Health & Welfare Plans Newsletter

July 20, 2020

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View COVID-19 News and Resources

[Official Guidance]

Text of Additional DOL FFCRA Questions and Answers: New Q&As 94-97

Updated on July 20, 2020 to add these Q&As:

  1. My employee used two weeks of paid sick leave under the FFCRA to care for his parent who was advised by a health care provider to self-quarantine because of symptoms of COVID-19. I am concerned about his returning to work too soon and potentially exposing my other staff to COVID-19. May I require him to telework or take leave until he has tested negative for COVID-19?
  2. I was working full time for my employer and used two weeks (80 hours) of paid sick leave under the FFCRA before I was furloughed. My employer said I could go back to work next week. Can I use paid sick leave under the FFCRA again after I go back to work?
  3. I have an employee who used four weeks of expanded family and medical leave before she was furloughed. Now I am re-opening my business. When my employee comes back to work, if she still needs to care for her child because her child care provider is unavailable for COVID-related reasons, how much expanded family and medical leave does she have available?
  4. My business was closed due to my state's COVID-19 quarantine order. I furloughed all my employees. The quarantine order was lifted and I am returning employees to work. Can I extend my former employee's furlough because he would need to take FFCRA leave to care for his child if he is called back to work?

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

[Official Guidance]

Text of CMS Summary Report on Permanent Risk Adjustment Transfers for the 2019 Benefit Year (PDF)

38 pages. "A total of 561 issuers participated in the risk adjustment program for the 2019 benefit year, of which 554 received a risk adjustment state transfer ... and 7 received a default risk adjustment charge, in at least one risk pool.... Nationwide, the absolute value of risk adjustment state transfers across all state market risk pools ... was about 7 percent of total premiums, very similar to the 2018 benefit year transfers[.]'

  • Appendix A  -- HHS Risk Adjustment Program State-Specific Data (XLSX)
  • Appendix B -- HHS Risk Adjustment Geographic Cost Factor (XLSX)
  • Appendix C -- Issuer-Specific Information for Non-Merged Market Issuers (XLSX)
  • Appendix D -- Issuer-Specific Information for Merged Market Issuers (XLSX)
  • Appendix E -- Default Risk Adjustment Charge (XLSX)
  • Appendix F -- Default Risk Adjustment Charge Allocation (XLSX)

Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

Editor's Pick The HSA Proportional Contribution Limit

"The standard rule is that employees who are HSA-eligible for only a portion of the calendar year have a reduced HSA contribution limit.... [A] special rule known as the 'last-month rule' may apply to permit the mid-year enrollee to contribute up to the full statutory limit -- even though the employee was not HSA-eligible for the full calendar year."

ABD Insurance & Financial Services

[Guidance Overview]

DOL Publishes New FMLA Forms, Signals More to Come with Expansive Request for Information on FMLA

"It may be easier and faster to complete the new forms. Also, the revisions are likely to curb inconsistent or incomplete responses from medical providers. However, it is unclear how the potential lack of medical information will impact the administration of the leave itself, particularly in cases involving intermittent leave or multiple serious health conditions."

Jackson Lewis P.C.

[Guidance Overview]

Text of DOL FFCRA Fact Sheet: Employer Paid Leave Requirements

Topics covered: [1] Covered employers; [2] Qualifying reasons for leave; [3] Duration of leave; [4] Calculation of pay; [5] Tax credits; [6] Employer notice; [7] Prohibitions; [8] Penalties and enforcement."

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

[Guidance Overview]

Text of DOL FFCRA Fact Sheet: Employee Paid Leave Rights

Topics covered: [1] Covered employer; [2] Eligible employees; [3] Notice; [4] Qualifying reasons for leave; [5] Duration of leave; [6] Calculation of pay.

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

[Guidance Overview]

Employers, Not Health Plans, Are Responsible for Some COVID-19 Testing Costs

"Under the clarified guidance in the June FAQ, employers, not health plans, would be responsible for the cost of testing done primarily for returning employees to work safely. State and local governments would be responsible for the cost of testing conducted for public health purposes. This could include testing conducted by state and local governments in order to restart in-person learning this fall."

PwC

[Guidance Overview]

DOL Issues New, Optional FMLA Forms

"[T]he new models forms include changes that will result in less confusion and elicit clearer information from health care providers ... Because the DOL has clarified that the old model forms remain acceptable, employers are not required to use the new forms. If they chose to use the new forms, they can begin doing so immediately or transition to them over time."

Miller Johnson

[Guidance Overview]

Mandatory Paid Sick Leave Becomes Permanent in Colorado (PDF)

"The [Healthy Families and Workplaces Act (HFWA)] mandates a paid sick leave benefit for employees working in Colorado and establishes an enhanced sick leave benefit in the time of a public health emergency.... The public health emergency provisions take effect immediately and apply to the current COVID-19 public health emergency through December 31, 2020."

Sherman & Howard

Administration Eases Rules to Give Laid-Off Workers More Time to Sign Up for COBRA

"[G]iving people more time to sign up for COBRA leaves the door open for hospitals or other providers to offer to pay sick patients' back premiums in order to increase their own payment above what they'd receive if someone were on Medicaid or uninsured. Doing so could be a boon for some patients but raise health care costs for employers[.]"

Kaiser Health News

Most Popular Items in the Previous Issue

Overview of COVID-19 Law and Guidance for Health and Welfare Plans
Hall Benefits Law, via Society for Human Resource Management [SHRM]; membership may be required to view article

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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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