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Associate General Counsel

Central Pension Fund of the IUOE
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Quality Control Specialist

Pentegra
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Nicholas Pension Consultants
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Compliance Specialist II

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Medical Claims Reviews: What Your Plan May Be Missing
International Foundation of Employee Benefit Plans [IFEBP] Link to more items from this source
Oct. 7, 2022

"With thousands and thousands of codes that can be assigned to everything from the diagnosis of a patient's condition to the facility where they receive care, there is plenty of room for error in medical billing. And it may never get caught -- partly because billing has become so complicated and partly because patients, health plans and claims administrators may not have all the data they need to catch the errors."

Tags: Health Plan Administration  •  Health Plan Costs

Considerations for Employer Group Health Plans in the Aftermath of Dobbs
Frost Brown Todd LLC Link to more items from this source
Oct. 7, 2022

"[M]any states have implemented laws that restrict abortion services through various civil and criminal penalties.... Some of [the] issues are obvious, such as how, if at all, will group health plans provide coverage for abortion services. Other issues are more obscure, such as whether reimbursements for abortion-related travel and lodging expenses are excludable for federal income tax purposes. Employers that choose to provide such reimbursements through their group health plans may encounter several legal obstacles."

Tags: Health Plan Design

What Is Driving Increased Spending on Mental Health Care Services? (PDF)
Employee Benefit Research Institute [EBRI] Link to more items from this source
Oct. 7, 2022

"Overall spending on mental health care services as a percentage of total spending increased from 6.8 percent in 2013 to 8.2 percent in 2020.... Among enrollees with a mental health diagnosis, average annual spending on mental health care services ... between 2013 and 2020 ... increased 20 percent, or an average of 3 percent per year.... Spending on outpatient mental health services increased 37 percent, while spending on prescription drugs for mental health disorders fell 15 percent."

Tags: Health Plan Costs

CMS Releases 2023 Medicare Part A and B Values
Buck Link to more items from this source
Oct. 7, 2022

"CMS has announced the 2023 Medicare Part A and B premium, deductible and coinsurance amounts. As in prior years, there are increases in the Part D amounts. However, the Part B premium and deductible will decrease."

Tags: Health Plan Costs  •  Medicare

California Extends Time to Use COVID-19 Sick Leave, Allows Further Testing as Prerequisite
ArentFox Schiff LLP Link to more items from this source
[Guidance Overview]
Oct. 7, 2022

"California extended the time for eligible employees to use COVID-19 supplemental paid sick leave by three months, or until the end of 2022. In a further change, Assembly Bill 152 also allows California employers to require further COVID-19 testing as a condition of using this paid sick leave."

Tags: Coronavirus (COVID-19)  •  FMLA and Other Leave  •  Local Regulation

In Cybersecurity Enforcement Action, Seventh Circuit Rejects Service Provider's Challenges to DOL Subpoena
Thomson Reuters Practical Law Link to more items from this source
Oct. 7, 2022

"In an enforcement action involving an administrative subpoena seeking documents from a service provider for employer-sponsored health and retirement plans, the Seventh Circuit held that the [DOL's] investigatory authority under [ERISA] is not limited to ERISA plan fiduciaries. The Seventh Circuit also concluded that the subpoena was not too indefinite or unduly burdensome." [Walsh v. Alight Solutions LLC, No. 21-3290 (7th Cir. Aug. 12, 2022)]

Tags: Cybersecurity  •  Health Plan Policy  •  Retirement Plan Policy

Big Players in 401(k) Industry Team Up to Launch 401(k) Rollover Plan Product
CNBC Link to more items from this source
Oct. 7, 2022

"401(k) plans hold a whopping $7.7 trillion in retirement savings. But cash-outs of small accounts pull billions from the system each year and can harm investors' chances of a secure retirement, research shows. A trio of the industry's largest 401(k) administrators -- Fidelity Investments, Vanguard Group and Alight Solutions -- have teamed up to change that."

Tags: 401(k) Plans  •  Retirement Plan Administration

House Passes Mental Health Matters Act: What Employers, Insurers, and Administrators -- Even for Retirement Plans -- Need to Know
Morgan Lewis Link to more items from this source
Oct. 7, 2022

"The Mental Health Matters Act [HR 7780], passed in the US House of Representatives on September 29, [1] significantly expands the [DOL's] authority to enforce or file civil litigation with respect to mental health parity violations and [2] eliminates discretionary clauses, potentially dismantling the administrative process of [ERISA]."

