"The guidance provides for a lot of flexibility for employers ... however, the IRS holds firm on the idea that a plan may not offer a grace period and a carryover.... Employers will want to provide notice to employees of any modifications made to the plan under this guidance[.]"

"All of these options add administrative burden to employers. So if you are considering adding or expanding a carryover or grace period provision, ... [review] your 2020 health FSA balances to determine if there are that many participants that will even benefit from the relief."

"[The Consolidated Appropriations Act, 2021] possibly offers relief for partial plan terminations that occur in either 2020 or 2021, even if the employer-initiated terminations occurred prior to March 13, 2020 or after March 31, 2021.... [L]egislation extending or modifying the relief period is likely."

"The CAA's accommodations blur the lines between a grace period and carryover, as the law allows unlimited carryovers (more than just $550) and up to 12-month grace periods. So, is an employer better off with a grace period or a carryover provision, and does it really make any difference for leftover balances from the 2020 and 2021 FSA plan years?"

"IRS Notice 2021-15 ... provides welcome clarity regarding several of the lingering questions, as well as some additional relief and guidance.... [This article includes] common questions from employers regarding the CAA relief and a summary of the answers provided by IRS Notice 2021-15."

"New Notice 2021-15 clarifies the latest temporary rules regarding health FSAs and DCAPS included in the Act.... [E]mployers that choose to adopt any of the 2021 changes must formally amend their plans to do so. The amendment can be retroactive, but must be adopted not later than December 31 of the first calendar year beginning after the end of the plan year in which the amendment is effective."

"Notice 2021-15 allows retroactive amendments to health FSAs and HRAs to cover OTC medicines and drugs, and menstrual care products as of January 1, 2020.... Notice 2021-15 also clarifies that the spend down feature under a health FSA does not relieve the employer of its requirement to offer COBRA continuation coverage under the health FSA."

34 pages. "This notice clarifies the application of Section 214 of the Taxpayer Certainty and Disaster Tax Relief Act of 2020, recently enacted as Division EE of the Consolidated Appropriations Act, 2021 ... which provides temporary special rules for health flexible spending arrangements (health FSAs) and dependent care assistance programs under Section 125 cafeteria plans.... This notice also provides additional relief with respect to mid-year elections for plan years ending in 2021.... The notice also provides relief with respect to the effective date of amendments to Section 125 cafeteria plans and health reimbursement arrangements (HRAs) to implement the expansion of allowed expenses for health FSAs and HRAs by the [CARES Act] to include over-the-counter drugs without prescriptions and menstrual care products."

"What information has your carrier or TPA provided to demonstrate the ability to meet the new NQTL comparative analysis reporting requirements? ... What additional provider selection support does your organization anticipate will be needed for your plan participants and beneficiaries to meet the new advanced EOB requirements under the CAA? ... How will your organization communicate information about the new identification card content requirements to your plan members?"

"[T]he No Surprises Act establishes a process by which health care providers and facilities ... and group health plans and insurers ... either negotiate or use an independent dispute resolution (IDR) process to work out the cost of the out-of-network care without balance billing the patient."

"In response to three recent tax bills, employers are implementing new provisions that both improve engagement with retirement plan participants and alleviate their own administrative burdens. Now that the dust has settled from 2020, business owners can more clearly see how these three pieces of legislation work in tandem as they and their plan participants head into 2021."

"[The Act] provides a 30-day period for insurers and providers to negotiate the payment of out-of-network charges. If no resolution is reached, these claims may be submitted to an independent dispute resolution process where an arbitrator makes the final decision."

"The new law details specific items that must be disclosed by the service provider to the plan fiduciary, including a description of the services provided and a description of all covered direct and indirect compensation. The disclosure requirements will be effective December 27, 2021."

"Transparency is coming to health care much as it did with the retirement industry. The CAA removes gag clauses on price and quality information and requires 408(b)(2)-style broker compensation disclosure."

"Employers with self-funded plans should consider engaging their existing mental health parity analysis vendor to assist in preparing this report.... While the February 10 deadline is not a filing deadline, it is not known when the federal agencies will begin requesting these reports."

40 presentation slides. Topics: [2] Legislative background; [2] No Surprises Act: Surprise billing provisions, Additional provisions; [3] Transparency provisions: Prohibition on gag clauses, Disclosure of broker and consultant compensation, MHPAEA NQTL comparative analyses, Mandatory annual reporting on pharmacy benefits and drug costs.

39 pages (78 presentation slides). Topics: [1] Update on 2021 legislative and regulatory developments; [2] FSA relief under CAA; [3] New Mental Health Parity Act requirement; [4] New compensation disclosure requirement; [5] Surprise billing and new transparency provisions; [6] Update on outbreak period expiration.

"Starting January 1, 2022, it will be illegal for providers to bill patients for more than the in-network cost-sharing due under patients’ insurance in almost all scenarios where surprise out-of-network bills arise, with the notable exception of ground ambulance transport."

"The February 10 effective date was an unwelcome surprise in the legislation.... [A]dditional steps will need to be taken to ensure compliance and prepare for possible informational requests from the DOL."

"The usual tests for a partial termination ... include a rebuttable presumption of partial termination if the employer has turnover of 20% or more during a plan year. The special rule provides relief for employers that prevents the occurrence of a partial termination during certain plan years if the number of active plan participants decreases by no more than 20% during a period of roughly one year from the onset of the pandemic."

"Upon request, group health plans will need to have and readily produce comparative analyses showing that the plans comply with the parity requirements, as well as other requested information. The Departments will publish reports of their investigations, identifying those plans out of compliance with the parity requirements. Sponsors and plan administrators of group health plans need to take immediate action to prepare for the Departments' inquiries. They may also need to make changes to their plan design and agreements with their plan vendors."

"[The] CAA provisions can be broken into three main categories: [1] reducing Out-of-Network (OON) costs for enrollees, [2] providing transparency regarding costs, and [3] permissive changes that allow participants enhanced access to amounts salary reduced to a Health Care Flexible Spending Account (HCFSA) and a Dependent Care Flexible Spending Account (DCFSA).... Many of the provisions in the CAA are effective in 2022 (although some are effective in 2021)."

"Employers who implement these changes will likely experience higher costs due to reduced forfeitures and changes in plan administration. Additionally, changes to health FSAa could adversely affect the participant's eligibility to contribute (or receive contributions) to a health savings account."

"March 31, 2021 ... is the date set under ... the Consolidated Appropriations Act, 2021 as the snapshot date on which a partial plan termination may be avoided through rehires that restore earlier plan participation levels. Specifically, a plan will not be treated as having experienced a partial plan termination if on March 31, 2021, the number of active plan participants is at least 80 percent of the number covered by the plan on March 13, 2020[.]"

"[T]he MHPAEA requirement under CAA section 203 goes into effect very soon -- on February 10, 2021.... [It] requires group health plans to 'perform and document comparative analyses of the design and application of [nonquantitative treatment limits (NQTLs)].' Group health plans must make this comparative analysis available, upon request, to [HHS], the [DOL], and the Department of the Treasury. Further, those agencies are required under the CAA to request these comparative analyses from at least 20 group health plans and/or health insurance issuers each year."