Health & Welfare Plans Newsletter

September 10, 2020

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[Official Guidance]

Text of IRS Notice 2020-66: Guidance Regarding the Premium Tax Credit and Medicaid Coverage of COVID-19 Testing and Diagnostic Services (PDF)

"This notice provides interim guidance addressing whether certain Medicaid coverage of Coronavirus Disease 2019 (COVID-19) testing and diagnostic services is minimum essential coverage for purposes of the premium tax credit under section 36B of the Internal Revenue Code. This notice also announces that the Department of the Treasury and the [IRS] intend to amend Section 1.5000A-2 of the Income Tax Regulations to add Medicaid coverage of COVID-19 testing and diagnostic services to the list of health care coverage that is not minimum essential coverage under a government-sponsored program." Icon to read more

Internal Revenue Service [IRS]

[Guidance Overview]

Massachusetts Issues Updated Paid Family and Medical Leave Regs

"Private plans must include an internal appeals process that employees can use before exercising their right to appeal to the DFML.... [E]mployers may not apply for an exemption on behalf of only a portion of their covered workforce.... Covered individuals who use accrued paid leave provided by their employer shall not receive any PFML benefits during the time they use such accrued paid leave." Icon to read more

K&L Gates

[Guidance Overview]

DOL Issues Back-to-School Guidance on Paid Leave and Unemployment Benefits

"Even if FFCRA leave is not available, regular FMLA leave may be available to care for a child who is unable to attend school. Other protections for caregiver responsibilities under federal, state, or local law may also be available.... FFCRA leave for childcare-related reasons may also be available if a school that has reopened temporarily requires remote instruction due to a possible COVID-19 exposure." Icon to read more

Buck

[Guidance Overview]

Health Plans May Use PHI to Contact Recovered COVID-19 Participants Regarding Plasma Donation

"Although it is unclear whether health plans will be interested in contacting participants for this purpose, this clarification will be welcome news for plans pursuing this type of case management. Plans relying on the guidance should fully document the justification for using and disclosing PHI of recovered COVID-19 patients, including determinations regarding whether a HIPAA authorization is required." Icon to read more

Thomson Reuters / EBIA

Health Care Reform, 10 Years Later

"Ten years later and the ACA is still being debated by both sides of the political aisle.... [A] series of lawsuits have given us a lot to watch this year.... Here are several messages to consider relaying [to employees]: [1] Your health and well-being are important to us.... [2] We have a thoughtful approach.... [3] You can get a lot of value by using our benefits and taking steps to improve your health.... [4] If you have questions, here's where to go." Icon to read more

Segal Benz

Benefits in General

How to Minimize Judicial Review of ERISA Fiduciary Decisions

"A recent decision from the Court of Appeals for the Seventh Circuit offers help to ERISA benefit professionals who prefer to maximize judicial deference in favor of the fiduciaries.... ERISA's core focus is the governing plan documents.... [If] they provide the fiduciary with broad discretion to interpret their terms, and provide that the fiduciary decision shall be final and binding, the court should give the fiduciary the benefit of the doubt." [Bator v. District Council 4, Graphics Communications Conference, No. 19-2626 (7th Cir. Aug. 27, 2020)] Icon to read more

Seyfarth

Exceptional Usefulness and Quality iconERISA Ruling Shows Daunting Review Standard for Claimants

"[T]he presence of a circuit split on the issue of whether a late appeal decision forfeits deferential review may invite Supreme Court review.... It is also somewhat surprising that the Eighth Circuit would buck a growing trend among the circuits to find gateways to de novo review.... For plan administrators, efforts need to be taken to strictly comply with the requirements of the claim regulations. While tardiness was excused in this instance, that may not happen the next time." [McIntyre v. Reliance Standard Life Ins. Co., No. 19-2367 (8th Cir. Aug. 25, 2020)] Icon to read more

DeBofsky Sherman Casciari Reynolds P.C.

Press Releases

Most Popular Items in the Previous Issue

Most Employers Intend to Offer Same Health Care Coverage in 2021
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David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
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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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