Health & Welfare Plans Newsletter

June 5, 2020

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View COVID-19 News and Resources

[Guidance Overview]

Takeaways from the DOL's Most Recent FFCRA Q&As as the Summer Unofficially Begins and Businesses Continue to Reopen

"The Q&As now specifically clarify that a 'place of care' under the FFCRA ... includes summer camps and summer enrichment programs ... The Q&As clarify that an employee generally may not take leave under the FFCRA if they are already on leave and receiving workers' compensation or temporary disability benefits, unless the employee was able to return to light duty before taking FFCRA leave.... The Q&As have now clarified what documentation employers may require from an employee who claims to have COVID-19 symptoms and is taking leave to seek a medical diagnosis."

Seyfarth Shaw LLP

[Guidance Overview]

2021 ACA Out-of-Pocket Maximums, ESR Penalties, Other Changes Ahead (PDF)

"The [Notice of Benefit and Payment Parameters for 2021] provides the adjustment factor that determines the 2021 ACA cost-sharing limits -- or out-of-pocket (OOP) maximums -- and employer shared-responsibility (ESR) assessments. The notice also clarifies the treatment of drug manufacturer coupons when tracking the ACA's OOP maximums and addresses health reimbursement arrangements (HRAs). Other changes to how insurers calculate medical loss ratios (MLRs) and how states report on essential health benefits (EHBs) could have some indirect effects on employer-sponsored plans."

Mercer

[Guidance Overview]

DOL and IRS Extend Certain Deadlines for Welfare Plans and Participants

"The deadline for employers to notify the plan of a qualifying event remains unchanged.... For group health plans, participant contributions must be submitted no later than 90 days from the date on which participant contributions are received by the employer or the date on which such amounts would otherwise be payable to the employee in cash.... The final regulations provide that plans do not have to send a COBRA Election Notice during the Outbreak Period."

The Wagner Law Group

Cases Highlight Importance of Governing Law Clauses in ERISA Plan Documents

"The U.S. Court of Appeals for the Tenth Circuit recently held that the choice of law provision contained in a long-term disability insurance policy (the 'LTD Policy') controlled when determining which state law applied to the case.... [T]he U.S. District Court for the Southern District of Florida dismissed Apex Technology's claims against the flexible benefits plan or Oracle (the employer). This district court previously found that the forum selection clause in Oracle's plan document was enforceable ... The court held that dismissal was the proper mechanism for enforcing the forum selection clause and thus, Apex was required to refile its claims in the proper forum." [Ellis v. Liberty Life Assurance Co. of Boston, No. 19-1074 (10th Cir. May 13, 2020); Apex Toxicology, LLC v. United Healthcare Services, No. 17-61840 (S.D. Fla. May 13, 2020)]

Haynes and Boone, LLP

Workers Report More Stress, Greater Appreciation for Benefits

"In 2010, 59% of employees said that because of the benefits they receive at work, they worry less about unexpected health and financial issues. This has increased to 68% in April 2020. In 2010, 50% of employees said that they are interested in a wider array of non-medical benefits they can choose to purchase and pay for. This increased to 56% in April 2020."

InsuranceNewsNet.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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