21 presentation slides. Topics: [1] Legislative update; [2] Outbreak period update; [3] COBRA subsidy: a deeper dive; [4] Notice 2021-15: FSA and election change relief; [5] Further agency guidance on COVID testing and vaccinations.

"The agencies have clearly signaled that any exceptions to mandatory coverage of COVID-19 diagnostic testing and immunizations will be strictly and narrowly construed."

"Holistic wellness solutions take front and center role ... Executive benefits are a winning play for senior talent ... Data analytics guide benefits strategy and design."

"While the Act did not add any additional penalties for noncompliance, the agencies can apply existing penalties to plans within their jurisdictions. For example, the DOL can assess a penalty of up to $161 per day for failure to provide requested mental health parity documents to participants."

"[The latest] guidance ... confirms that plans and insurers must cover, without cost-sharing, COVID-19 tests for asymptomatic individuals ... But the Departments do not go so far as to require coverage for general workplace health and safety or public health surveillance testing."

"A growing number of employers have their HSAs administered alongside their retirement plans ... Contributions above the required cash balance are invested like 401(k) assets. Greater savings to HSAs can be encouraged, as well, by matching employee contributions."

"The Rescue Plan allows assistance-eligible individuals to pay just 15% of the COBRA premium, with the remaining 85% paid by the employer, plan, or insurer and reimbursed by the government through a refundable FICA tax credit.... The legislation would also extend the availability of the refundable paid sick leave and family and medical leave credits through September 30, 2021."

"[DOL] officials explained their expectation is that each employer plan sponsor will be able to produce an organized and thorough report with evidence and a soundly reasoned conclusion.... [If] they find one group health plan that is out of compliance, the DOL will approach the group's service providers ... to find all of the other non-compliant plans within the vendor's clientele."

"Plans cannot require the presence of symptoms or a recent known or suspected exposure to COVID-19, or otherwise impose medical screening criteria on coverage for tests."

"If I allow a rollover or grace period, then how do I also help employees preserve their HSA eligibility? ... What kind of prospective changes am I allowed to offer my employees? ... What else should employers do?"

"The FAQs address the requirement to cover items and services related to diagnostic testing, qualifying preventive services, and recommended immunizations of COVID-19 without the imposition of cost sharing, prior authorization, or other medical management requirements."

"The fact that patients struggle to shop in this favorable setting makes it unlikely that greater cost sharing and price transparency will lead them to shop for more complex services. A more promising avenue may be to harness the power exerted by referring physicians and help them to help their patients select better value providers."

"This article highlights the 20 key takeaways from Notice 2021-15 for employers with cafeteria plans.... Carryovers and grace periods ... Eligibility to contribute to an HSA ... Mid-year election changes ... Post-participation Health FSA reimbursements"

"Group health plans that provide coverage for mental health or substance use disorder benefits and are therefore subject to mental health parity rules will soon be required to prepare a comparative analysis and have it available upon request."

"The court explained that where provisions of an arbitration agreement operate as a prospective waiver of a party’s right to pursue statutory remedies, the agreement would be unenforceable as against public policy. But here, Aflac represented to the court that it would waive Paragraph 10.7.1 and it is judicially estopped from revoking the waiver." [American Family Life Assurance Company of New York v. Baker, No. 20-1435 (2d Cir. Mar. 1, 2021; unpub.)]

"While the Notice clarifies the permissible opportunities available under the Act, the IRS twists long established rules under Section 125 of the Code ... The Notice offers up a cornucopia of additional opportunities that create administrative burdens and may be too costly for a third-party administrator to implement given the emphasis in the Notice that these permissible opportunities are all temporary in duration."

"Group health plans must cover the required COVID-19 testing even for an asymptomatic individual with no known or suspected exposure to COVID-19.... This requirement does not, however, require group health plans to cover without participant cost-sharing, prior authorization, or other medical management requirements COVID-19 tests that are required for public health surveillance or employment purposes."

"A California law that took effect Jan. 1 ... [requires] state-regulated commercial health plans ... to use nationally recognized clinical standards established by nonprofit associations of clinical specialists to determine which mental health and addiction treatments they'll cover -- and for how long."

"The centerpiece ... is to combine the grace period and carryover rules. Conceptually there is no distinction between the grace period and carryover for PYs 2020 and 2021 PYs. In order to avoid confusion, the IRS refers to the period as the 'temporary extension period.' An employer has the discretion to adopt all, some or none of the opportunities presented by TCDRA and Notice 2021-15."

"The 10Plan ... would cover the 28 million individuals who are uninsured and the nearly 20 million who purchase private coverage in the nongroup market ... Because the 10Plan allows payments for medical expenses to be spread over multiple years, understanding the plan's effects requires understanding the system dynamics around medical spending, income, and family structure over a 15-year period."

11 pages; 14 Q&As. "This document addresses the requirement under section 6001 of the [FFCRA], as amended by section 3201 of the [CARES Act], for group health plans and health insurance issuers offering group or individual health insurance coverage, including grandfathered health plans, to provide benefits for certain items and services related to diagnostic testing for COVID-19, without imposing any cost-sharing requirements, prior authorization, or other medical management requirements. In addition, this document addresses the requirement under section 3203 of the CARES Act for non-grandfathered group health plans and health insurance issuers offering non-grandfathered group or individual health insurance coverage to cover, without cost sharing, qualifying coronavirus preventive services, including recommended COVID-19 vaccines. This document also addresses other health coverage issues related to COVID-19 and includes information about how providers may seek federal reimbursement when delivering COVID-19 related services to the uninsured."

"This guidance makes clear that private group health plans and issuers generally cannot use medical screening criteria to deny coverage for COVID-19 diagnostic tests for individuals with health coverage who are asymptomatic, and who have no known or suspected exposure to COVID-19. Such testing must be covered without cost sharing, prior authorization, or other medical management requirements imposed by the plan or issuer.... In addition, the guidance confirms that plans and issuers must cover point-of-care COVID-19 diagnostic tests, and COVID-19 diagnostic tests administered at state or locally administered testing sites. "

"One of the EEOC Commissioners ... [stated] on February 18, 2021, that the rules remain under consideration at EEOC ... The incentive issue has particular currency and importance today as many employers consider whether to offer incentives to encourage employees to receive COVID-19 vaccinations."

"In this most recent notice, the IRS broadened the relief ... so that an employer may allow election changes for all pre-tax health benefits in the 2021 plan year without a qualifying reason. The rules retain the written attestation requirement of other coverage for revoking medical coverage."

"[S]elf-insured employers can immediately put their benefits data to use, working with their brokers to create effective employee health and wellness programs. These organizations can access demographic information, presentism and absenteeism data, compensation information, healthcare claims, biometric screening results, and aggregate personal health assessments."