Health & Welfare Plans Newsletter

July 13, 2020

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View COVID-19 News and Resources

[Guidance Overview]

DOL Launches Public Service Campaign to Promote Workers' Rights to Paid Sick Leave, Safe Workplaces and Lawful Pay

"WHD's campaign uses public service announcements in English and Spanish to provide employers and employees information about the new paid sick leave and expanded family and medical leave benefits available under the [FFCRA]. The campaign will also feature short educational videos, digital guides, stakeholder outreach, and social media to educate workers about their rights and encourage them to contact WHD with their workplace concerns. Announcements will run on local radio and television stations and on popular social media platforms."

Wage and Hour Division [WHD], U.S. Department of Labor [DOL]

[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

[Guidance Overview]

IRS Temporarily Expands Mid-Year Election Change Opportunities for Cafeteria Plans

"Notice 2020-29 provides increased flexibility for participants to make mid-year health plan, health flexible spending account (Health FSA), and dependent care flexible spending account (Dependent Care FSA) election changes. Notice 2020-33 increases the carryover limit permitted for Health FSAs. This guidance is permissive, so employers are not required to make these plan changes."

Trucker Huss

[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

[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

[Guidance Overview]

Group Health Plan Sponsors Receive Welcome Guidance on COVID-19 Testing Coverage Provisions

"The June 23 guidance in FAQs Part 43 ... provides specific clarifications on testing coverage and provider payments, summary of benefits coverage (SBC) notifications, temporary telehealth relief provisions, and various other compliance matters of significance to group health plans."

Fisher Phillips

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

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

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

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

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

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

Benefits in General

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

Press Releases

Most Popular Items in the Previous Issue

Text of Agency Proposed Regs: Grandfathered Group Health Plans and Grandfathered Group Health Insurance Coverage
Employee Benefits Security Administration [EBSA]; U.S. Department of Labor [DOL] Internal Revenue Service [IRS]; Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

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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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