Health & Welfare Plans Newsletter

September 18, 2020

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[Guidance Overview]

Exceptional Usefulness and Quality and Usefulness iconPlan Coverage of COVID-19 Testing: Issues Remain After June Guidance

"[E]mployers should take the following into consideration: [1] Review notice and need for clarification.... [2] Check vendor claims processing and assist employees.... [3] Steer employees to providers with transparent costs.... [4] Return-to-the-workplace considerations.... [5] Review compliance requirements for stand-alone telehealth.... [6] Mental health parity considerations." Icon to read more

Mercer

[Guidance Overview]

Upcoming Deadline iconSupplemental Paid Sick Leave for All Coming to California

"When do I have to give employees leave under the new law? ... How do I have to pay for the new COVID-19 leave? ... But what if I already provided COVID-19 paid sick leave? ... Food sector employees.... Update Wage Statements/Written Notice.... Enforcement.... What else should employers do now?" Icon to read more

Seyfarth Shaw LLP

[Guidance Overview]

Upcoming Deadline iconCalifornia Dramatically Expands Coverage Under State Leave Law, Creating New Obligations for Employers

"Senate Bill 1383 expands [the California Family Rights Act (CFRA)] to apply to employers with five or more employees, and expands the scope of 'family members' for whom employees can take leave to include many additional categories. It will go into effect on January 1, 2021 ... [B]ecause SB 1383 now expands the definition of 'family member' under the CFRA in a manner inconsistent with the definition under the federal FMLA, the two laws are no longer in sync. This creates the unfortunate situation in which an employee is eligible for 12 weeks of leave under the CFRA but remains eligible for a full additional 12 weeks under the FMLA." Icon to read more

Fisher Phillips

[Guidance Overview]

Philadelphia to Expand Emergency Sick Leave Benefits to More Workers

"The bill will broaden the scope of Philadelphia's Promoting Healthy Families and Workplaces sick leave law by providing paid 'public health emergency leave' to more people who work within the geographic boundaries of the city, including individuals workings for companies with 500 or more employees, independent contractors and 'gig economy' workers." Icon to read more

Duane Morris LLP

[Guidance Overview]

New York Paid Family Leave Benefits and Employee Contributions Set to Increase

"On January 1, 2021, the amount of employee contributions, the number of weeks of leave and benefits, and the amount of weekly benefits granted under the program are scheduled to increase. This will be the last of three annual increases in weekly benefits.... [T]he employee payroll contribution toward NYPFL also will be adjusted on January 1, 2021 to 0.511% of an employee's gross wages each pay period, capped at a maximum annual contribution of $385.34." Icon to read more

Epstein Becker Green

High Risk Issue iconGroup Life Insurance and Clerical Errors: Court Finds Employer, Not Insurer, Liable for Death Benefit

"[Although] it was the third party that made the repeated verbal representations that the benefits were larger ... the court held the employer, as plan administrator in the context of its benefit program, responsible ... [It] is unclear from this case whether the coding error occurred on the employer's side or the third-party's side.... [A] check of payroll records may have avoided this issue." [Sullivan-Mestecky v. Verizon Communications Inc., No. 18-1591 (2d Cir. Jun. 1, 2020)] Icon to read more

HUB International

Tips for a Successful Remote Open Enrollment

"[1] Communicate benefits changes with real-world connections.... [2] Adapt your materials for a remote environment.... [3] Select and vet the technology you'll use.... [4] Engage with the whole family.... [5] Evaluate your performance for the future." Icon to read more

HealthEquity

Nationwide Evaluation of Health Care Prices Paid by Private Health Plans

"In 2018, across all hospital inpatient and outpatient services, employers and private insurers ... paid 247 percent of what Medicare would have paid for the same services at the same facilities.... Some states ... had relative prices under 200 percent of Medicare; others ... had relative prices that approached 350 percent of Medicare.... High-value hospitals -- those offering low prices and high safety -- do exist." Icon to read more

RAND Corporation

How Payers Are Doing Financially This Year

"Payers have moved into a strategic phase. They are considering strategic initiatives that were put on the back burner when COVID-19 hit in March and also working to stabilize near-term and long-term performance. Top of mind are initiatives that mitigate MLR rebates while simultaneously improving other aspects of the business. For example, payers are looking at provider partnerships to ensure members get the care they need this year and stop deferring needed care." Icon to read more

PwC

COVID-19 Recession Caused Loss of Employer-Sponsored Health Insurance Coverage

"We find that [between April 23-May 12 and July 9-21, 2020], the number of nonelderly adults with ESI fell by 3.3 million, while the number of uninsured adults increased by 1.9 million.... [G]roups experiencing larger losses in ESI coverage experienced corresponding increases in public coverage or uninsurance rates, with smaller observed changes in private nongroup coverage rates." Icon to read more

Urban Institute

Converting PTO Funds to Student Loan Relief Is a Timely Benefit

"Companies have long struggled with the problem of unused PTO. Some have allowed employees to roll over accrued hours year to year, creating financial liabilities when those workers must be paid for those hours when their employment ends. Others ... [employ] end-of-year 'use it or lose it' policies that limit rolling over PTO to just a week or two, posing employee relations challenges.... One option is to let employees convert unused PTO into loan-repayment funds or cash that can be used for other pressing needs." Icon to read more

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

[Opinion]

Mercer Submits Comments to DOL Supporting National Paid Leave Standard

"[T]he COVID-19 pandemic has highlighted the need for a uniform, nationwide approach to paid leave and put a spotlight on the patchwork of state and local requirements that arise in the absence of a federal solution. The comment letter explains that employers, particularly multijurisdiction employers, are struggling in a time of crisis to understand the compliance requirements of numerous different laws, while trying to support their workforce in a consistent and meaningful way." Icon to read more

Mercer

Benefits in General

Portable Benefit Solutions: Financial, Health & Retirement (PDF)

16 pages. "One of the challenges in building an entrepreneurial ecosystem is that the new jobs created rarely offer employee benefits.... [This] project aimed to assess the feasibility of an online platform to serve as a virtual human relations department for entrepreneurs, self-employed workers, independent contractors, freelancers and other workers without access to benefit resources.... The use of online, fintech platforms hold great promise for bridging this gap and connecting independent workers with information, services and opportunities to build a stronger financial future." Icon to read more

Women's Institute for a Secure Retirement [WISER]

Selected Discussions
on the BenefitsLink Message Boards

► It's easy to sign up and participate in discussions! Post answers, ask questions, create custom feeds and views. Join your peers (and potential referral sources or customers)—there is no charge.

Opting Out of Medical Coverage Entirely, Due to Coverage Under Spouse's Plan

"I'm hoping I can get information regarding the following scenario: Large government employer currently offers a cafeteria plan under which employees can pay premiums for medical, dental, life, and to make contributions to FSA and HSA. Employees must elect one of the medical policies offered, but otherwise they can take the rest as cash if they make no other elections/contributions. Employer is considering allowing employees to opt out of medical coverage if they can show that they are covered under their spouse's medical. What issues do you see?" Icon to read more

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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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