Health & Welfare Plans Newsletter

August 28, 2020

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How to Balance School Re-Openings and New Jersey State and COVID-19 Leave Laws
September 9, 2020 WEBCAST
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2020 Group & Worksite Benefits Conference
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Virtual Benefits Forum - Fall 2020
September 16, 2020 WEBCAST
Southeast Benefits Education Network [SBEN]

2020 Annual Washington Update
October 2, 2020 WEBCAST
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October 15, 2020 WEBCAST
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[Official Guidance]

Text of Additional DOL FFCRA Questions and Answers: New Q&As 98-100

Updated on Aug. 27, 2020 to add these Q&As:

  1. My child's school is operating on an alternate day (or other hybrid-attendance) basis. The school is open each day, but students alternate between days attending school in person and days participating in remote learning. They are permitted to attend school only on their allotted in-person attendance days. May I take paid leave under the FFCRA in these circumstances?
  2. My child's school is giving me a choice between having my child attend in person or participate in a remote learning program for the fall. I signed up for the remote learning alternative because, for example, I worry that my child might contract COVID-19 and bring it home to the family. Since my child will be at home, may I take paid leave under the FFCRA in these circumstance?
  3. My child's school is beginning the school year under a remote learning program out of concern for COVID-19, but has announced it will continue to evaluate local circumstances and make a decision about reopening for in-person attendance later in the school year. May I take paid leave under the FFCRA in these circumstances?
 Icon to read more

Wage and Hour Division [WHD], U.S. Department of Labor [DOL]

[Guidance Overview]

DOL Confirms There Are Limits to FFCRA for Child Care Leave on Certain School Days

"The FAQs generally explain that employees are eligible for FFCRA leave while a child's school is closed; if the school is open for in-person learning but a parent has selected a remote option, leave may not be available, depending on the circumstances." Icon to read more

FMLA Insights

[Guidance Overview]

How Do You Apply FMLA+ Given New School Year Policies?

"[P]arents are faced with new child care concerns due to the continued risk of COVID-19 transmission and varying approaches to that risk by different school districts. In some cases, online study is the only option. In others, in-person attendance may be periodic or may be voluntary.... [A] chart outlines when FMLA+ may apply under different school scenarios[.]" Icon to read more

Lockton

Countdown to the SCOTUS Oral Argument on ERISA Preemption

"[T]he Supreme Court has agreed to hear Arkansas's challenge to a decision by the Court of Appeals for the Eighth Circuit holding that ERISA preempts an Arkansas law regulating prescription drug reimbursement.... [T]he precise location of where the Supreme Court draws the line on preemption will likely cause ripple effects well beyond pharmaceutical benefits.... Two recent case developments underscore Rutledge's importance, both in the pharmaceutical benefits realm and beyond." Icon to read more

Seyfarth

President Trump Orders HHS to Rescind Discount Safe Harbor for PBMs, But Questions Remain

"Questions remain ... as to whether HHS has the legal authority to carry out the Order and, if it does, whether it can do so in a manner that will not increase costs. This article provides a background on the legal issues surrounding HHS's approach to the use of rebates by pharmaceutical manufacturers, then addresses the February 2019 proposed rule in light of the Order, and concludes with a discussion of future considerations." Icon to read more

Seyfarth Shaw LLP

Recent OCR Settlements Target HIPAA Security Rule Non-Compliance

"The first three HIPAA settlements of 2020 highlight that compliance with the Security Rule remains a top priority for OCR in its investigations. In all three investigations, OCR scrutinized the Covered Entities' alleged sustained failure to implement appropriate safeguards in accordance with the HIPAA Security Rule standards, at times knowingly." Icon to read more

Data Matters, Sidley Austin LLP

Competing with Apple and Fitbit, Amazon Launches Health Wearable That Tracks Activity, Body Fat, Emotions

"Amazon is looking to get a slice of the health wearables market with its new Amazon Halo fitness tracker. It marks the first wearable device launched by the tech giant as it takes on a market dominated by the Apple Watch and Fitbit. It's a market estimated to be worth around $52 billion ... Along with the Halo wristband, Amazon also launched a subscription service and smartphone app." Icon to read more

FierceHealthcare

Making Sense of Competing Estimates: The COVID-19 Recession's Effects on Health Insurance Coverage

"[F]our studies each attempt to quantify the number of individuals losing employment-based health insurance due to COVID-19-related job loss, with figures ranging from around 5 million up to 30 million. Estimates of the increase in the number of uninsured people range from about 3 million to more than 8 million. Recent evidence from small household surveys is more consistent with the lower estimates or delayed impacts." Icon to read more

Urban Institute

[Opinion]

ERIC Appeals Seattle Employer Health Care Mandate Decision to Ninth Circuit Court of Appeals

"Companies affected by Seattle's health ordinance already provide health benefits to their workers in Seattle in compliance with federal law. The ordinance would require those companies to amend their federally regulated health plan, a mandate that violates [ERISA] ... [ERIC is] taking this case to the Ninth Circuit so it will reverse the district court's decision, ending the Ninth Circuit's deviation from the Supreme Court and other courts' recognition that ERISA preempts state and local laws that seek to mandate the substance, value, or structure of employer-sponsored health benefits." [The ERISA Industry Committee v. City of Seattle, No. 20-35472 (notice of appeal to 9th Cir. filed Aug. 27, 2020)] Icon to read more

The ERISA Industry Committee [ERIC]

Benefits in General

High Risk Issue iconThe Importance of Including Exhaustion Requirements in Plan Documents

"[P]lan fiduciaries assume that this language setting forth the plan's claims and appeals process and requiring administrative exhaustion is already in the plan document.... [but] in light of this decision, [they] should review their plan documents, including summary plan descriptions (SPDs), to ensure that such language is included. As the Sixth Circuit ... points out in its decision, failure to do so may allow the claimant to head straight to court without exhausting his or her administrative remedies." [Wallace v. Oakwood Healthcare, Inc., No. 18-2316 (6th Cir. Mar. 31, 2020)]  Icon to read more

Trucker Huss

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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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