Welfare Benefit Plan ERISA News
February 2016

Concierge Medical Care Comes to the Middle Class
Concierge DoctorA growing number of primary care doctors, spurred by frustration with insurance requirements, are bringing [concierge medical care] to the masses.... Patients pay $100 a month or less directly to the physician for comprehensive primary care, including basic medication, lab tests and follow-up visits in person, over email and by phone. The idea is that doctors can focus on treating patients, since they no longer have to wade through heaps of insurance paperwork. They spend less on overhead, driving costs down.... It's legal under the Affordable Care Act. ... But since it doesn't cover specialists or emergencies, consumers still need a high-deductible health plan. Still, the combined cost of the monthly fee and that plan is often cheaper than traditional insurance." (National Public Radio)
Cadillac Tax Delayed Two Years:
Five Things You Need to Know
PATIENT PROTECTION AND AFFORDABLE CARE ACT[1] The tax is still part of the law.... [2] The delay doesn't modify the Cadillac tax inflation-rate cap.... [3] There are concrete steps employers can take to reduce potential Cadillac tax exposure ... [4] Emerging strategies can reduce inefficiencies, in addition to costs.... [5] Helping employees help themselves has the longest shelf life and arguably the best outcomes." (bswift)

Supreme Court: ERISA Plan Cannot Recover Settlement Funds That Have Been Spent

SUPREME COURT SEALThe Supreme Court held in an 8-1 ruling that when a plan participant has spent - on nontraceable items such as fees for services or travel - all the settlement proceeds that could have been used to reimburse the plan, the plan fiduciary may not reach the participant's other assets as a broader means of recovery. Therefore, SPDs should include language that puts participants on notice of the plan's reimbursement rights in the case of a tort recovery and the obligation of participants to guard and not spend any medical expense funds received in a tort recovery that may be subject to the plan's claim for reimbursement.... Plan fiduciaries must anticipate the need to enforce and monitor the plan's subrogation rights when plan assets are paid related to personal injury scenarios and should establish administrative procedures to carry out such enforcement and monitoring." [Montanile v. Bd. of Trustees of Nat. Elevator Ind. Health Benefit Plan, No. 14-723 (U.S. Jan. 20, 2016)] (Jackson Lewis P.C.)

IRS Releases 2016 Version of Publication 15-B
(Employer's Tax Guide to Fringe Benefits)

Internal Revenue ServiceThe IRS has released the 2016 version of Publication 15-B (Employer's Tax Guide to Fringe Benefits), with information for employers on the employment tax treatment of various fringe benefits, including accident and health coverage, adoption assistance, company cars (and other employer-provided vehicles), dependent care assistance, educational assistance, employee discounts and more. IRS Publication 15-B (Employer's Tax Guide to Fringe Benefits)

Fidelity Enters the Benefits Business:
Why Many Others Will Follow

You may have seen the press release announcing that Fidelity has entered the benefits business as a broker. According to the Boston Globe "Fidelity will act as a broker, selling the plans of traditional insurance providers and competing against hundreds of other agents and brokers for that business." (Joe Markland)
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© 2017 ERISAPros, LLC, All rights reserved. Information on ERISAPros' website, its newsletter, “News & Views,” and its blog, “ERISA Wonk,” is published as a general informational source. Information and articles are general in nature and are not intended to constitute legal or tax advice in any particular matter. Blog posts and comments reflect the personal views of their respective authors - not those of ERISAPros. Transmission of this information does not create an attorney-client relationship. ERISAPros, LLC is not a law firm and is not giving legal or tax advice. It does not warrant and is not responsible for errors or omissions in the content on its website or in its newsletters. ERISA is a complicated and confusing law. Summary Plan Descriptions (SPDs), Wrap Plan Documents, and Form 5500s require review and updating by qualified ERISA compliance professionals.


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