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[Official Guidance]

Text of CMS Technical Fact Sheet: CCIIO Premium Reductions Provisions (PDF)

"[On August 25,] CMS issued a sweeping array of new rules and waivers of federal requirements, including provisions addressing the individual and small group health insurance markets.... [F]or the purposes of 2020 benefit year risk adjustment data submissions, issuers of risk adjustment covered plans that provide temporary premium reductions must report the adjusted plan premiums that reflect actual premiums billed to enrollees for any temporary premium credits provided.... HHS's calculation of risk adjustment payment and charges for the 2020 benefit year under the state payment transfer formula will be calculated using the statewide average premium that includes the lower premiums billed by issuer offering these temporary premium reductions.... [F]or the purposes of MLR reporting and rebates, ... issuers that elect to provide temporary premium reductions must report as earned premium the actual, lower premium billed to enrollees for any temporary premium credits provided for the applicable months of 2020 coverage." [Unnumbered and undated; published on CMS website Aug. 25, 2020] Icon to read more

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

[Guidance Overview]

HHS Addresses HIPAA Rules for Contacting COVID-19 Survivors About Donating Plasma

"[H]ealth plans may use PHI (such as COVID-19 test results) to identify and contact individuals who have recovered from COVID-19 to inform them about how to donate their plasma.... These actions are permitted as health care operations activities to the extent that facilitating the supply of donated convalescent plasma is expected to improve a health plan's or provider's ability to conduct case management for individuals who have or may become infected with COVID-19." Icon to read more

Thomson Reuters Practical Law

Eighth Circuit Upholds Decision to Lay Off Employee Who Was on FMLA Leave

"An employee on leave covered by the [FMLA] is entitled to no more job protection in a reduction in force (RIF) than any other employee ... The court stated that '[u]sing FMLA leave does not give an employee any greater protection against termination for reasons unrelated to the FMLA than was available before.' " [Button v. Dakota, Minnesota & Eastern Railroad Corp., No. 19-1398 (8th Cir. Jun. 30, 2020)] Icon to read more

Society for Human Resource Management [SHRM]; membership may be required to view article

Exceptional Usefulness and Quality iconRemote Control: HIPAA Challenges for a Growing Virtual Workforce

"To mitigate the risk of compromising protected health information with an increased virtual workforce, ... a thorough risk analysis [would include] the threats posed by personal devices, a remote workforce, unsecured electronic transmission, epidemic/pandemic protocols, and computer virus/malicious code. The risk analysis should be performed by a combination of IT, Benefits, and Physical Security personnel, and should document the likelihood and cost impact of these threats and list the mitigating controls in place for each." Icon to read more


Closing the Gap on Preventive Care Could Reduce Lost Productivity for Employers

"Depression represents a disproportionately high productivity cost to employers: averaging $17 per employee per year in disability wage replacement costs compared with $2 for diabetes, the next-highest chronic condition. Screening gaps are less dramatic for cancers but opportunities for improvement in disability leave is still substantial.... Employees who take leave for cancer ... at earlier ages take less time off from work than those who enter the disability system at a later age, suggesting the potential for lower disability leave costs and better health outcomes if cancers are detected earlier on." Icon to read more

Integrated Benefits Institute

Alphabet's Verily Plans to Use Big Data to Help Employers Predict Health Insurance Costs

"Verily, the Alphabet Inc. life sciences unit that's previously targeted mosquito-borne illness and launched COVID-19 testing programs, is getting into the health insurance business.... Verily hopes that by adding its data-crunching and technological prowess to the equation, it can help employers more accurately assess what sort of risks they face and, eventually, intervene to better predict and control health-care spending on individual employees.... But the move could fan growing concerns about who has access to health-care data, and for what purposes." Icon to read more


Health Insurance and the COVID-19 Shock: What We Know So Far About Health Insurance Losses and What It Means for Policy

"In March and April, ... new hiring led to 2.4 million workers gaining ESI coverage each month, but historically large layoffs led to 5.6 million workers losing coverage each month. This rate of lost coverage -- over 3 million workers -- dwarfs a similar calculation for the number of workers losing coverage each month during the biggest job-losing period of the Great Recession ... Since the onset of the COVID-19 shock to the economy, roughly 6.2 million workers have lost access to health insurance that they previously got through their employer, according to the best measure of net employment change." Icon to read more

Economic Policy Institute


Countering Threats to the Small-Business Health Insurance Market

"Although transitional plans will become less relevant as time passes, other forms of noncompliant ACA plans can have a similar impact.... '[A]ssociation health plans' created by trade groups and others to sell insurance that is not compliant with the ACA ... could draw disproportionately healthier subscribers, leading to higher premiums in the regulated small-group market. Fortunately, some states have imposed stricter standards and others are considering doing so, to avoid harm to the existing market." Icon to read more

The Commonwealth Fund

Press Releases

DOL Obtains Default Judgment to Restore $65,842 to Defunct Ohio Company Retirement Plan
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

SS&C Automates Retirement Plan Onboarding
SS&C Technologies Holdings, Inc.

ARA Launches Women in Retirement Council
American Retirement Association [ARA]

Most Popular Items in the Previous Issue

Prepare for an Unprecedented Open Enrollment
Chelko Center for Benefits Management

View COVID-19 News and Resources, Inc.
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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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