Health & Welfare Plans Newsletter

June 15, 2020

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View job as Associate Consultant / Retirement Plan Administration Associate Consultant / Retirement Plan Administration  View details

Spectrum Pension Consultants, Inc.
Tacoma WA / Honolulu HI / Fresno CA / Pasadena CA / Las Vegas NV / Mansfield OH / Telecommute

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View COVID-19 News and Resources

[Official Guidance]

Text of CMS Final Regs: Nondiscrimination in Health and Health Education Programs or Activities

338 pages. "This final rule eliminates certain provisions of the 2016 Rule that exceeded the scope of the authority delegated by Congress in Section 1557. The 2016 Rule's definition of discrimination 'on the basis of sex' encompassed discrimination on the basis of gender identity ... [and] imposed several requirements regarding medical treatment and coverage on the basis of gender identity. The same definition also encompassed discrimination on the basis of 'termination of pregnancy' without incorporating the explicit abortion-neutrality language of 20 U.S.C. 1688 in Title IX ... [T]hese provisions have already been vacated and remanded by court order. This final rule omits the vacated language concerning gender identity and termination of pregnancy, thereby bringing the provisions of the Code of Federal Regs into compliance with the underlying statutes and up-to-date as to the effect of the court's order."

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

[Official Guidance]

Text of CMS Memo: 2018 Benefit Year HHS Risk Adjustment Data Validation Results (PDF)

26 pages. "The 2018 benefit year HHS-RADV results will be used to adjust 2019 benefit year risk adjustment plan liability risk scores ... This memo contains an overview of the HHS-RADV error rate methodology, a summary of the 2018 benefit year HHS-RADV results, and information to assist issuers in understanding their results."

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

[Official Guidance]

Text of CMS Memo: Temporary Period of Relaxed Enforcement for Submitting the 2019 MLR Annual Reporting Form and Issuing MLR Rebates in Response to COVID-19 (PDF)

"[CMS] is exercising discretion to adopt temporary policies of relaxed enforcement in connection with [certain] standards under the conditions outlined in this bulletin. CMS is providing this additional flexibility to permit issuers to prepay to enrollees a portion or all of the estimated MLR rebate for the 2019 MLR reporting year ... Additionally, under this temporary policy of relaxed enforcement, CMS is extending the deadline by which it will accept 2019 MLR Annual Reporting Forms."

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

[Guidance Overview]

HHS Fact Sheet: Final ACA Section 1557 Rule (PDF)

"The final rule makes clear that the substantive protections prohibiting discrimination on the basis of race, color, national origin, disability, age, and sex remain in effect. The final rule returns HHS's enforcement of civil rights protections to the mechanisms provided for, and available under, longstanding civil rights statutes and their implementing regulations. The rule complies with applicable court orders that had vacated certain provisions of the previous administration's Section 1557 rule (2016 Rule) as being inconsistent with laws passed by Congress."

Office for Civil Rights [OCR], U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

Editor's Pick HHS Removes Gender Identity, Sex Stereotyping, Language Access Provisions from ACA Anti-Discrimination Rule

"The final rule entirely eliminates: [1] The definitions section of the current rule (thereby eliminating definitions of key terms such as 'covered entity' and 'on the basis of sex'); [2] Specific nondiscrimination protections based on sex, gender identity, and association; [3] Major language access requirements (such as a requirement that covered entities include translated taglines on notices and significant communications to consumers); [4] Notice requirements that require covered entities to post information about Section 1557 and nondiscrimination at its locations and on its website; [5] Requirements to have a compliance coordinator and written grievance procedure to handle complaints about alleged violations of Section; and [6] Various enforcement-related provisions (such as protections against intimidation and retaliation)."

Katie Keith, in Health Affairs

[Guidance Overview]

IRS Issues Guidance on PTO Donations to Charity

"Notice 2020-46 expands [existing] leave donation opportunities by allowing employees to forgo their vacation, sick or personal leave to allow their employer to make cash payments before January 1, 2021, to nonprofit organizations for the relief of victims of the COVID-19 pandemic in the affected geographic areas. Currently, all 50 states and the District of Columbia are affected areas."

Littler

[Guidance Overview]

Editor's Pick Don't Leave Eligible FFCRA Tax Credits on the Table

"Employers can choose to pay employees on qualified leave more than the CARES Act provides, but the Credit cannot exceed those amounts. Employers that choose to pay more should consider whether it is more advantageous to count an employee's pre-tax salary reductions for health benefits as wages or as health plan expenses."

Frost Brown Todd LLC

[Guidance Overview]

Coming July 1: What Chicago Employers Need to Know About the New Paid Sick Leave, Minimum Wage and Fair Workweek Rules

"Employers must now provide individual notice to employees on an annual basis with their first paycheck on or following July 1.... Records regarding paid sick leave usage, rates of pay, hours worked and wage deductions must be kept for at least five years, and made available for inspection upon request by [Chicago's Department of Business Affairs and Consumer Protection (BACP)]."

Thompson Coburn LLP

HIPAA: Mind Your Compliance Gaps (PDF)

"Common but critical gaps in compliance with this law include ... [1] Infrequent risk/threat analysis.... [2] Missing or outdated business associate agreements (BAAs).... [3] Inadequate workforce training.... [4] Outdated privacy and security policies."

benefits magazine, a publication of the International Foundation of Employee Benefit Plans [IFEBP]

Benefits in General

Court Holds Contribution and Indemnity Claims May Be Brought Against ERISA Co-Fiduciaries

"After filing a complaint asserting various ERISA breaches of fiduciary duty, the defendant-plan administrator responded with counterclaims for contribution and indemnification in connection with the plaintiffs' own alleged wrongdoing. The U.S. District Court held that ERISA does not foreclose such claims, but that affirmative defenses for proportional liability and equitable contribution for the portion of loss allegedly caused by the plaintiffs are not permissible.' [Leventhal v. MandMarblestone Group, LLC, No. 18-2727 (E.D. Penn. May 27, 2020)]

Holland & Knight

Benefit Considerations in Uncertain Times

"The initial fallout from the COVID-19 pandemic is putting new urgency on company benefits. As employees look to their benefits offerings, companies are responding in kind by leveraging, expanding, and creating new benefits to answer the needs of their employee populations.... [This article outlines] some of the most impactful new and enhanced additions for employers to consider implementing to support their people -- and how to decide whether to roll out these benefits."

HR Daily Advisor

Reimagining the Four Pillars of Employee Well-Being

"Confronted with statistics like the 34% increase in anti-anxiety prescriptions from mid-February to mid-March, employers are starting to think about new ways to bolster employee well-being in these challenging circumstances and safeguard employee engagement and productivity. While the four pillars of employee well-being haven't changed, they need to be reimagined[.]"

Mercer

Auditing Employee Benefit Plans: COVID-19-Related Subsequent Events

"Benefit plan clients with year-ends after December 2019 will likely have pandemic-related events that may require an adjustment to the financial statements or additional disclosures. Auditors will have to work with clients to ensure any subsequent events have been accurately identified and reflected in the financial statements as required."

International Foundation of Employee Benefit Plans [IFEBP]

Press Releases

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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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