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Walt Bernard Podgurski,  Editor,  440-773-1108, 

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Editorial Mission Statement: The goal of this publication is to provide readers a broad selection of what is being written about the insurance industry and related issues. Some articles may have a “tilt” towards a particular perspective one way or another. Inclusion in this newsletter is not an endorsement of any views or content; but report the various and differing views appearing in media.
  Wednesday, 04/10/19 - https://DailyInsuranceReport.com 

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How 60 of the nation’s biggest employers are uniting to fight the benefits status quo
Kathryn Mayer / ebn

What started as a small group of companies — Apple, Goodyear, Fidelity, Google and Target — meeting together in 2014 has quietly blossomed into a powerful industry force that has intentionally flown under the radar until now: The Employer Health Innovation Roundtable, a grassroots group made up of nearly 60 of the country’s biggest employers that represent nearly 8 million employees.

On the surface, the roundtable is a twice-yearly meeting for companies including Boeing, Delta, Facebook, Walmart and more to connect and match with health-tech startups and to look for solutions to a host of health-related issues plaguing the workplace: The opioid epidemic. Mental health struggles. Musculoskeletal disorders. Caregiving responsibilities.

But at its core, the group represents something more meaningful: Employers joining together to try to take more control of a health system they see as wasteful, costly and confusing.

“Employers large and small are disgusted with the fact that the massive incumbents — the big hospital systems and the big carrier systems — aren’t doing anything to help [find] a solution,” says Sally Welborn, Walmart’s former senior vice president of global benefits who joined the group as an employer member and now serves as the group’s executive adviser. “And there is a subset of us who are saying, ‘OK, we’re so fed up with it, we are going to take matters into our own hands and change things.’”

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Trump is targeting Obamacare again. Here's everything you need to know about where the law stands now
Ashley Turner / CNBC

In December, a federal judge in Texas ruled Obamacare unconstitutional after 20 Republican-led states filed a suit against the health-care policy. U.S. District Judge Reed O'Connor said that without the individual mandate, the law could not stand.

O'Connor's ruling, backed by the Justice Department, awaits deliberation with the U.S. Court of Appeals for the 5th Circuit in New Orleans. But what does that mean for the millions of Americans who receive coverage under the Affordable Care Act?

What happens while O'Connor's ruling awaits appeal

Americans covered under the Affordable Care Act don't have to worry about losing benefits for now.

O'Connor said his ruling should not be immediately implemented because "many everyday Americans would otherwise face great uncertainty" regarding their health care during an appeal. A ruling from the 5th Circuit on O'Connor's decision is not assured for 2019.

Joseph Antos, a health-care and retirement policy scholar at the conservative American Enterprise Institute, said if the appeals court supports O'Connor's ruling — which he believes is unlikely — the earliest the Supreme Court would hear the case is sometime in 2020.

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DOJ asks for speedy hearing in case that could kill Obamacare

The Trump administration wants oral arguments in the appeal of a lower court ruling invalidating Obamacare to take place the week of July 8.

The Justice Department filed a motion to expedite oral arguments in the 5th Circuit Court of Appeals Monday. It indicated that its proposed timeline is unopposed by the other parties in the case.

Sixteen largely Democratic-led states and the District of Columbia have appealed the December ruling, which has been put on hold while the case proceeds.

The Trump administration had initially argued that only the Affordable Care Act's insurance protections should be struck down as unconstitutional. But two weeks ago it broadened its case against the law, calling for the appellate court to uphold the ruling that jettisoned the entire ACA.

2 Ways To Lower America's High Health Care Costs
Holly Lawrence, Next Avenue Contributor / Forbes

The United States ranks No.1 for highest health care costs per person. Annual family health insurance premiums rose 5% last year, averaging $19,616, according to the Kaiser Family Foundation. A healthy couple retiring at 65 this year can expect to spend $285,000 on health care in retirement, says Fidelity Investments. So, what could lower crushing health care costs in America?

Value-based health care and health care cost transparency, said experts at West Health’s Healthcare Costs Innovation Summit in Washington, D.C. April 2. But, the speakers at the “High Costs, Broken Promises: Healthcare in America” event conceded, neither will be easy to pull off.

Comptroller suspends more than $5.7M in payments to state contractor
Peter Hancock / Capitol News Illinois

Illinois State Comptroller Susana Mendoza announced Monday that her office has suspended more than $5.7 million in payments to a company that designed a web portal that manages state employee benefits.

Mendoza made that announcement following the release of an audit in late March that outlined numerous problems with the state’s MyBenefits Marketplace system, which was designed and built by a Toronto-based company, Morneau Shepell.

The system serves an estimated 450,000 state employees and retirees to use when they sign up for health insurance, flexible spending accounts and other employee benefits. Launched in 2016, it replaced a system in which those benefits were administered by the Department of Central Management Services and staff in all of the various state agencies.


