Health & Welfare Plans Newsletter

June 16, 2020

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COVID-19: Impact on Benefits & Other Issues
RECORDED
Graydon

Securities Litigation and Employee Benefits Updates
June 24, 2020 WEBCAST
Morgan Lewis

Cost-sharing Reduction Reconciliation Discrepancy Process for Benefit Year 2019 and Benefit Year 2018 Restatements
June 25, 2020 WEBCAST
Centers for Medicare & Medicaid Services [CMS]

Legislative and Regulatory Process with Benefits Legislation
July 9, 2020 WEBCAST
American Bar Association Joint Committee on Employee Benefits [JCEB]

Planning for 2021 Open Enrollment
July 22, 2020 WEBCAST
American Bar Association Joint Committee on Employee Benefits [JCEB]

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View COVID-19 News and Resources

[Guidance Overview]

CMS Scales Back ACA Nondiscrimination Rules

"[T]he Section 1557 regulations will no longer: [1] define sex discrimination to include gender identity and sex stereotyping; [2] require certain health plans and insurers to cover gender reassignment surgery; [3] maintain specific grievance procedures to address complaints of discrimination under section 1557; or [4] require the distribution of nondiscrimination notices and foreign language taglines. The new final rules also narrow the application of the nondiscrimination requirements to apply to health insurers only for programs and activities that receive financial assistance from HHS[.]"

Ballard Spahr LLP

[Guidance Overview]

Regulatory Actions Impacting Health Insurers and Managed Care Companies in Response to COVID-19

"As health insurers and managed care companies work to serve their patient communities during the COVID-19 pandemic, they must also track and adapt to a multitude of new state and federal COVID-19-related regulatory actions impacting their operations.... [This article summarizes] major regulatory actions in each state and [includes] useful resources, guidance and notifications released by state regulators. [It also provides] an overview of federal legislative activity impacting insurers and managed care companies."

Faegre Drinker

[Guidance Overview]

IRS Provides Guidance on Employer Leave-Based Donation Programs That Aid Victims of the COVID-19 Pandemic

"The tax treatment provided by the Notice is essentially identical to prior IRS guidance regarding leave-based donations made regarding Hurricane Harvey and Tropical Storm Harvey, Hurricane Irma and Tropical Storm Irma, and the Ebola Virus."

Jackson Lewis P.C.

[Guidance Overview]

Editor's Pick How COBRA and Medicare Interact for Retirees

"There are four primary issues for Medicare-eligible employees to consider upon deciding if and when to elect COBRA after terminating employment.... [1] Medicare will pay primary ... [2] The eight-month Medicare Special Enrollment Period is not extended by COBRA enrollment ... [3] COBRA does not qualify to avoid Part B late enrollment penalties ... [4] Early termination of COBRA upon enrollment in Medicare."

ABD Insurance & Financial Services

[Guidance Overview]

Editor's Pick Potential COVID-19 Impacts on Health FSAs and Recent Health FSA Changes

"Health flexible spending arrangements (FSAs) are an optional benefit employers may offer that allow their employees to set aside money, on a tax-advantaged basis, to pay for certain out-of-pocket medical expenses. The rules of such arrangements may affect an individual's ability to use or modify their FSA in light of the [COVID-19] pandemic and corresponding recession. This [article] provides a brief overview of health FSAs and some potential ways that the COVID-19 pandemic may affect individuals with such arrangements. It concludes with a description of recent COVID-19-related executive branch and congressional activity around health FSAs." [IF11576, Jun. 15, 2020]

Congressional Research Service [CRS]

New Health Plan Calculations for Revised SBC Template

"Late last fall, ... HHS released new data that must be used to calculate the coverage examples page of the SBC. These changes apply to plan years beginning on or after January 1, 2021.... [T]he new data means that plan sponsors will have to redo the coverage examples portion of every SBC, even if the plan's cost-sharing requirements have not changed."

Segal

The SIHRA Health Plan Option for Larger Self-Insured Plans

"The Spousal Incentive Health Reimbursement Account (SIHRA) is an effective tool that self-insured health plans for larger groups can use to hedge their risks and improve their cash positions -- while keeping their plans and people whole.... [T]he SIHRA option gives financial incentives to the working spouses to enroll in their own employers' group health plans. Likewise, employees (and children) currently enrolled are also eligible to elect the SIHRA option and enroll in their spouse's employer's health plans."

HUB International

Impact on Employee Benefit Plans of Supreme Court Ruling on LGBTQ Bias (PDF)

11 pages. "While [this] ruling is about wrongful employment termination, the decision has implications for employer-sponsored health plans and other benefits. For example, employers may want to adjust group health plan coverage of gender dysphoria and related services, including gender-affirmation surgeries; review and compare benefits for same-sex and opposite-sex spouses; and review the need for gender assignment as an identifier in benefit plan administration." [Bostock v. Clayton County, Ga., No. 17-1618 (S. Ct. June 15, 2020)]

Mercer

Transforming Pharmacy Benefits: The Role of Biosimilars in Driving Down Costs (PDF)

"If employers are serious about driving down costs, while ensuring their members have access to therapies that treat complex chronic, life threatening and rare medical conditions, this is the time to act on the use of biosimilars. Here are steps employers can take now[.]"

Midwest Business Group on Health [MBGH]

[Opinion]

U.S. Health Care Is in Flux -- Here's What Employers Should Do

"[Employers] should not seek a short-term fix by raising copayments, deductibles, and other out-of-pocket costs for next year. While this strategy may initially reduce spending on health care, studies show that it will disincentivize employees to seek preventative treatment.... Here are three strategies that can help employers weather the inevitable ups and downs of 2021 and beyond and improve employee health: [1] Manage health care benefits like all other purchases.... [2] Leverage technology.... [3] Partner with hospitals and physicians."

Harvard Business Review, via WellNet

Press Releases

Working Women Bear Emotional Brunt of COVID-19
National Alliance of Healthcare Purchaser Coalitions

Most Popular Items in the Previous Issue

HHS Fact Sheet: Final ACA Section 1557 Rule (PDF)
Office for Civil Rights [OCR], U.S. Department of Health and Human Services [HHS]

Text of CMS Final Regs: Nondiscrimination in Health and Health Education Programs or Activities
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

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David Rhett Baker, J.D., Editor and Publisher  davebaker@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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