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Office for Civil Rights Update on HIPAA and COVID-19
April 24, 2020 WEBCAST
U.S. Department of Health & Human Services [HHS]

COBRA Compliance
April 29, 2020 WEBCAST
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

COBRA Compliance
April 30, 2020 WEBCAST
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

CARES Act: Employee Benefits Provisions, DOL Guidance, Relief for Sponsors of Certain Plans and Pensions
June 17, 2020 WEBCAST

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View Coronavirus (COVID-19) News and Resources

[Official Guidance]

Text of CMS FAQs on Issuer Flexibilities for Utilization Management and Prior Authorization (PDF)

"[1] What flexibilities can health insurance issuers, including those offering coverage in the individual and large and small group markets, offer with respect to utilization management to mitigate the impact of the [COVID-19] public health emergency on providers? ... [2] What flexibilities are available to issuers regarding the application of utilization management to formulary drugs that are being prescribed for off-label use to treat COVID-19?" [Unnumbered document, Apr. 21, 2020]

Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

CMS Delays Implementation of Interoperability and Patient Access Final Rule

"CMS is extending the implementation timeline for the admission, discharge, and transfer (ADT) notification Conditions of Participation (CoPs) ... [T]he final rule ... will now be effective 12 months after [it] is published in the Federal Register.... CMS finalized the Patient Access API for Qualified Health Plan (QHP) issuers on the individual market Federally-Facilitated Exchanges (FFEs) beginning with plan years beginning on or after January 1, 2021. CMS will not enforce the new requirements under 45 CFR Part 156 until July 1, 2021." [Editor's note: publication of the final rule is expected on May 1, 2020.]

Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

Employer Responsibilities for Reinstating Employees Returning from FFCRA Leave

"The provisions of the FFCRA make clear that employers have certain responsibilities to restore an employee, upon return from Emergency Paid Sick Leave or Expanded Family and Medical Leave, to the same or equivalent position held by the employee when their leave commenced. An equivalent position means one with equivalent benefits, pay, and other terms and conditions as the employee's prior position."

McAfee & Taft

[Guidance Overview]

Editor's Pick Two Leave-Sharing Program Options for Employers During the COVID-19 Pandemic

"Leave-sharing programs that are properly structured under [IRS] guidance permit exclusion of transferred leave from the gross income of a donor employee and inclusion of the transferred leave in the gross income of the coworker recipient. However, the IRS has generally limited this favorable tax treatment to leave-sharing programs for: [1] major disasters, and [2] medical emergencies."

Snell & Wilmer

[Guidance Overview]

Employer Tax-Free, Deductible Disaster Relief Benefits for Employees

"Qualified disaster relief payment programs were originally authorized under Section 139 in response to the September 11 terrorist attacks. In addition to the favorable tax treatment, such a program may be implemented by an employer with little administrative burden."

Krieg DeVault

[Guidance Overview]

Employer-Paid Student Loan Relief for 2020

"The CARES Act relief permits an employer to amend its 127 plan to allow for the direct payment to the lender, or payment to the employee, to pay/reimburse principal and interest payments on a 'qualified education loan' incurred by the employee for education of the employee."

Groom Law Group

[Guidance Overview]

Editor's Pick COVID-19 Emergency Local Paid Sick Leave Chart (California) (PDF)

Local governments across California have enacted various measures to expand paid sick leave to workers in their jurisdictions. This chart summarizes the COVID-19 local paid sick leave laws passed in California to date, including Emeryville, Los Angeles, San Francisco, and San Jose.  Chart will be updated as developments warrant.

Davis Wright Tremaine LLP

[Guidance Overview]

New Jersey Makes Additional Changes to the Family Leave Act to Expand Protection and Benefits to Employees for COVID-19

"[T]he new bill not only expands the categories of protected leave under the NJFLA, but it also expands the categories of employees eligible to take it.... The bill expands the definition of 'family temporary disability leave' ... to include in-home care or treatment of the family member of an employee ... [E]mployers should be aware that for a period of disability taken for any of these newly enumerated reasons, there is no seven-day waiting period."


ACA Round-Up: Latest on SEPs, Pass-Through Funding, and RADV

"[CMS continues] to issue new guidance and materials ahead of the 2021 plan year and in light of the COVID-19 crisis. This post summarizes the latest information on special enrollment periods, letters to 13 states on federal pass-through funding for 2020, and a decision from CMS to postpone the risk adjustment data validation (RADV) process. CMS also released its final unified rate review instructions for the 2021 plan year."

Katie Keith, in Health Affairs

New York Attorney General Contends DOL Rule Unlawfully Limits Workers' Right to Virus Leave

"[T]he lawsuit asserts that the DOL exceeded its authority under the FFCRA by prohibiting employees from taking leave unless their employer approves it and allowing employers to deny paid leave requests if they don't have work for their employees. The complaint also takes issue with an exclusion from coverage that affects 'a large class of workers' who are considered health care providers." [New York v. DOL, No. 20-3020 (S.D.N.Y. complaint filed Apr. 14, 2020)]

Society for Human Resource Management [SHRM]; membership may be required to view article

Court Highlights Limitations of an 'Unlimited' Vacation Policy in California

"[T]he trial court concluded that the plaintiffs' ability to take vacation was not truly 'unlimited' and therefore accrued, unused vacation was owed. The court found that 'vacation time vests under a policy where vacation time is provided, even if the precise amount is not expressly defined by the employer in statements to employees.' " [McPherson v. EF Intercultural Foundation, Inc., No. B290869 (Cal. App. 2d, Apr. 1, 2020)]

Fisher Phillips

Companies Accelerate Workforce, Compensation and Benefits Changes in Response to COVID-19

"70% of companies are providing additional scheduling flexibility to employees with children; 57% of companies are providing as-needed payments or equipment purchases to assist employees with work-from-home arrangements; 42% of companies are providing temporary increases in sick leave entitlements (e.g., special 'pandemic leaves'); 38% of companies are allowing employees to use sick leave for COVID-19 related quarantines (in addition to what is required by law); and 26% of companies are allowing employees to use sick leave to care for children when they are off from school (in addition to what is required by law)."


Benefits in General

[Official Guidance]

Text of DOL Notice: EBSA Participant Assistance Program Customer Survey

"This survey will collect customer satisfaction data for a sample of private citizens who call into the participant assistance program to ask about their private sector employer provided benefits such as pensions, retirement savings, and health benefits. Three types of callers will be queried: [1] Those who need benefit claim assistance; [2] Those who have a valid benefit claim; and [3] Those who have an invalid benefit claim.... The results of the survey will be analyzed to provide actionable data that could be used to improve program performance."

Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

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PEO's Calculation of COBRA Rates

"I was co-employed by a PEO and know the combined employer/employee rates for Medical coverage because I have the contract between my former employer and the PEO. Therefore, when I received the COBRA notice, I was surprised that the Medical rate wasn't just 102% of the total cost of the medical plan (employer + employee). Is there something that I am missing that would allow the PEO to charge more than 102%?"

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2020, 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, 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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