Health & Welfare Plans Newsletter

August 17, 2020

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[Guidance Overview]

Exceptional Usefulness and Quality and Usefulness iconChanging Health Plan Elections under Section 125 Plans Based on Spouse's Different Plan Year

"[Section 125 rules allow] employees to change their health plan election on account of and corresponding with the start of the spouse's new plan year.... This permitted election change event for different health plan years does not permit employees to change their health FSA election.... [T]he employer should still confirm that the carrier (or stop-loss provider for a self-insured plan option) will accept the mid-year spouse enrollment.... [C]afeteria plans are not required to offer this different plan year permitted election change event."

ABD Insurance & Financial Services

[Guidance Overview]

COVID-19 Benefit Changes: Action Required for Employer Health Insurance Plans

"Recently enacted COVID-19 legislation and related federal guidance require some mandatory group health plan benefit changes and offer other voluntary changes you can elect to provide temporary relief to employees.... [S]ome of the changes require that you notify participants via a summary of material modification (SMM) or an updated summary plan description (SPD)."

Milliman's Healthcare Town Hall

High Risk Issue iconFederal Court's Rejection of Some DOL FFCRA Rules May Affect Your Pandemic Leave Policies

"It is unclear whether the district court's decision applies nationwide or is limited to the State of New York -- or indeed only applicable to employers in the Southern District of New York -- as the order is silent as to its reach and the court did not issue an injunction, nationwide or otherwise. The impact on employers outside of New York (or, indeed, outside the Southern District of New York) depends in large part on the DOL's response." [New York v. U.S. Dept. of Labor, No. 20-3020 (S.D.N.Y. Aug. 3, 2020)]

Epstein Becker Green

Connecticut District Court Enforces ERISA Venue Provisions and Dismisses Lawsuit with No Connection to Connecticut

"[T]he plaintiff ... brought suit in Connecticut, alleging venue was proper because he had also sued LINA's indirect parent, Cigna Corporation, which is a Connecticut corporation.... The Court ... addressed whether venue was still proper in the District of Connecticut after Cigna Corporation was dismissed from the case.... The Court dismissed the balance of the case in its entirety[.]" [Cook v. Life Ins. Co. of North America, No. 20-139 (D. Conn. Aug. 4, 2020)]

Robinson & Cole LLP

Michigan Auto Insurance Reform Could Mean Higher Claims Against Health Plans

"Employers that coordinate their health plan's benefits with auto insurance medical coverage -- even plans that pay secondary -- may face greater exposure to Michigan claims than in the past.... [T]he employee and any covered family members may be in a position to opt out of or substantially reduce PIP medical coverage offered by the auto insurer. This could leave the employer-sponsored health plan as the sole source of medical coverage for injuries related to an auto accident in some situations."

Mercer

Exceptional Usefulness and Quality icon2021 Transportation, Health FSA and Archer MSA Limits Projected

"Mercer has projected 2021 limits for qualified transportation (parking and transit) benefits, health flexible spending arrangements (FSAs) and Archer medical savings accounts (MSAs). These unofficial 2021 limits are determined using the Internal Revenue Code's cost-of-living adjustment methods, chained Consumer Price Index for All Urban Consumers (chained CPI) values through July and Mercer's projected chained CPI for August. IRS is expected to announce the official 2021 limits for these benefits in October."

Mercer

Health Insurers in Pennsylvania and New Hampshire May See Lower ACA Individual Plan Premiums

"Pennsylvania and New Hampshire recently received CMS approval of Section 1332 State Innovation Waivers that establish a state-based reinsurance program with funding from CMS.... The reinsurance programs are expected to reduce premiums for 2021 by 16% in New Hampshire and 5% in Pennsylvania."

PwC

State Health Insurance Marketplaces Increasingly Take Over Obamacare Exchanges from Feds

"Pennsylvania is one of six states shifting in the next several years from the federal insurance exchange to run their own online marketplaces ... They will join 12 states and the District of Columbia with self-contained exchanges. The transitions come amid mounting evidence that state marketplaces attract more consumers, especially young adults, and hold down prices better than the federal exchange."

Kaiser Health News

[Opinion]

The Value of Short-Term Health Plans: Rebutting the Energy and Commerce Democratic Staff Report

"Short-term plans represent an important option for millions of Americans harmed by federal policy over the past decade that has resulted in reduced choice of health insurance plans and skyrocketing premiums and deductibles. Eliminating this option would force those enrolled in short-term plans to choose between paying much higher premiums for ACA-compliant coverage and becoming uninsured."

Brian Blase and Doug Badger, Health Affairs Blog; free registration may be required.

Benefits in General

[Opinion]

Uber Issues an Empty Threat to Cease Operations in California

"On Monday, the New York Times ran a quixotic op-ed from Uber CEO Dara Khosrowshahi.... [He] casts the blame for gig workers' sorry lot on our 'outdated' employment system that forces workers to choose between benefits and freedom. Economists and drivers counter that giving Uber drivers the benefits of full-time employees, like health insurance and paid-time off, is vastly preferable to 'flexibility.' "

Salon

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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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