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View COVID-19 News and Resources

[Guidance Overview]

HIV PrEP Drug Coverage Now Required with No Cost-Sharing

"[I]n the summer of 2019, the United States Preventive Services Task Force (USPSTF) recommended that health plans cover pre-exposure prophylaxis (PrEP) for persons who are at high risk of HIV acquisition. Under the [ACA], USPSTF recommendations must be covered by non-grandfathered health plans with no cost-sharing for covered persons for plan years beginning after June 19, 2020. This requirement means that most employer-sponsored health plans must soon provide the specialty PrEP HIV drugs at no cost to participants for all participants at risk for HIV exposure."


[Guidance Overview]

PCORI Fees Are Back! Payment Due July 31

"Plan sponsors of applicable self-funded health plans must make PCORI fee payment by July 31, 2020.... [Notice 2020-44] sets forth the PCORI amount imposed on insured and self-funded health plans for policy and plan years that end on or after October 1, 2019 and before October 1, 2020. The Notice also provides transition relief for calculating the applicable fee for this same period."

Fraser Trebilcock

[Guidance Overview]

DOL Clarifies COVID-19 Testing Coverage Requirements under FFCRA and CARES Act

"The new FAQs clarify that all in vitro diagnostic tests for COVID-19 that have received an emergency use authorization (EUA) under section 564 of the Federal Food, Drug, and Cosmetic Act must be covered and directs employer plan sponsors to a complete list of such tests on the EUA page of FDA website.... COVID-19 testing for surveillance or employment purposes is not required to be covered under the FFCRA.... The new FAQs clarify that there is no numerical limit on the number of tests a plan must cover relating to a specific individual."


[Guidance Overview]

IRS Proposed Rules Address TCJA's Elimination of Deduction for Qualified Transportation Fringe Benefit Expenses

"[T]he proposed regulations address: [1] The TCJA's disallowance of a deduction for the expenses of providing or reimbursing an employee for travel between the employee's residence and place of employment, subject to an exception relating to ensuring employees' safety. [2] Applicability of certain exceptions under Code Section 274(e) that may allow these expenses to be deductible. The regulations expand on IRS interim guidance from December 2018 that addressed how employers could determine nondeductible amounts for parking expenses[.]"

Thomson Reuters Practical Law

[Guidance Overview]

Proposed Updates to DOL's MHPAEA Self-Compliance Tool Would Address Disclosures and Internal Compliance Process

"The proposed updates to the DOL's self-compliance tool: [1] Incorporate final FAQ guidance issued by the DOL in 2019. [2] Address implementation of internal plan procedures to promote MHPAEA compliance. [3] Include additional examples and warning signs of noncompliance."

Thomson Reuters Practical Law

District Court Opinion Upholding HHS Requirements for Hospital Price Transparency (PDF)

43 pages. "Where, as here, the goal of the statute is '[b]ringing down the cost of health care coverage,' it is reasonable for the agency to have construed the statute to require the publication of charges that would impact the largest group of patients.... The agency's Rule is exacting, but the demands flow from ... the congressional determination about the role of price transparency in bringing down health care costs and the reality of hospital billing.... By acknowledging conflicting data and articulating which information it found most convincing, the agency fulfilled its duty to examine the evidence before it and connect it to the Final Rule." [The American Hospital Association v. Azar, No. 19-3619 (D.D.C. Jun. 23, 2020)]

United States District Court for the District of Columbia

House Committee Chairs Unveil Bill to Make Health Care and Prescription Drugs More Affordable

"The Patient Protection and Affordable Care Enhancement Act makes health care more affordable by lowering health insurance premiums with strengthened and expanded affordability assistance. Specifically, the legislation expands eligibility for premium tax credits beyond 400 percent of the federal poverty line and increases the size of tax credits for all income brackets. The legislation creates a national reinsurance program to help cover the costs of consumers with expensive medical conditions, which helps lower premiums, and provides funds to states to help lower deductibles and out-of-pocket costs for everyone. It also offers funding to states to establish their own State-Based Marketplaces, which oftentimes have lower premiums. The legislation also makes prescription drugs more affordable by empowering Medicare to negotiate lower drug prices and making those prices available to Americans with private health insurance." [Also available:  A one-page summary and a section-by-section.]

Energy & Commerce Committee, U.S. House of Representatives

New York State Reduces Amount of Required Paid Voting Leave

"The State has again revised its Election Law in the FY 2020-21 budget, returning to its pre-2019 requirement of two hours of paid leave. The New York State Board of Elections has also published a Voting Leave Rights FAQs in conjunction with the 2020 amendments."

Davis Wright Tremaine LLP

Press Releases

Most Popular Items in the Previous Issue

Text of Agency ACA Implementation FAQS, Part 43: FFCRA and CARES Act (PDF)
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]; U.S. Department of Health and Human Services [HHS]; and U.S. Department of the Treasury, Inc.
1298 Minnesota Avenue, Suite H
Winter Park, Florida 32789
(407) 644-4146

Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager

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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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