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"If employers are changing COBRA vendors as part of their renewal, the new vendor MUST receive the historical election, enrollment and payment data all the way back to at least the beginning of [2020] There may be potential COBRA beneficiaries who are still able to elect and pay for COBRA due to the [COVID-19 outbreak period (OP)], so new vendors need to know about them.... Employers who are changing medical carriers as part of their renewals need to make sure the old carriers are equipped to accept retroactive enrollments related to the OP while coverage with that carrier was in force. Likewise, they'll need to make sure new medical carriers are equipped to accept delayed enrollments related to the OP."
HUB International
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"Virtual enrollment has been trending for several years, and the COVID-19 pandemic is helping to solidify its prominence. A virtual enrollment process typically includes an online enrollment platform for selecting benefits, remote meetings between employees and HR, and downloadable benefits resources.... Preparation will be the key factor for a successful open enrollment this year.... Employers should review [listed] strategies and consider how similar initiatives might improve their own open enrollment efforts."
Chelko Center for Benefits Management
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"The decline in elective procedures has paid off for ... organizations that self-insure ... Post-pandemic, many employers ... are going to follow the example of their self-insured brethren -- and opt out of the traditional insurance market, too.... Employers that self-insure can identify the care that delivers the most value for their employees because they have control of their medical claims data. That data can offer insights into what's driving health costs."
Keith Lemer, in International Business Times
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"Four ERISA plan participants, who participated in four different ERISA plans, commenced an ERISA class action against four of the nation's largest pharmacy benefit managers (PBMs), alleging that the PBMs breached their fiduciary duties by failing to ensure that the plaintiffs and other plan participants received the benefit of discounts that the PBMs had negotiated with ... a company that markets and sells EpiPens.... [A] federal judge in Minnesota recently denied their motion for class certification of four nationwide classes -- one class for each PBM.... The court determined that it would need to examine the terms of each plan to determine [1] whether each PBM was a fiduciary, [2] if a PBM was a fiduciary, whether the PBM breached its fiduciary duty, and [3] how to measure any losses." [In re: EpiPen ERISA Litig., No. 17-1884 (D. Minn. Aug. 5, 2020).]
Proskauer
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"The court allocated 40 minutes to each side, up from the usual 30 minutes per side. The justices also granted requests from the House and the Trump administration to participate in the argument. On the side defending the health law, a group of blue states -- led by California -- will have 30 minutes of argument time, and the House will have 10 minutes. On the side challenging the law, a group of red states -- led by Texas -- will have 20 minutes, and the U.S. solicitor general will have an additional 20 minutes." [California v. Texas, No. 19-840; Texas v. California, No. 19-1019 (cert. pet. granted Mar. 2, 2020)]
SCOTUSblog
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Benefits in General
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[Official Guidance]
"The IRS is offering this relief to any area designated by [FEMA] as qualifying for individual assistance. Currently this includes Linn County in Iowa, but taxpayers in localities added later to the disaster area will automatically receive the same filing and payment relief.... The tax relief postpones various tax filing and payment deadlines that occurred starting on Aug. 10, 2020.... [A]ffected individuals and businesses will have until Dec. 15, 2020, to file returns and pay any taxes that were originally due during this period."
Internal Revenue Service [IRS]
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[Official Guidance]
"The IRS is offering this relief to any area designated by [FEMA] as qualifying for individual assistance. Currently this includes Lake, Monterey, Napa, San Mateo, Santa Cruz, Solano, Sonoma and Yolo counties in California, but taxpayers in localities added later to the disaster area will automatically receive the same filing and payment relief.... The tax relief postpones various tax filing and payment deadlines that occurred starting on Aug.14, 2020.... [A]ffected individuals and businesses will have until Dec. 15, 2020, to file returns and pay any taxes that were originally due during this period."
Internal Revenue Service [IRS]
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"Having succeeded on his administrative claim, the participant sued the claims administrator under ERISA Section 502(a)(3) alleging that it breached ERISA's fiduciary duties of prudence and loyalty ... [T]he participant sought an order surcharging the claims administrator for ... the ERISA attorney's fees he incurred to internally appeal the administrator's decision.... [T]he Ninth Circuit held that ERISA Section 502(a)(3) does not authorize attorney's fees incurred by a participant in an administrative appeal of the ERISA claims process." [Castillo v. Metropolitan Life Ins. Co., No. 19-56093 (9th Cir. Aug. 17, 2020)]
Thomson Reuters Practical Law
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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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