Health & Welfare Plans Newsletter

March 12, 2020

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[Guidance Overview]

IRS Gives HSA-Compatible Plans Green Light to Pay for COVID-19 Services Below the High Deductible

"The decision by the IRS to allow HDHPs to pay for treatment of COVID-19 below the high deductible opens the door for employees and their dependents to, among other things, receive diagnoses and treatment for the coronavirus via telemedicine portals, with no cost sharing required.... Some insurers and claims administrators appear to be waiving cost sharing for all telemedicine visits for a period, whether or not related to treatment of the coronavirus. Waiving cost sharing for telemedicine visits unrelated to the virus falls outside [the relief provided in IRS Notice 2020-15] and, to the extent the patient has not yet met their high deductible, appears to threaten the qualified nature of the HDHP."

Lockton

[Guidance Overview]

IRS Guidance on COVID-19 and High-Deductible Health Plans

"This change is not required under federal tax law.... However, some states have taken steps to require insured plans to provide this coverage. Employers with self-insured plans may consider whether to make such an amendment and, if they so elect, must comply with all of the normal requirements for a change in the benefit plan coverage, such as amendment, SMM distribution, and working with the third-party administrator and any insurance carrier."

Jackson Walker

[Guidance Overview]

IRS and DOL Issue New COVID-19 Guidance

"[IRS Notice 2020-15] provides relief for all HDHPs confirming that they will not fail to maintain HDHP status if they provide medical care services and items purchased related to testing for and treatment of COVID-19 prior to the satisfaction of the applicable minimum deductible.... The DOL also issued guidance addressing how and when FMLA applies to protect a leave of absence for employees who may miss work related to COVID-19, the flu, or any other public health emergency/pandemic."

ABD Insurance & Financial Services

[Guidance Overview]

Editor's Pick HIPAA Training for Employers (PDF)

60 presentation slides cover HIPAA Portability, and HIPAA Privacy and Security, for employers.

ABD Insurance & Financial Services

[Guidance Overview]

The ACA Employer Mandate Is Like a Diamond: It's Forever

"[E]mployers need to keep records of the coverage they offered for as long as possible. This includes copies of: [1] Insurance policies or other plan documentation; [2] Offers of coverage ... [3] Documentation of waived coverage; [4] The Forms 1094-C and 1095-C. This also means that when an employer switches insurance carriers, third party administrators, or ACA reporting vendors, they should request copies of all documentation before terminating the contract."

HUB International

[Guidance Overview]

Colorado Emergency Rule Requires Employers to Provide Paid Sick Leave Days for Employees Tested for COVID-19

"Covered employers must provide employees with flu-like symptoms who are being tested for COVID-19 up to four paid sick leave days. The paid leave entitlement ends when employees receive a negative COVID-19 test result. If employers already offer a sufficient amount of paid leave, they need not provide additional paid sick leave unless employees have exhausted such leave and then experience a qualifying event."

Littler

[Guidance Overview]

New Pittsburgh Paid Sick Days Act Set to Take Effect in Middle of Coronavirus Outbreak

"Employees are eligible to earn sick leave under the PSDA if they perform at least 35 hours of work within the city in a calendar year. This includes employees working for employers located outside the city but who perform work within the city.... Employees may use sick leave for the diagnosis, care or treatment of the employee's mental or physical illness, injury, or health condition or that of a family member, for preventive medical care for the employee or a family member; or for certain public health emergencies."

Porter Wright Morris & Arthur LLP

Self Insured Plan and Contract Amendments Likely Required to Waive Deductibles, Expand Other Coronavirus Coverage

"While the announcement indicates that insurers involved in the meeting plan to expand coverage and waive deductibles, self-insured employer and union sponsored plans aren't technically covered by the agreement.... Self-insured plan sponsors and fiduciaries should confirm appropriate plan language is adopted and that their stop loss insurance carriers are on board or other arrangements are made to plan for and cover costs, and that other plan vendors are on board to handle responsibilities."

Solutions Law Press

COVID-19 and the FMLA: A Brief Overview of Medical Leave and Job Protections

"Because containment is critical to controlling COVID-19, employers should heavily consider allowing paid leave for any employee diagnosed with COVID-19, or responsible for caring for a qualifying family member with COVID-19, so as to encourage employees to abide by the quarantine recommendations without fear of losing pay. Employers should also provide employees with information needed to apply for short-term disability benefits where available."

