response to those changes. Then Chase and K.C. dive into some legislation that’s been introduced in Congress regarding changes to the HSA rules, including: 1. Clarifications on what constitutes “impermissible coverage” (including telehealth and onsite medical clinics) 2. A clarification that expenses for dependents up to age 26 can be reimbursed from an HSA 3. Some expansion on the types of expenses that can be paid out of an HSA (including gym memberships and home gym equipment) Chase closes with a discussion of issues that aren’t currently included, but which would be nice to include in the final version, including how HSA eligibility interacts with #Medicare entitlement and direct primary care #DCP arrangements.

In this episode, Beth Allen and Chase Cannon break down a recent case (Stein v. Atlas Industries, Inc.) being litigated in federal court. Beth outlines the facts of the case, which involve an employee who had two events going on — his son’s extremely serious medical event and his own torn meniscus, which led him to be out on an FMLA-protected leave. Eventually, the employer terminated the employee for not following proper employer-outlined protocol with regard to employee notification for absences from work. Beth describes the employee’s claims against the employer, which were based on the employee’s FMLA protections and on ERISA Section 510, which generally prohibits an employer from retaliating against an employee (including terminating them) for exercising a right granted under ERISA. The employee claimed that the employer was terminating him due to the high claims and costs associated with his son’s medical event. Beth unpacks the arguments of both the employee and employer and explores why the court allowed the case to proceed to the jury. Beth also expertly describes the important takeaways for employers, including the importance of separating employment decisions from employee benefit plan decisions, keeping protected health information private, establishing definitive FMLA and leave policies and procedures, and consulting with legal counsel in tricky situations.

In this episode, Chase Cannon and Suzanne Spradley discuss a topic that seems to be less pressing, but ever recurring: employer contribution strategies.

In this episode, Suzanne Spradley and Chase Cannon delve into the health care delivery side of things with a discussion on direct primary care (DCP) arrangements, a type of clinical practice in which a physician offers primary care services to patients who pay a monthly membership or subscription fee. Suzanne further describes the details and history of DCP arrangements, how employers play in to the equation, the pros and cons of DCPs, and the state and federal regulatory considerations. Suzanne and Chase finish by discussing what to look for in 2018 as DCP arrangements continue trending upward.

In this episode, Beth Allen, former DOL enforcement attorney, discusses the DOL’s fiduciary rule and how it changed the definition of “fiduciary” to include more investment advisors. Then she highlights the recent Fifth Circuit Court decision that could result in the Fiduciary Rule's demise.

Podcast Episode 25: Study Outlines Possible Reasons for Individual Market Premium Increases by NFP's Insights from the Experts