CHICAGO, IL – The U.S. District Court for the Northern District of Illinois has sentenced Lake County, Illinois-based business owner Richard Booy, to serve five years imprisonment followed by an additional three years of supervised release, and to make $1,439,678 million in restitution for defrauding his clients in a Ponzi-type scheme totaling approximately $2 million. As a result of the the March 18, 2019 sentencing, Booy is statutorily barred from serving as a fiduciary under the Employee Retirement Income Security Act (ERISA).

Booy pleaded guilty on July 26, 2018, to one count of mail fraud. Founder of the Libertyville, Illinois-based Principal Financial Strategies, LLC (PFS) and owner and operator of the now-defunct Vernon Hills, Illinois-based Safe Financial Strategies Inc., Booy used the promise of no-risk investments and guaranteed returns to persuade his primarily elderly clients to invest their money with him.

The action follows a joint investigation by the U.S. Department of Labor's Employee Benefits Security Administration (EBSA), the U.S. Postal Inspection Service, and the State of Illinois Securities Department.

Another 401(k) plan sues Fidelity over 'kickbacks'

A participant in the Publicis 401(k) retirement plan has filed a class-action lawsuit against Fidelity Investments, charging that the record keeper received kickbacks from other fund companies whose funds are offered in the program.

The suit, filed in the U.S. District Court for the District of Massachusetts, charges that beginning on or about 2017, Fidelity began requiring that various fund companies and others offering investment products through the plans for which Fidelity provided record keeping "make secret payments to Fidelity for its own benefit in the guise of 'infrastructure' payments or so-called relationship-level fees in violation of the Employee Retirement Income Security Act."

The suit asks that the court grant the plaintiffs, who work for the U.S. arm of a French-based advertising and marketing firm, a judgment saying that Fidelity violated ERISA, and enjoining it from continuing the practices in question.

Parties Reach Settlement Agreement in Anthem 401(k) Excessive Fee Case
The case is notable for arguing that an investment that had only a 4 basis point annual fee could have been replaced by one charging only 2 basis points.
Rebecca Moore / PLANSPONSOR

The parties in an excessive fee lawsuit filed against the committee that oversees the Anthem 401(k) plan have reached a settlement agreement.

A February 19 docket entry in the case of Bell v. Anthem says, “The parties have reached a resolution subject to class approval.” The judge ordered that on or before March 15, 2019, the parties are to file a motion for preliminary approval of class settlement. Details of the settlement will be available then.

In the complaint, it is alleged that plan fiduciaries allowed unreasonable expenses to be charged to participants for administration of the plan, and that they selected and retained high-cost and poor-performing investments compared to available alternatives. The complaint suggests the Anthem plan, “as one of the country’s largest 401(k) plans … with over $5.1 billion in total assets and over 59,000 participants with account balances,” should have gotten as good or better a deal than anyone in the institutional investing markets, but it failed to do so in a variety of ways, leading to about $18 million in unnecessary fees/losses for participants.

Checksmart Wins Dismissal of 401(k) Excessive Fee Lawsuit
From Benefits & Executive Compensation News
Employee Benefits News examines legal developments that impact the employee benefits and executive compensation employers provide, including federal and state legislation, rules from federal...

By Carmen Castro-Pagan

Checksmart Financial LLC defeated a lawsuit accusing it of violating federal benefits law by offering high-fee, poorly performing investment funds in its $25 million 401(k) plan.

The participant’s claim of fiduciary breach against Checksmart and Cetera Advisor Networks LLC are untimely under the Employee Retirement Income Security Act’s three-year time limits provision, Judge James L. Graham of the U.S. District Court for the Southern District of Ohio held July 12.

The proposed class action, filed two years ago by Checksmart employee Enrique Bernaola, made waves in the financial industry for being one of the first to challenge alleged excessive fees in a smaller 401(k) plan. Such lawsuits usually have targeted major companies, including Verizon, Chevron, American Airlines, and Anthem. In recent years, however, companies with smaller plans also have been sued, including Gucci America Inc. ($97 million) and Novitex Enterprise Solutions Inc. ($157 million).

Graham held that Bernaola’s claims were barred by ERISA’s statute of limitations because the expense ratios for the various investment options offered by the plan were disclosed to him three years before he filed his lawsuit.


Monday, 04/08/19 - Trump Is Being Vague About What He Wants to Replace Obamacare. But There Are Clues.

Tuesday, 04/09/19 - 'Medicare X': Bill to expand public health care introduced in Congress

Wednesday, 04/03/19 - Association health plan ruling could result in thousands losing coverage

Thursday, 04/04/19 -
Americans Borrowed $88 Billion to Pay for Health Care Last Year, Survey Finds

Friday, 04/05/19 - OneDigital Health and Benefits Acquires Northwestern Benefit in Biggest Acquisition in Company History

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Walt Bernard Podgurski - - Editor