ReedSmith

FAQs for California Non-Profit Employers on Responding to the Coronavirus (COVID-19) Outbreak

"The advice [in this article] addresses many of the questions and scenarios that California nonprofit organizations are facing with regard to employees and the Coronavirus."

Liebert Cassidy Whitmore

COVID-19 Questions: Does Your PBM Agreement Hold Answers?

"Health plans should reach out to their PBMs to coordinate and collaborate regarding the impacts of COVID-19 on delivery of pharmaceuticals to members, but not without first evaluating their PBM agreements. While no contract can anticipate every possible scenario, a well-drafted PBM agreement will anticipate and address certain key areas that may be helpful in managing your pharmaceutical benefit and PBM in the months ahead."

Wiley Rein LLP

Benefits in General

Emerging Benefit Plan Issues Relating to the Coronavirus

"This legal alert discusses the following important topics for employers to consider during this time: [1] HIPAA-protected health information and data sharing on potential infections; [2] Covering COVID-19 testing under medical plans; [3] HSA-paired high deductible plans and preventive care and treatment, including just-issued relief under IRS Notice 2020-15; [4] Employee access to benefit plan documents, including SPDs and SBCs; [5] Health FSA approved purchases and health FSA coverage during unpaid leave; [6] 401(k) plan investment information and hardship withdrawals; and [7] Short term disability coverage for quarantined employees."

Eversheds Sutherland

Multiemployer Funds and Coronavirus Communications

"Here are just a few things you can do to reassure and support participants: [1] Communicate more frequently.... [2] Be sure to respond to questions and concerns.... [3] Leverage both the local union and participating employers.... [4] Make use of all your communications tools."

Segal Consulting

ERISA Advisory Council Report: Beyond Plan Audit Compliance -- Improving the Financial Statement Audit Process (PDF)

28 pages; Nov. 2019. "[T]he Council recommends that the Department make available to plan administrators new educational resources and access to tools and data regarding the uses of financial statement audits, specifically:

  • Send notices to plan administrators advising them of their responsibilities regarding selecting, retaining, and interacting with the independent auditor of the plan's financial statements, and of the tools available to assist them in these responsibilities.
  • Publish a revised brochure regarding the selection, retention and interaction with an independent auditor of the plan's financial statements, including a best practice checklist. The Council has drafted a sample checklist, which is included in Appendix A to this report.
  • Publish a list of the most common deficiencies found in plan audits.
  • Make more information available to plan administrators and their advisors regarding auditors who perform financial statement audits for employee benefit plans ...
  • Expand the Department's financial statement audit education programs to target plan advisory groups in the Department's outreach."

Advisory Council on Employee Welfare and Pension Benefit Plans, Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

Press Releases

Upcoming Events About Health & Welfare Plans

Mar. 16
Webcast
Free
Use of Individual Medicare Marketplaces for Public Sector Retiree Health Care: A Guide For Elected Officials
Center for State and Local Government Excellence
Mar. 17
Webcast
Free
Getting It Right - Know Your Fiduciary Responsibilities: Retirement and Health Plan Sponsors - Day 3
Employee Benefits Security Administration [EBSA], U.S. Department of Labor
Mar. 18
Texas
IRA and HSA Seminar
Ascensus
Mar. 19
Georgia
Innovative Total Compensation Panelist Discussion
Worldwide Employee Benefits Network [WEB] - Atlanta Chapter
Mar. 19
Webcast
COVID-19 and HIPAA, HRA and HSA Workplace Developments: New Challenges and Opportunities for Plan Sponsors and Their Advisers
Worldwide Employee Benefits Network [WEB] - New York Chapter
Mar. 19
Webcast
Free
Is Your Out-Of-Network Savings Solution Out of Date?
Zelis

Most Popular Items in the Previous Issue

Text of DOL Q&As on COVID-19 or Other Public Health Emergencies and the Family and Medical Leave Act
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

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David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
Holly Horton, Business Manager  hollyhorton@benefitslink.com

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2020 BenefitsLink.com, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.

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