Families First Coronavirus Response Act Impact on Benefits

Adapted from: Employee Benefit Advisor (July 18, 2018) - Cort Olsen, Associate Editor The number of million-dollar medical claims has nearly doubled, with cancer care remaining the most costly health condition, according to a new Sun Life Financial report. Cancer made up $798.7 million in reimbursements to self-funded employers from 2014 to 2017, followed by metabolic disorder and hemophilia disorder, according to Sun Life’s 2018 High-Cost Claims Report. The report, based on analysis of Sun Life’s database of over 62,000 medical stop-loss claimants, shows that high-cost conditions totaled $6.9 billion in paid charges over the four-year period. The number of patients with million dollar claims rose 87%, to 194 in 2017 from 104 in 2014, with most charges ranging from $1 million to $1.5 million, and totaling over $935 million in charges. The growth in million-dollar claims can be expected to expand further due to new life-saving treatment options coming to market, along with existing treatments getting approved for expanded use. “This means better care and outcomes for patients,” says Dan Fishbein, president of Sun Life Financial, who notes that the trend is an important consideration for employers who self-fund their medical plans. “We partner with our clients to protect them from the financial risks of these high-dollar claims, but also to work with them to identify opportunities for cost savings that may improve patient care as well.” Also see: “ In a broken healthcare system, an adviser offers custom medical plans ” Other analysis from the report showed that rare conditions hit highest dollars. The two highest claims for a patient in a single policy year were for metabolic disorder in 2016, with a total of $6.7 million in treatment costs, followed by hemophilia disorder with a total treatment cost of $5 million in 2017. Million-dollar cases left a big footprint. Patients with claims of more than $1 million represented only 2% of the total number of stop-loss claims from 2014 to 2017, but roughly 20%, or nearly $600 million, of the total $3 billion in stop-loss reimbursement. White Paper How virtual behavioral healthcare breaks down barriers and increases access to quality care Employers that offer convenient ways for their employees to identify and treat mental health issues will see healthier employees, decreases in absenteeism and presenteeism, and lower costs as a result of proactively treating the mental health issues that often occur alongside physical conditions. The impact of injectable drugs peaked in 2017 with four of the five costliest injectable drugs, used to treat cancer or related conditions, accounting for approximately $45 million, or 24% of the total $186.3 million spent that year. Employers had an 85% chance of seeing a high-dollar claim in any given policy, according to the report. Those who self-insure their health plans use a stop-loss coverage to protect themselves from excessive financial losses from high-dollar claims. This article originally appeared in Employee Benefit Adviser. See the full article here: https://www.benefitnews.com/news/million-dollar-medical-claims-increase-by-87

Adapted from: Employee Benefits Corporation (May 10, 2018) - Need to Know Speed Read Fact #1 | 100+ Filing the Form 5500 is a requirement for private employers who fall under the Employee Retirement Income Security Act ( ERISA ), who have unfunded health and welfare benefit plans with 100 or more participants on the first day of the plan year. Fact #2 | Health FSA, HRA Employers who offer Health Care Flexible Spending Accounts ( Health FSA ) under a cafeteria plan, and/or Health Reimbursement Arrangements ( HRA ) in some cases, must file Form 5500. The same rules from Fact #1 apply. It is only required if they have 100+ participants on the first day of the plan year. Health FSAs and HRAs may be filed as standalone Form 5500s, or may be filed as part of a Wrap plan filing (see Fact #3 for more). Schedule A is not required for Health FSA and HRA plans. Fact #3 | Fully-Insured or Self-Funded Insurance Plans One, or many? For each fully-insured or self-funded benefit plan an employer offers, the employer must file a separate Form 5500. Employers can also choose to file just one Form 5500 by using one wrap plan for multiple benefit plans. (A wrap plan document and SPD are required for this type of filing.) Fact #4 | Deadlines Calendar-year plans : The many employers with plans that ended December 31, 2017 should be aware that their Form 5500 deadline is July 31, 2018 . General due date for other plans: The exact Form 5500 filing deadline for any benefit plan is the last day of the seventh month following the last day of the plan year. Fact #5 | Extensions Employers can file for an extension of up to 2 ½ months on or before their Form 5500 deadline, by using IRS Form 5558. Want more facts and information about Form 5500s requirements? Please see the Compliance Buzz article " Form 5500 Filing Tips-Who, When, What, How? ".

Adapted from: OPTUMBank 2018 On April 26th, the IRS updated its decision to decrease the 2018 maximum contribution limit for family coverage only. The maximum annual contribution limit for family coverage limit is now back to $6,900. Earlier this year, the IRS had adjusted the maximum contribution limit for family coverage from $6,900 to $6,850. Yesterday the IRS updated its decision. To view the official IRS announcement, please visit the Internal Revenue Service press release . In response to the IRS update, Optum Bank has updated its systems to ensure compliance with the IRS updated decision for its clients and account holders. In addition, Optum Bank plans to notify account holders by email next week on the IRS updated decision for the 2018 annual maximum contribution limit for family coverage and has posted the alert to the optumbank.com website. Here are up-to-date 2018 contribution limits: • $6,900 for family coverage • $3,450 for individual coverage Note: There is no change for the individual coverage annual contribution limit