Tags: Health Plan Administration  •  Health Plan Design  •  Retirement Plan Design

HHS Proposed Regs Restore, Update Obama-Era ACA Section 1557 Rules
Groom Law Group Link to more items from this source
[Guidance Overview]
Oct. 7, 2022

"The Proposed Rule also suggests that TPAs subject to Section 1557 may be held liable for Section 1557 violations when the allegedly discriminatory act or feature originated with the TPA. For example, if a group health plan adopts a template plan document provided by the TPA, the TPA could be found liable. This appears to be the case even in the event the plan sponsor formally adopts the document or benefit design as the plan settlor."

Tags: Health Plan Administration  •  Health Plan Design

How Plan Sponsors Can Combat Cybercrime
PLANSPONSOR; free registration may be required Link to more items from this source
Oct. 7, 2022

"[C]oordination between departments such as IT, risk, legal, and cybersecurity is essential to prevent information from being siloed off between them.... [F]raudsters will often try to manipulate staff into offering pieces of information that the fraudster lacks, such as by suggesting an answer or appearing sympathetic or forgetful in order to solicit missing pieces of identifying information."

Tags: Cybersecurity  •  Retirement Plan Administration

Retirement Plan Sponsors Have Short 2022 Year-End Amendment List
Mercer Link to more items from this source
[Guidance Overview]
Oct. 7, 2022

"Parts of 2020 Required Amendments List still due in 2022... [1] Difficulty-of-care payments under the SECURE Act.... [2] CARES Act expansion of CSEC plans.... [3] Periodic updates not specifically mentioned on RA List."

Tags: Retirement Plan Amendments

California Benefit Plan Vendor Contracts May Be Impacted by State Privacy Laws Effective in 2023
Michael Best Link to more items from this source
[Guidance Overview]
Oct. 7, 2022

"[T]he employee-employer exemption included in the [California Consumer Privacy Act (CCPA)] expires on January 1, 2023 ... Civil penalties may be assessed for a failure to comply ... including failure to amend contracts deemed subject to the law."

Tags: Health Plan Administration  •  Health Plan Design  •  Local Regulation

Auto-Portability: A Guide for Retirement Plan Sponsors
E is for ERISA Link to more items from this source
Oct. 7, 2022

"Auto-portability can prove especially useful in industries with lower wages and high employee turnover, which may include retail, transportation, hospitality, and restaurants, because this can often lead to numerous account balances of $5,000 or less being involuntarily rolled to default IRAs. Note that SECURE 2.0 proposals could increase the involuntary cash-out threshold to $7,000, which could expand the potential market for auto-portability solutions."

Tags: Retirement Plan Administration  •  Retirement Plan Design

Fidelity Readies Annuity Platform for 401(k) Assets
ThinkAdvisor Link to more items from this source
Oct. 7, 2022

"[T]he Guaranteed Income Direct program aims to provide a straightforward income option in the form of an immediate income annuity. The annuities come with institutional pricing and are offered by a significant variety of insurers."

Tags: 401(k) Plans  •  Retirement Plan Design

California Expands Bereavement Leave Benefits for Public Employers and Private Employers of 5 or More Employees
CDF Labor Law LLP Link to more items from this source
[Guidance Overview]
Oct. 7, 2022

"This bill requires covered employers to provide eligible employees with 5 days of unpaid bereavement leave for the death of an employee's family member. AB 1949 goes into effect on January 1, 2023 and applies to private employers with five or more employees and to all public employers."

Tags: FMLA and Other Leave  •  Local Regulation

Case Studies: Considerations for Unfreezing Defined Benefit Plans to Drive Business Value
Milliman Link to more items from this source
Oct. 7, 2022

"[T]he environment has come full circle in such a way that unfreezing DB plans and using their surplus funding now makes sense in many cases.... DB plans can serve as a way for employers to reduce cash outlays, manage their workforces, and differentiate their companies in a tight labor market. Here are specific case studies where plan sponsors worked with Milliman consultants to reopen their DB plans in ways that were advantageous to their business."

Tags: Funding of DB Plans  •  Retirement Plan Design

Defined Benefit Plans Are Making a Comeback: Here's Why (PDF)
Pentegra Link to more items from this source
Oct. 7, 2022

"[D]ue to rising interest rates, beneficial regulatory pension relief, COVID induced changes in our work environment and the hiring challenges many employers face -- the defined benefit plan can and will become, a game changer for many employers."

