"[T]he Rule clarifies that plan fiduciaries must base their investment decisions solely on pecuniary factors -- those that have a material effect on an investment's risk and return based on appropriate time horizons consistent with the plan's investment objectives and funding policy."

38 presentation slides. Summary of Act introduced on October 27 by Ways and Means Committee Chairman Neal and Ranking Member Brady.

"Workers have been focusing on building up their emergency funds and cutting household expenses during the coronavirus pandemic. Retirement saving is still a priority. Savings rates remain steady in workplace plans. Saving outside of employer plans has also gained momentum. At the same time, furloughed workers are experiencing more financial stress and expect to withdraw money from retirement accounts within the next 12 months."

35 presentation slides. Topics: [1] Legislative Developments; [2] Regulatory Developments -- Non-COVID: Final Health Plan Transparency Rules, ICHRA Final Rule and Follow-up Guidance on Pay-or-Play and Non-Discrimination Requirements, DOL Electronic Disclosure Rule (for qualified plans), New SBC requirement for 2021, 2021 NBPP (includes some important HSA guidance re: coupons), Direct Primary Care, and Grandfather Rule Relief; [3] Misc. Sub-Regulatory Developments: 2021 Cost-of-living Adjustments for Popular Benefits; [4] Health Plan Litigation Developments; [5] Recap of Coronavirus Impact on Employer H&W Benefits; [6] State Law Potpourri; [7] Cafeteria Plan, Grace Period, and Carry-Over Relief; and [8] COBRA, Claims and Appeals, and Special Enrollment Extensions.

"The IRS explains that the amount of qualified health plan expenses taken into account in determining the credits generally includes both the portion of the cost paid by the employer and the portion of the cost paid by the employee through pre-tax salary reduction contributions, but not amounts that the employee paid with after-tax contributions."

24 pages. "The AV Calculator represents an empirical estimate of the AV calculated in a manner that provides a close approximation to the actual average spending by a wide range of consumers in a standard population. This document is meant to detail the specific methodologies used in the AV calculation.... The draft 2022 AV Calculator is available [online].... [T]he 2022 AV Calculator does not affect any 2021 plans, and will only be applicable for 2022 plans.... [CMS] will accept comments on the draft 2022 AV Calculator, as well as the draft 2022 AV Calculator User Guide and the draft 2022 AV Calculator Methodology until ... December 24, 2020."

"For plan years beginning January 1, 2022, health plans and insurers must disclose three separate files on their websites that include detailed pricing information for all covered items and services under the applicable plan. The first file must show negotiated rates for all in-network covered items and services. The second file must show information regarding charges from, and payments to, out-of-network providers. The third file must provide historical information regarding in-network prescription drug pricing by pharmacy location."

24 pages. "The copy-cat lawsuits -- now nearly 200 in number with over 90 filed in 2020 alone -- attack retirement plan investment options that are commonplace and longstanding.... Fiduciary liability insurance companies have paid an estimated $1B+ in settlements and well over $250 million in attorney fees to a growing network of plaintiff firms chasing these outsized fee awards.... Systemic reforms are necessary before American employers decide the cost and risk of offering voluntary defined contribution plans is too high."

"Beginning in 2020 and running through 2022, small businesses with more than 5 employees are required to offer a retirement savings option to their employees. Employers can either sponsor their own plan, e.g. a 401(k) plan, or register for CalSavers. It is important to take action as noncompliance can result in fines ranging from $250 to $500 per employee. What if you already offer your employees an employer sponsored plan? ... You will need to notify the state by certifying your plan exemption online[.]"

"These new tables reflect an increase in life expectancies since the last tables were issued nearly 20 years ago. Although the updated tables do not apply until distribution years beginning in 2022, financial professionals should learn how the new life expectancy figures may affect their clients and should assess how their administrative systems will accommodate the changes."

"The final Rule requires certain disclosures regarding prices and cost-sharing information for certain healthcare items and services provided by non-grandfathered group health plans and insurance issuers. The Rule generally applies to traditional health plan coverage, and does not apply to account-based group health plans (such as HRAs, including individual coverage HRAs, or health FSAs), excepted benefits, or short-term limited-duration insurance. The Rule requires two categories of disclosures: disclosures to the public, and disclosures to plan participants."

"The new rules require most employer-sponsored group health plans and health insurance issuers to disclose price and cost-sharing information up front, giving enrollees estimates of any out-of-pocket expense they will have to pay to meet their plan's cost-sharing requirements. Health plan sponsors and insurance issuers will also have to give patients and other stakeholders access to previously unavailable pricing information, using a standardized format that allows easy cost comparisons."

"Only Baby Boomers are counting on Social Security as a meaningful contribution to their retirement income. All three generations believe their participation in a 401(k) or similar plan will provide a significant portion of their retirement income, but ... no generation is currently participating in their defined contribution plans at a level that supports [their] income expectations[.]"

"[T]he Final Rule amends the AKS discount safe harbor ... to eliminate safe harbor protection for drug discounts and rebates offered by pharmaceutical manufacturers to pharmacy benefit managers (PBMs), Medicare Part D prescription drug plan sponsors, and Medicaid managed care organizations.... [T]he Final Rule creates two new pharmaceutical-related safe harbors: [1] a safe harbor (the 'Point-of-Sale Safe Harbor') applicable to certain prescription drug point-of-sale discounts as offered to Medicare and Medicaid beneficiaries to reduce their direct out-of-pocket prescription drug costs and [2] a safe harbor (the 'PBM Service Fees Safe Harbor') applicable to flat fee arrangements paid by drug companies directly to PBMs for PBM services."

