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View COVID-19 News and Resources

[Official Guidance]

Text of CMS Instructions for MLR Annual Reporting Form for 2019 (PDF)

55 pages. "These are the filing instructions for the report to the Secretary required by section 2718 of the Public Health Service Act (PHSA), which includes elements that make up the medical loss ratio (MLR) and the calculation and provision of rebates to enrollees. The data included in the MLR Annual Reporting Form are the exact data that will be used to calculate an issuer's MLR and rebates, if any, under section 2718 of the PHSA and the implementing regulation ... [These] Instructions only apply to the 2019 MLR reporting year and its reporting requirements." [Also available: MLR 2019 Annual Reporting Form (XLSX) and MLR 2019 Calculator and Formula Tool (XLSM)]

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

[Guidance Overview]

DOL Offers Additional COVID-19 Guidance Under the FMLA

"Updated COVID-19 guidance from the DOL's Wage and Hour Division addresses qualifying for -- and returning to work from -- FMLA leave. New Q&As focus on telemedicine and testing issues employers may have to navigate when evaluating requests for leave and bringing employees back into the workplace."


[Guidance Overview]

Massachusetts Clarifies Paid Leave Taxes for Temporary Telecommuters

"Until the earlier of Dec. 31, 2020, or 90 days after the Massachusetts state of emergency ends, the presence of one or more employees temporarily working remotely in Massachusetts won't trigger any state tax consequences.... An individual who previously worked in Massachusetts but is temporarily working from home in another state solely because of COVID-19 continues to be subject to PFML ... Employers that have no presence in Massachusetts but do have employees temporarily working from home there should document the need for the temporary arrangement.... If this remote work continues beyond the end of 2020 (or 90 days after the end of the state of emergency, whichever is sooner), these businesses may need to register with the state and begin collecting PFML contributions."


[Guidance Overview]

Oakland, California Releases Emergency Paid Sick Leave FAQs

"Nearly two and a half months after its emergency paid sick leave (EPSL) ordinance took effect on May 12, 2020, Oakland, California released frequently asked questions (FAQs) about the new law. The FAQs do offer some clarification, but more often merely mirror the ordinance's text, leaving employers with ambiguity on some critical ordinance provisions."


HHS Extends National Public Health Emergency Through October 23

"This public emergency declaration is important to health plan sponsors because it determines the period of time during which group health plans and insurers must pay for COVID-19 tests and related services without charging cost sharing. Other plan requirements, most notably the requirement to extend certain deadlines related to COBRA, special enrollment, and claims and appeals, are pegged to a different COVID-19 emergency declaration ... That emergency declaration does not expire automatically."


Boost Low Employee Engagement with Your Benefits Programs

"One reason for low engagement is employees are overwhelmed with the vast landscape of vendors, programs, websites, phone numbers, and ID numbers.... HR can increase engagement with vendors and programs in a clear and simple way.... [1] Deliver a better open enrollment experience; [2] Recreate and automate the 'just ask HR' experience; [3] Engage employees in new ways; [4] Educate employees via targeted communications."

Tango Health

Some Insurers and Providers Likely to See Continued Impacts from Short-Term Health Plans

"In the midst of a global pandemic and global recession, short-term plans could have a bigger impact than previously expected on health insurers offering ACA-compliant plans through the individual market and on provider revenues.... In a survey of 2,500 consumers ... 18% of respondents said they would be willing to select a health plan that does not pay for care for existing health conditions but that would pay for new health issues that arise."


Benefits in General

[Guidance Overview]

IRS Letter Allows Allocation of Contributions Between HRA and Profit-Sharing Plan

"In a private letter ruling, the IRS has affirmed that employees may allocate employer contributions between a funded [HRA] and a qualified profit-sharing plan without altering the tax effects of either plan. The ruling was requested by a union proposing plan amendments that would give employees an annual advance election to allocate a portion of their employers' contributions ... between the HRA and the profit-sharing plan. In the absence of an employee election, a default uniform fixed contribution would be allocated to the profit-sharing plan and the remainder would go to the HRA."

Thomson Reuters / EBIA

Plans That Have Many Employers/Members in Many States May Have Better Chance Winning Choice of Law Issues

"[M]any states ban discretionary language in ERISA plans. This issue tees up litigation over what state law will apply ... This new case ... provides helpful analysis when litigating choice of law issues ... Choice of law decisions may be more favorable when the employer's plan is part of a trust with a Master Policy covering participating members over many states." [Earle v. Unum Life Ins. Co. of America, No. 19-2903 (C.D. Cal. Jul. 23, 2020)]

Lane Powell PC

How to Communicate Employee Benefits in Uncertain Times

"Develop a plan and use a variety of communication channels ... Determine the right channels to reach the workforce ... Benefits communication Is a year-round opportunity ... Measure, refine, and plan for next year."


For Employees: Understanding and Maximizing Your Employee Benefits

"[It] can be challenging to consider all angles of a benefits package at the early stages of your career, or conversely, difficult to re-assess as life progresses and your needs change.... [This guide can] serve as a summary of the most common benefits provided by employers, with some helpful hints to help you navigate the world of employee benefits as you review your options."

Wealthspire Advisors

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Due Date for 2019 Calendar Year 5500 -- Extension in the Works?

"Is anyone hearing anything as to whether the October 15 extended deadline will be extended to 1/1/2021 due to COVID-19?"

BenefitsLink Message Boards

Press Releases

Most Popular Items in the Previous Issue

Avoiding Surprises in Your Medical Bills: A Guide for Consumers (PDF)
Healthcare Financial Management Association [HFMA]

Addressing Surprise Medical Billing
Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS], 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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