Tags: Retirement Plan Design

ACA Round-Up: Uninsured Data, Litigation Updates, and More
Health Affairs Forefront Link to more items from this source
Oct. 7, 2022

"This article discusses the latest data on marketplace enrollment and the uninsured rate; updates on litigation over the preventive services mandate; a request for information on implementation of the advanced explanation of benefits (AEOB) requirement; and state updates from Wisconsin and Vermont."

Tags: Health Plan Administration  •  Health Plan Design  •  Local Regulation

2022 Spending in Retirement Survey: Understanding the Pandemic's Impact
Employee Benefit Research Institute [EBRI] Link to more items from this source
Oct. 7, 2022

"Overall, more than half retired earlier than expected.... Similar to 2020, 7 in 10 said Social Security is a major source of their income.... Approximately half of retirees said they spend less than $2,000 each month, while 1 in 3 spend between $2,000 and $3,999 each month.... On average, retirees reported that nearly a third of their monthly income goes towards housing expenses. The second largest reported expenditure was food."

Tags: Retirement Plan Design

U.S. Pension Finance Watch, September 2022
Willis Towers Watson Link to more items from this source
Oct. 7, 2022

"The WTW Pension Index increased slightly in September 2022, recovering the losses incurred last month and reverting back to July's level. This month's change was due to a decrease in liabilities, almost completely offset by negative investment returns. The end-of-September index level of 97.0 reflects an increase of 0.1% for the month."

Tags: Funding of DB Plans

Tips for Employees: Choosing the Right Dental Insurance Plan
Forbes; subscription may be required Link to more items from this source
Oct. 7, 2022

"[1] See if your employer provides dental benefits ... [2] Determine which type of dental plan is right for your needs ... [3] Understand network access and out-of-pocket costs ... [4] Get dental insurance before you need care ... [5] Make sure your provider takes the dental insurance ... [6] Understand dental insurance limitations."

Tags: Health Plan Information for Employees

Young Versus Old Will Define Fight Over Public Pensions
Aaron Brown, Bloomberg, Via the Washington Post; Subscription May Be Required Link to more items from this source
[Opinion]
Oct. 7, 2022

"Many people think of state and local employees as having gold-plated benefits, but there is a catch. First, you generally must put in long service with a single employer to collect full value. Moving around or taking time off means you lose coverage. Second, many public employees, especially newer and lower-paid ones, are excluded from the most generous plans.... The fight in 2023 may be more between younger and older public employees than between united public employees and taxpayers."

Tags: Funding of DB Plans  •  Retirement Plan Policy  •  State and Local Government Plans

Court Defers to Insurer's Discretionary Authority
The Wagner Law Group Link to more items from this source
Oct. 6, 2022

"[B]ecause the new insurer had discretionary authority under the LTD policy, the court was required to consider whether the new insurer's interpretation of the benefits eligibility exclusion was reasonable. Here, the court found that reasonable grounds did exist to support insurer's interpretation and decision, even if it wasn't the best reading of the policy exclusion." [Stewart v. Hartford Life & Accident Ins. Co., No. 21-11919 (11th Cir. Aug. 10, 2022)]

Tags: Disability Plans

House Approves Bill Banning Arbitration Clauses in ERISA Plans
American Retirement Association [ARA] Link to more items from this source
Oct. 6, 2022

"The proposed changes were passed as part of the Mental Health Matters Act [HR 7780], which the House approved Sept. 29 by a near party-line vote of 220-205 ... HR 7780 now moves to the U.S. Senate, where Sen. Tina Smith (D-MN) introduced companion legislation [S 4219]."

Tags: Retirement Plan Design  •  Retirement Plan Policy

Editor's Pick Addressing Employee Health Plan Exception Requests, Part VII: Correcting an Erroneous Section 125 Cafeteria Plan Election Mid-Year
Newfront Link to more items from this source
[Guidance Overview]
Oct. 6, 2022

"Informal IRS guidance provides that employers can undo a mistaken employee cafeteria plan election and implement the intended election mid-year where there is 'clear and convincing evidence' of an error. This is a very high standard that will apply only in very limited circumstances."

Tags: Cafeteria Plans

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