Benefits Monthly Minute

Expansion of Preventive Care Benefits | So, You've Been Appointed to the Retirement Plan Committee | Last Call — 2019 PCORI Fee Deadline Approaching

Expansion of Preventive Care Benefits

Effective July 17, 2019, the IRS expanded the list of preventive care benefits permitted to be provided by an HDHP without a deductible, as described in IRS Notice 2019-45. The expanded list is in response to President Trump’s Executive Order 13877 which called for guidance to expand the ability of patients to select HDHPs used alongside HSAs that cover low-cost preventive care to help maintain health status for individuals with chronic conditions. The new guidance signifies a departure from prior guidance which generally did not treat benefits intended to treat existing illness as preventive care.  It should be noted that the mid-year effective date raises some implementation questions, particularly for calendar year plans.

Preventive Care for Specified Conditions

For Individuals Diagnosed with

Angiotensin Converting Enzyme (ACE) inhibitors

Congestive heart failure, diabetes, and/or coronary artery disease

Anti-resorptive therapy

Osteoporosis and/or osteopenia


Congestive heart failure and/or coronary artery disease

Blood pressure monitor


Inhaled corticosteroids


Insulin and other glucose lowering agents


Retinopathy screening


Peak flow meter




Hemoglobin A1c testing


International Normalized Ratio (INR) testing

Liver disease and/or bleeding disorders

Low-density Lipoprotein (LDL) testing

Heart disease

Selective Serotonin Reuptake Inhibitors (SSRIs)



Heart disease and/or diabetes

So, You've Been Appointed to the Retirement Plan Committee

Are you responsible for the actions of the prior members of the retirement plan committee? Fiduciaries have a duty to remedy the continuing effect of their predecessors’ breach if they know of the breach. But what type of knowledge is required for liability to attach? In Fuller v. SunTrust Banks, Inc., a federal court evaluated whether actual or constructive knowledge is sufficient. The court found that successor fiduciaries must have actual knowledge of their predecessors’ breach to be held liable. In so finding, the court rejected plaintiffs’ reliance on general trust law principles which adopt a constructive knowledge standard, and favored the approach endorsed by the Department of Labor and other courts which require actual knowledge. Although the court’s reasoning is arguably circular at times and may be appealed, the decision is a win for today’s plan fiduciaries seeking to avoid liability for their predecessors’ mistakes.

Last Call — 2019 PCORI Fee Deadline Approaching

By July 31, 2019, health insurance policy issuers and sponsors of self-insured health plans must report and pay the annual PCORI fee on Form 720. The good news is that the PCORI fee is only effective for policy and plan years ending after Sept. 30, 2012, and before Oct. 1, 2019, meaning that the July 31, 2019 payment will be the last PCORI payment for plan years ending in October, November and December 2018. (A July 2020 PCORI payment will still be due for those plans with plan years ending from January 2019 through September 2019.) The amount of the PCORI fee is equal to the average number of lives covered during the policy or plan year multiplied by the applicable dollar amount. For policy and plan years ending after Sept. 30, 2018, and before Oct. 1, 2019, the applicable dollar amount is $2.45. 

KMK Employee Benefits and Executive Compensation email updates are intended to bring attention to benefits and executive compensation issues and developments in the law and are not intended as legal advice for any particular client or any particular situation.  Please consult with counsel of your choice regarding any specific questions you may have.

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