[Guidance Overview]
Departments Propose Rule to Help Plans Maintain Grandfathered Status
"[T]he proposed rule would clarify that grandfathered group health coverage that is a high-deductible health plan (HDHP) may increase fixed-amount cost-sharing requirements, such as deductibles, to the extent necessary to maintain [its] status as an HDHP without losing grandfather status.... [T]he proposed rule provides an alternative method of measuring permitted increases in fixed-amount cost sharing that would allow plans and issuers to better account for changes in the costs of health coverage over time."
EPIC
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[Guidance Overview]
FAQ on Extended Period for Flexible Spending Accounts
"[IRS Notice 2020-29] does not answer all the necessary questions surrounding these changes. The biggest challenge with the extension is where the employee moved from a non-HDHP to an HDHP during open enrollment, had a [general purpose health FSA (GPHFSA)] account balance as of the end of the 2019-2020 run-out period, and has participated in an HSA in the new plan year."
TRI-AD
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[Guidance Overview]
Group Health Plans Must Cover Some -- Not All -- COVID-19 Testing
"[Part 43 of the ACA FAQs] confirms private health insurance plans (must cover COVID-19 testing and related services used for diagnostic purposes without cost-sharing, but excludes non-diagnostic (surveillance) testing.... from its scope.... [T]his means that plans may deny coverage for testing conducted solely as a return to work mandate or for other non-diagnostic purposes."
Davis Wright Tremaine LLP
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Supremes Look at Little Sisters Again, Uphold ACA Birth Control Exception
"Justice Thomas wrote the majority opinion and held that the ACA granted broad discretion to the Health Resources and Services Administration (HRSA) when it states that health plans must provide women with 'preventive care and screenings ... as provided for in comprehensive guidelines supported by HRSA.' The discretion to define what must be covered also provides the discretion to identify and create exemptions. Thomas then made quick work of the alleged procedural defects finding there was no prejudicial error or requirement of 'open mindedness' in the APA." [Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania, No. 19-431 (S. Ct. Jul. 8, 2020)]
Murphy Austin
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Direct Primary Care Gains Ground as Employer Strategy
"The higher deductibles go, the more attractive [direct primary care (DPC)] will become.... One drawback of the DPC arrangement for employers is that they don't receive medical claims or other data on their members' encounters with DPC providers. This limits reporting to support quality metrics which is the opposite direction of making quality data more readily available so consumers can make informed decisions on where to seek care."
Mercer
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Mental Health and Substance Use State Fact Sheets
"[T]his national summary and ... accompanying fact sheets [examines] national and state-level data on mental health both before and during the coronavirus pandemic.... [M]ental health outcomes, access, and coverage vary substantially from state to state.... [T]he accompanying state reports ... present detailed state-level data for all fifty states and the District of Columbia."
Henry J. Kaiser Family Foundation
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Walgreens Strikes Deal to Open Doctor Offices in Stores
"Walgreens and VillageMD have struck a deal to open doctor offices in 500 to 700 drugstores over the next five years. Most of the primary-care clinics will be about 3,300 square feet, about a quarter of the size of Walgreens' average store. More than half will open in areas with a shortage of health professionals and a population that's underserved."
CNBC
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Walmart Quietly Registers Insurance Business in Latest Health-Care Move
"Walmart has created 'Walmart Insurance Services LLC' to sell insurance policies ... [T]he company says it's looking to hire insurance agents in the Dallas area to sell supplemental Medicare insurance. The big-box retailer has opened primary-care clinics, made health-care acquisitions and spoken about its broader ambitions."
CNBC
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More Insurers Bundling Health/Dental Coverage
"[T]he percentage of health insurers offering dental insurance products has risen from 68% in 2018 to 80% today, and the percentage offering adult dental benefits has more than doubled to 48%. Of the 20% of health insurers who do not offer dental benefits, 25% are likely to offer them in the future. This is a shift from 2018, when health insurers that didn't offer dental benefits essentially had no plans to add them."
InsuranceNewsNet.com
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Benefits in General
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Getting Severance Right Through ERISA
"Just because an employer's practices are unwritten and informal doesn't mean that they are unenforceable; they can often create a legal obligation. The result could be an ERISA-covered plan without many of the employer protections that a carefully crafted plan can provide....If an employer designs its severance plan to fall within ERISA, it opens the door for defusing future litigation risks through ... well-established mechanisms for expediting and efficiently resolving ERISA disputes."
Eversheds Sutherland, via Bloomberg
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