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[Guidance Overview]

Trump Administration Finalizes Transparency Rule for Health Insurers

"Insurer stakeholders quickly panned the new rule, arguing that it is unnecessary and will lead to higher (not lower) health care prices. It remains unclear if the rule will be challenged in court: the preamble includes an extensive legal justification after commenters questioned the Departments' statutory authority and raised questions about the rule's constitutionality. The rule also newly includes a severability clause." Icon to read more

Health Affairs Blog

[Guidance Overview]

Can an Employer Terminate COBRA Coverage During the Pandemic’s Outbreak Period?

"The question the employer should ask themselves is, 'How do I normally (in a non-pandemic time) treat those individuals from the date of the qualifying event until the first payment is received?' A similar question is 'How do I normally (in a non-pandemic time) treat individuals who are in the [normal] 30-day grace period for payments?' " Icon to read more

Kushner & Company

[Guidance Overview]

Dependent Care FSA When a Child Reaches Age 13

"In most cases, the employee will have eligible dependent care expenses for the child only for the period of the year prior to the child reaching age 13. The test for having qualifying expenses applies on a day-by-day basis. Employees can therefore incur expenses that are eligible for reimbursement under the dependent care FSA through the day before the child's 13th birthday." Icon to read more

ABD Insurance & Financial Services

[Guidance Overview]

D.C. COVID-19 Leave Law Is in Effect and Will Be Enforced

"Washington, D.C. employers must remember to provide both paid and unpaid leave under the new District of Columbia Coronavirus Support Temporary Amendment Act of 2020.... [T]he Act formally became effective on October 9, 2020 and will remain in effect through the end of the declared COVID-19 public health emergency -- currently December 31, 2021. The law repeals the emergency laws ... but carries over the additional obligations to provide employees with paid and unpaid leave for COVID-19-related reasons." Icon to read more

Epstein Becker Green

[Guidance Overview]

Upcoming Deadline iconNew York City Employers: Act Now to Comply with New Sick Leave Requirements

"[T]his article provides a side-by-side] summary of the new requirements for New York City employers under New York City's ESSTA and the New York State Sick Leave Law. Employers located in New York City will need to ensure compliance with both laws when revising their policies[.]" Icon to read more

Fox Rothschild LLP

[Guidance Overview]

Washington State to Establish Employee-Funded Long-Term Care

"Starting Jan. 1, 2022, employers in the state will have to collect 0.58% of wages through payroll deduction and remit these employee premium contributions to the state. Employees with other long-term care (LTC) insurance can waive participation." Icon to read more


Healthcare Consumers Want to Know the Price of a Service in Advance

"80% of consumers utilize a payer or provider website (or other resource) to research healthcare costs. And 47% of consumers choose a provider based on costs. Only 53% of survey respondents reported being provided with clear out-of-pocket costs in advance of treatment and 48% report having 'partial to no' understanding of their financial responsibility for their medical bill." Icon to read more

Healthcare Financial Management Association [HFMA]

CMS Report: Agents and Brokers in the Marketplace (PDF)

"CMS has built innovative tools and new enrollment pathways to give consumers options for how they shop for coverage, empowering agents and brokers to provide comprehensive support to their customers throughout the year. These tools have allowed private sector partners to craft a more consumer-centric experience with increased plan choice, enhancing their ability to support consumers in making important insurance decisions and providing year-round assistance." Icon to read more

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

CMS Report: Increasing Competition on the Exchanges to Improve Consumer Choice and Affordability (PDF)

"CMS conducted its own analysis of the impact of issuer competition using 2018 and 2019 data from the Exchanges in all 50 states and the District of Columbia.... [C]ounties with one additional issuer in 2019 were associated with a 2.5 percent reduction in the benchmark premiums compared to 2018.... [C]ounties where there was any increase in the number of issuers from 2018 to 2019 were associated with a nearly 8 percent reduction in the benchmark premium.... As a result of [CMS] efforts, the number of issuer options available to consumers increased in hundreds of counties nationwide, resulting in a 53 percent increase in counties with more than one issuer from 2018 to 2020." Icon to
read more

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


New HHS Transparency Rule Creates Historic Opportunities for Employers to Control Health Care Costs

"The final rule requires employers to have their third-party administrators publicly disclose detailed health care pricing data. It also mandates that employers make available to health plan participants an internet-based self-service tool that provides price and personalized out-of-pocket cost information. The cost of these disclosure requirements will likely be passed onto employers, but the historic increase in transparency ... will enable large employers to substantially improve value-based care and better control health care spending in the long run." Icon to read more

HR Policy Association


New Price Transparency Rule Will Help Transform America’s Health Care System

"The Trump administration's health care price transparency reform will help drive market competition among health insurance companies, health care systems, physicians, and other health care professionals. This will directly benefit patients by helping to drive down prices and improve quality. But how will this really work to improve the care provided to everyday Americans?" Icon to read more

The Heritage Foundation

Benefits in General

ERISA Advisory Council to Meet December 4

"[T]he 204th open meeting of the [ERISA Advisory Council] will be held via a teleconference on Friday, December 4, 2020.... [T]he Council members will receive an update from [EBSA] and present their recommendations ... on the following issues: [1] Examining Top Hat Plan Participation and Reporting, and [2] Considerations for Recognizing and Addressing Participants with Diminished Capacity.... Instructions for public access to this teleconference meeting will be posted on the ERISA Advisory Council's web page ... prior to the meeting." Icon to read more

Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

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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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