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Health & Welfare Plans Newsletter July 8, 2020 |
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Newly Posted Telehealth Regulation Post-Pandemic: Returning to Stricter Requirements
New IRS Rules for Section 125 Cafeteria Plans: Key Plan Amendments, Timing of Elections, Claims, HDHP Relief
Ethics - It's Never the Wrong Time to Do the Right Thing
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This Newsletter:
BenefitsLink Retirement Plans Newsletter:
Message Boards Digest:
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[Guidance Overview] COBRA and Costly Consequences of Non-Compliant Notices "There are many ways an employer's COBRA notices may be deficient ... [such as] using confusing verbiage that the average employee may not understand, failing to explain the COBRA enrollment process, failing to describe consequences of delayed enrollment or payment, omitting the mandatory 'explanatory information' regarding coverage, and not including the contact information for the administrator of benefits. The last 10 years have seen numerous cases filed surrounding COBRA notice obligations." Akerman |
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"The Departments had the authority under the ACA to promulgate the religious and moral exemptions.... As legal authority for both exemptions, the Departments invoke Section 300gg-13(a)(4), which states that group health plans must provide women with 'preventive care and screenings ... as provided for in comprehensive guidelines supported by [HRSA].' The pivotal phrase, 'as provided for,' grants sweeping authority to HRSA to define the preventive care that applicable health plans must cover. That same grant of authority empowers it to identify and create exemptions from its own Guidelines.... Because the ACA provided a basis for both exemptions, the Court need not decide whether RFRA independently compelled the Departments' solution. However, the argument that the Departments could not consider RFRA at all is without merit.... The rules promulgating the exemptions are free from procedural defects." [Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania, No. 19-431 (S. Ct. Jul. 8, 2020)] Supreme Court of the United States |
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Supreme Court Allows Employers to Opt Out of ACA's Mandate on Birth Control Coverage "The Supreme Court Wednesday settled -- at least for now -- a decade's worth of litigation over the women's health provisions of the [ACA], ruling 7-2 that employers with a 'religious or moral objection' to providing contraceptive coverage to their employees may opt out without penalty. The Trump administration was within its rights to exempt religious nonprofit agencies, like the lead plaintiff in the case -- the Catholic order Little Sisters of the Poor -- from having to participate in any way from facilitating contraceptive coverage for their employees. Wrote Justice Clarence Thomas in the majority opinion, 'We hold today that the Departments had the statutory authority to craft that exemption, as well as the contemporaneously issued moral exemption.' " [Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania, No. 19-431 (S. Ct. Jul. 8, 2020)] Kaiser Health News |
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Virtual Benefit Fairs Draw Interest for Fall Open Enrollment "For the fall 2020 open enrollment period, during which employees will select their benefits for 2021, more employers are expected to go virtual, taking benefit fairs online. Virtual fairs give more people access to helpful information, especially with much of the staff likely to still be working from home -- and for those at the worksite practicing social distancing[.]" Society for Human Resource Management [SHRM]; membership may be required to view article |
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Dos and Don'ts for Your Gen Z Communication Strategy "[1] Do ensure your Gen Z communication strategy represents diversity.... [2] Don't assume Gen Zers need the same communications as older employees.... [3] Do tie your company's benefits to financial independence.... [4] Don't leverage fear in your benefits communications.... [5] Do use video in your Gen Z communication strategy.... [6] Don't rely on technological communications alone." Tango Health |
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Use the Telemed Safe Harbor While it Lasts "Since the outset of the pandemic, we've seen increased utilization of telehealth services and, importantly, an increase in first-time users -- and not just for COVID-19 related items. There's been a huge shift among providers as well, as many were thrust into using virtual technology.... Now is the time for employers to take a thoughtful pause to determine how their plan design needs to change to take advantage of this new environment." Mercer |
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Section 1557 and the Supreme Court Decision: Implications for Employer-Sponsored Group Health Plans "Employers offering employee benefit health programs that were subject to the 2016 final rule can roll back some of their notice obligations. Covered entities should review and identify desired changes to grievance procedures. Communications regarding health and welfare benefits can be revised to remove the nondiscrimination notices and foreign language assistance taglines. Applicable group health plans must provide healthcare and coverage to all individuals regardless of race, color, national origin, sex, age or disability. Employers can maintain more expansive benefit and nondiscrimination policies and practices than what federal or state law requires.' [Bostock v. Clayton County, Ga., No. 17-1618 (S. Ct. June 15, 2020)] International Foundation of Employee Benefit Plans [IFEBP] |
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The Preliminary Reported Impact of COVID-19 on ACA Premiums "This paper examines the reported impact of COVID-19 on preliminary rate filings among six states and D.C. that have been publicly released as of June 15, 2020.... [H]ealth insurers assumed that COVID-19 would increase premiums by an average of 0% to 4.3% for 2021, depending on the state and market. However, many regulators have already indicated they will allow additional adjustments after the original filings, and health insurers have noted that they will continue to monitor the pandemic and may adjust 2021 premiums as new information becomes available." Milliman |
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"[The authors] examined the impact of the San Francisco Paid Parental Leave Ordinance, the first in the US to provide parental leave with full pay.... [T]he law increased parental leave uptake in San Francisco by 13 percent among fathers, but there was little change in leave among mothers. Data from a survey of mothers suggest that the limited impact may be partly a result of low understanding of benefits." Julia M. Goodman, Holly Elser, and William H. Dow, in Health Affairs |
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Selected Discussions |
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Infertility Services: An Essential Health Benefit? "A client maintains a self-funded group health plan for its employees. There is a proposal to amend the plan to subject reimbursement for infertility services to a lifetime maximum of $25,000 per family for in-network and out-of-network care. Are infertility services considered an essential health benefit which would make the proposed lifetime limit illegal?" BenefitsLink Message Boards |
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"Can someone point me to the statutory authority (or an IRS publication, etc.) which precludes passive enrollment for FSAs? I am trying to determine whether the spousal surcharge would roll over, and want to know more about a tobacco surcharge." BenefitsLink Message Boards |
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Press Releases |
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