Health & Welfare Plans Newsletter

September 28, 2020

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[Guidance Overview]

Administration Finalizes Drug Importation Plans, But Legal and Practical Questions Remain

"[HHS] released a final rule aiming to permit states or other specific actors to establish programs to import prescription drugs from Canada. If it is not blocked in court, the rule will become effective 60 days after its publication in the Federal Register, [which is scheduled for October 1]. This rule is one element of the Trump Administration's broader agenda on drug pricing, but it faces several large obstacles which are likely to derail its implementation." Icon to read more

Rachel Sachs in Health Affairs Blog

[Guidance Overview]

Upcoming Deadline iconNew York Sick Leave Law Goes Into Effect September 30

"Employees may use NYSSL for absences related to ... [1] a mental or physical illness, injury, or health condition of an employee or the employee's family member ... [2] the diagnosis, care or treatment of an existing health condition of, or preventive care for, an employee or an employee's family member, or a ward for whom the employee is the guardian; or [3] an employee or an employee's family member who is a victim of domestic violence, a sexual offense, stalking or human trafficking in order to avail themselves of services or assistance." Icon to read more

BakerHostetler

[Guidance Overview]

Philadelphia Workers Now Entitled to Public Health Emergency Leave

"Philadelphia has amended its Promoting Health Families and Workplaces Ordinance ... to provide two weeks of paid emergency public health leave (PHEL) to Philadelphia workers during declared public health emergencies. The PHEL will expire on December 31, 2020.... It covers not only employees, but also many independent contractors, including those in certain industries.... It also applies regardless of the size of the employer." Icon to read more

Ballard Spahr LLP

[Guidance Overview]

Upcoming Deadline iconMaine DOL Releases Final Rules for Earned Paid Leave Law

"As the January 1, 2021, effective date of Maine's Earned Paid Employee Leave Law approaches, the state [DOL] has promulgated the much-anticipated final regulations for implementing the statute. Under the law, private employers with at least 10 employees in Maine must provide employees one hour of paid leave for every 40 hours worked, up to a maximum of 40 hours of paid leave per year, for any reason." Icon to read more

Jackson Lewis P.C.

Most Common Open Enrollment Pitfalls and How to to Avoid Them

"[1] Ending open enrollment outside of standard office hours ... [2] Overlooking additional decision makers ... [3] Offering a short open enrollment window ... [4] Focusing 100% on technology ... [5] Electing a passive enrollment ... [6] Not optimizing your online enrollment system ... [7] Ignoring voluntary benefits ... [8] Not demonstrating the value of the benefits program ... [9] Forgetting total out-of-pocket cost ... [10] Not funding a health savings account (HSA)." Icon to read more

OneDigital Health and Benefits

Second-Largest HIPAA Fine Paid by Premera Blue Cross for 2014 Breach

"During the breach, which went undetected for nearly nine months ... a hacker had unauthorized access to the Premera network containing 10.4 million individuals' protected health information including their names, addresses, dates of birth, email addresses, Social Security numbers, bank account information and health plan clinical information, according to HHS. The hackers used a phishing email to install malware that gave them access to Premera's IT system." Icon to read more

FierceHealthcare

Proposed Drug Discount Cards Will Be Funded by a Medicare Trust Fund

"A plan ... to send millions of prescription-drug discount cards to 33 million seniors will be funded by a Medicare trust fund ... Trust fund money is rarely spent on matters unrelated to the direct receipt of health care by seniors and people who are disabled. The plan to use the funds for a pilot program also comes as the pandemic has added pressure on the hospital-care trust." Icon to read more

The Wall Street Journal; subscription may be required

Health Insurance Menu Design for Large Employers

"Using detailed administrative data from Harvard University, [the authors] estimate a model of plan choice and utilization, and evaluate the benefits of cost sharing and plan variety. For a single plan with a generous out-of-pocket maximum ... a modest coinsurance rate of approximately 30% with a zero deductible maximizes average employee surplus. Gains from offering choice are limited if based solely on financial dimensions, but can be economically significant if paired with other features that appeal to sicker households." Icon to read more

National Bureau of Economic Research [NBER]; purchase required for full document

As COVID-19 Looms, Some Workers Face Loss of Health Insurance

"While estimates vary, a recent Urban Institute analysis of census data says at least three million Americans have already lost job-based coverage, and a separate analysis from Avalere Health predicts some 12 million will lose it by the end of this year. Both studies highlight the disproportionate effect on Black and Hispanic workers." Icon to read more

The New York Times; subscription may be required

Benefits in General

[Guidance Overview]

DOL Proposes New Rule to Streamline Independent Contractor Analysis

"The new proposed regulation identifies two 'core factors' that are the 'most probative' and should be 'afforded greater weight' in the analysis: 'the nature and degree of the individual's control over the work'; and the worker's 'opportunity for profit and loss.' Three other factors are identified that the proposed rule affords lesser weight." Icon to read more

Jackson Lewis P.C.

[Guidance Overview]

DOL Publishes Proposed Rule on Independent Contractor Classification

"While the Proposed Rule retains the longstanding 'economic realities' test, it aims to streamline the factors and clarifies that the ultimate inquiry when evaluating independent contractor status is whether a worker is in business for herself or himself or is economically dependent on the potential employer." Icon to read more

Morgan Lewis

Press Releases

Most Popular Items in the Previous Issue

HHS Takes Action as Part of President Trump's Healthcare Plan
U.S. Department of Health and Human Services [HHS]

ACA Architect Predicts the Future of Healthcare
Jonathan Gruber, Ph.D., via American Healthcare Journal

View COVID-19 News and Resources

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David Rhett Baker, J.D., Editor and Publisher
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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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