"U.S. single premium buy-out sales totaled $4.6 billion in the third quarter, down 41% from third quarter 2019 but double the $2.3 billion sold in the second quarter ... Year-to-date buy-out sales totaled $11.3 billion, a drop of 32%, compared with the $16.7 billion sold in the first nine months of 2019."

"New York's sick and safe leave law requires employers with five or more employees to provide paid sick and safe leave (SSL), and those with fewer than five employees and a net income of $1 million or less to provide unpaid SSL each calendar year. Eligible employees began accruing SSL on September 30, 2020, and may utilize earned SSL starting January 1, 2021."

"Three-fourths of plans indicated they have not noted an increase in plan loan activity since the beginning of COVID-19.... 35.0 percent of hospitals and healthcare organizations noted an increase as did nearly 30 percent of higher education institutions.... More than 80 percent of organizations (83.6 percent) are not planning on any changes to plan contributions this year. However, nearly thirty percent of higher education institutions either have, or will by year-end, reduce or suspend contributions to their 403(b) plans."

"Two competing Congressional proposals illustrate opposing strategies for eliminating [Social Security's] long-term financing gap. A plan from Representative John Larson (D-CT) achieves solvency by raising revenue; former representative Sam Johnson (R-TX) gets there by cutting costs. How would these proposals affect workers, beneficiaries, and the program's finances? To find out, we use DYNASIM4, the Urban Institute's dynamic microsimulation model, to project the effects of both plans over the next seven decades."

"The Trump administration added more than 60 telehealth services that will be reimbursable during the public health emergency caused by the COVID-19 pandemic. Those changes to telehealth coverage will also be allowed permanently in rural areas."

"The proposed regulations provide that if a plan or agreement is amended to remove the provision requiring the company to delay a payment if the company reasonably anticipates at the time of the scheduled payment that the deduction would not be permitted under Section 162(m), then the amendment will not [1] result in an impermissible acceleration of payment under Section 409A, or [2] be considered a material modification for purposes of the grandfather rule under the amended Section 162(m).... The plan amendment must be made no later than December 31, 2020."

"In the same way a NQDC plan is exempt from most requirements of ERISA, requirements are also different regarding the QDRO and an NQDC plan compared to a qualified plan. Although a plan sponsor must comply with a QDRO regarding a qualified plan, in the case of most NQDC plans, the plan sponsor may actually be prohibited from complying with the court order."

"The Form 5500 and Form 5500-SF instructions have been revised to reflect that the Form 5500-SF can no longer be used by a one-participant plan or a foreign plan in place of filing of the Form 5500-EZ with the IRS. Effective for plan years beginning after 2019, one-participant plans and foreign plans can file the Form 5500-EZ electronically using the EFAST2 filing system....

"Administrative Penalties: The instructions have been updated to reflect an increase to $2,233 per day in the maximum civil penalty amount assessable under [ERISA] section 502(c)(2) ...

"Schedule H Part III - Accountant's Opinion: To conform to the new Statement on Auditing Standards 136, 'Forming an Opinion and Reporting on Financial Statements of Employee Benefit Plans Subject to ERISA,' the instructions for the questions on line 3a regarding the accountant's opinion have been revised. Line 3b and its instructions have been updated to permit filers to indicate more accurately whether there have been any permissible limitations on the scope of the audit pursuant to the Department's regulations.

"Schedules H and I, Line 4l and Form 5500-SF, Line 10f: The instructions ... have been revised to increase the required minimum distribution age from 70½ to 72 ...

"Schedules H and I, Line 5c ... has been revised to make clear that if the plan was covered by PBGC at any time during the plan year, filers should check the 'Yes' box....

"Schedule R: Line 14 has been revised to provide multiemployer plans with a choice of three counting methods to count inactive participants and to require that an attachment be provided depending on the counting method chosen....

"Information copies of the forms, schedules and instructions are available on the EBSA website."

"[T]ypically claimants seeking ERISA-governed benefits make claims for recovery under Section 1132(a)(1)(B). Now you are likely seeing more simultaneous assertions of equitable claims for breach of fiduciary duty and disgorgement under Section 1132(a)(3). A successful claimant asserting this theory may recover additional forms of monetary relief, and may get broader discovery. But the availability of relief under Section 1132(a)(3) claims is narrow ... So, how do you defend Section 1132 (a)(3) equitable claims?" [Davis v. Hartford Life & Accident Ins. Co., No. 19-6091 (6th Cir. Nov. 19, 2020)]

"Despite real differences in how the three study countries administer risk adjustments, ... even the sophisticated risk adjustment methods they currently use fail to accurately compensate health plans for the risks represented by specific enrollees.... This study demonstrated the important payment improvements that can be achieved across the board by reinsuring against losses for the small portion of enrollees whose care is grossly undercompensated and suggests this reinsurance will not weaken plan incentives to effectively manage care for these very high cost patients."

48 pages. "[A] cancer diagnosis and treatment together comprise just one part of the patient journey. What happens when people move beyond active treatment to survivorship? ... [This guide] is designed to provide you with information on the challenges and opportunities associated with cancer survivorship and practical guidance on creating a workplace that supports people living with cancer and is productive for all."