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Health & Welfare Plans Newsletter August 18, 2020 |
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Newly Posted Professionalism for Healthcare Actuaries: More of "What Not To Do"
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Discussions |
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This Newsletter:
BenefitsLink Retirement Plans Newsletter:
Message Boards Digest:
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[Guidance Overview]
"The DOL made extensive changes to the notice of eligibility and rights and responsibilities ... The most notable change to the designation form might be the DOL's effort to outline the steps that an employee should take to amend an incomplete or insufficient certification ... The revised health care provider certification for an employee's own serious health condition or a family member's condition now requires the health care provider to provide a 'best estimate' of the employee's or family member's future treatment." Society for Human Resource Management [SHRM]; membership may be required to view article |
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[Guidance Overview]
"Under the Washington COVID-19 Food Production Workers Paid Leave Program, no food production employer in Washington may operate from August 18, 2020, to November 13, 2020, unless the employer provides its workers with paid leave for certain qualifying events.... Proclamation 20-67 applies to food production employers that operate orchards, fields, dairies, fruit- and vegetable-packing warehouses, meat and seafood processors and packers, certain farm labor contractors, and other specified industries." Jackson Lewis P.C. |
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[Guidance Overview]
"There are potentially four situations where the notice must be provided.... [1] annually prior to the Part D annual enrollment period beginning October 15th.... [2] prior to an individual's enrollment in the employer's plan. Therefore, it should also be sent to new hires.... [3] if the employer's prescription drug benefit ever changes from 'Creditable' to 'Non-Creditable' (or the other way around), an updated notice must be provided as soon as possible, but no later than 30 days from the change.... [and] [4] on request. [It can] be sent electronically ... if the employer meets the ERISA rules for electronic delivery." HUB International |
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"A federal judge in New York temporarily blocked a regulation that would have removed certain health care protections for transgender individuals. The regulation was scheduled to take effect on Aug. 18.... Judge Frederic Block ... [said] that the administration should consider the impact of a recent U.S. Supreme Court decision holding that sexual orientation and gender identity are protected under Title VII of the Civil Rights Act of 1964." [Asapansa-Johnson v. Azar, No. 20-2834 (E.D.N.Y. Aug. 17, 2020)] Society for Human Resource Management [SHRM]; membership may be required to view article |
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"[1] Have you issued a summary of material modifications (SMM) for any changes you've made to your plan for COVID-19 testing/ treatment and for telemedicine? ... [2] Have you talked to your vendors about the extensions the agencies created between March 1, 2020, and the end of the pandemic period (as yet unknown) for COBRA, special enrollment and claims periods? ... [3] Have you reviewed your COBRA notices for accuracy/conformance to the COBRA regulations in light of increased litigation in this area?" Faegre Drinker |
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"While in theory, external reviews protect patients against arbitrary claim denials, in practice, there is growing reason to suspect that the independent review organizations have become the victim of regulatory capture." DeBofsky Sherman Casciari Reynolds P.C. |
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"Many employees who have HSAs don't understand how they work or how contributions can grow.... A key point of confusion: the difference between a Health Savings Account and a Flexible Savings Account (FSA).... Another thing that confounds some about HSAs: how to use them as investment accounts for retirement.... The CARES Act broadened HSA reimbursements in a number of ways, and 13% of HSA participants surveyed by Charles Schwab said they've used the accounts for coronavirus-related expenses." Forbes |
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"The Federal Circuit agreed with the lower courts that Section 1402 imposes an 'unambiguous obligation' on the government to make CSR payments to insurers and that this obligation is enforceable for damages in court. However, the panel differed with the lower courts on damages and limited the amount of unpaid CSRs that insurers can recover based on premium loading." [Sanford Health Plan v. U.S., Nos. 2019-1290 and 19-1302 (Fed. Cir. Aug. 14, 2020); Community Health Choice v. U.S., No. 19-1633 (Fed. Cir. Aug. 14, 2020)] Health Affairs Blog |
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[Opinion]
"In this post, [the authors] explain how gaps in eligibility for federal assistance programs, perceptions of affordability, and administrative complexity create barriers that prevent millions of Americans from obtaining affordable coverage. To address these issues, we propose three interventions that merit bipartisan support." American Enterprise Institute |
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Benefits in General |
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"[T]he COVID-19 pandemic is changing how both employees and employers feel about benefits.... 73% of employees now say they value the insurance benefits their company offers them, down from 80% three months earlier.... 55% of employees say they trust their company is making the best decisions about the benefits available, compared to 61% in wave one of the study. When asked to rate their organization's overall benefits package compared with what other employers are offering in their marketplace, only 44% rate their benefits as above average compared to 56% in wave one." The Hartford |
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Press Releases |
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Empower Retirement Closes Acquisition of Personal Capital
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Most Popular Items in the Previous Issue |
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COVID-19 Benefit Changes: Action Required for Employer Health Insurance Plans
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Changing Health Plan Elections under Section 125 Plans Based on Spouse's Different Plan Year
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David Rhett Baker, J.D., Editor and Publisher
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