Health & Welfare Plans Newsletter

November 9, 2020

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[Official Guidance]

Text of CMS Announcement: 2021 Medicare Parts A & B Premiums and Deductibles

"The standard monthly premium for Medicare Part B enrollees [in 2021] will be $148.50 for 2021, an increase of $3.90 from $144.60 in 2020. The annual deductible for all Medicare Part B beneficiaries is $203 in 2021, an increase of $5 from the annual deductible of $198 in 2020.... The 2021 Part B total premiums for high-income beneficiaries are shown in [a] table ... The Medicare Part A inpatient hospital deductible that beneficiaries will pay when admitted to the hospital will be $1,484 in 2021, an increase of $76 from $1,408 in 2020." Icon to read more

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

[Guidance Overview]

Health Plan Transparency Final Rule Requires New Health Plan Disclosures

"The final rule imposes significant new requirements on group health plans, including all issuers of non-grandfathered individual and group health insurance coverage and self-insured plans (that are not account based plans), to disclose information on pricing and cost-sharing under their plans. Grandfathered health plans and excepted benefit health plans are not subject to the transparency rules." Icon to read more

Faegre Drinker

[Guidance Overview]

Colorado Voters Approve Paid Medical and Family Leave Initiative

"[T]he Paid Medical and Family Leave (PMFL) Initiative, Proposition 118, ... creates a state-run paid family and medical leave insurance program in Colorado that allows employees to take up to 12 weeks of leave and keep their job. The program, which begins on January 1, 2024, is similar in many ways to unemployment insurance and what exists in California and New Jersey." Icon to read more

Jackson Lewis P.C.

[Guidance Overview]

Colorado Becomes Ninth State to Enact Paid Family Leave Law

"Like certain other paid family leave laws, Colorado [Paid Family and Medical Leave Insurance (PFMLI)] funding will be split between the worker and the employer. Qualifying absences ... broadly involve bonding with a new child, the serious health condition of the employee or a family member, military family needs, and addressing the effects of domestic violence, sexual assault, and stalking. Payroll contributions begin January 1, 2023, and benefits become available to covered workers on January 1, 2024." Icon to read more

Seyfarth Shaw LLP

[Guidance Overview]

States Increase Group Health Plan Reporting Obligations

"Reports due in 2021 for the 2020 coverage year will follow the same schedule in some states as the IRS deadlines to file federal Forms 1094/1095. Some jurisdictions have indicated they will accept the federal forms that employers or other applicable entities must send to IRS and won't require employers to send duplicative statements to residents. New Jersey and Washington, DC, delayed their 2020 filing deadlines due to COVID-19, but regulators haven't indicated any similar delay in 2021." Icon to read more

Mercer

More Small Businesses Turn to Level Funded Health Plans to Manage Health Care Benefit Costs

"Level funded plans ... are designed to pair with any standard medical plan  ... but with lower rates and more financial flexibility, in part resulting from employers being rated on the health status of their employee population, as opposed to community-rated. Thirteen percent of small firms (with three to 199 employees) are in a level funded plan, which combines a relatively small self-funded component with stop-loss insurance that protects an employer from excessive claims[.]" Icon to read more

The Business Journals

Employer HSA Contributions

"Both employer and employee HSA contributions apply toward the statutory maximum contribution limit.... [T]he HSA contribution limit is different from the 401(k) contribution rules, which have separate deferral and aggregate employer annual additions contribution limits. No similar concept applies to HSA contributions -- there is simply one unified annual HSA contribution limit." Icon to read more

ABD Insurance & Financial Services

California v. Texas at the Supreme Court: A Preview

"Tuesday November 10 ... the Supreme Court will hear oral argument in California v. Texas and once again decide the fate of the entire [ACA]. The ins and outs of this lawsuit have been covered extensively at the Health Affairs Blog. This post summarizes the background of the case, potential outcomes, and key issues to note during oral argument (which can be streamed here)." [California v. Texas, No. 19-840; Texas v. California, No. 19-1019 (cert. pet. granted Mar. 2, 2020)] Icon to read more

Health Affairs Blog

Explaining California v. Texas: A Guide to the Case Challenging the ACA

"This issue brief answers key questions about the litigation as we await a decision from the Supreme Court about the ACA's survival. [1] Who is challenging the ACA? ... [2] What is the Federal government's position in the case, and how has it changed over time? ... [3] Who is defending the ACA? ... [4] What did the 5th Circuit decide? ... [5] What is happening at the Supreme Court?" [California v. Texas, No. 19-840; Texas v. California, No. 19-1019 (cert. pet. granted Mar. 2, 2020)] Icon to read more

Henry J. Kaiser Family Foundation

Coronavirus Implications for Short- and Long-Term Disability Plans

"For a majority of employer-sponsored group disability plans, coverage for a disability linked to COVID-19 is likely to depend on each individual plan's definition of 'disability.' Although definitions may differ from plan to plan, most plans typically state that an employee is considered disabled if he or she is unable to perform the duties of his or her occupation. Employees that test positive for COVID-19 but only experience minor symptoms will probably not qualify as disabled under their employer's group plan; however, those who are severely affected by coronavirus may be eligible for benefits." Icon to read more

Hall Benefits Law, via Lexology; free registration required

Annual Report to Congress on HIPAA Privacy, Security, and Breach Notification Rule Compliance, for Calendar Year 2018 (PDF)

19 pages. "[In] addition to requiring covered entities and business associates to take corrective action in hundreds of cases, for 2018, the Department resolved eleven investigations with resolution agreements/corrective action plans or the imposition of civil money penalties totaling more than $28 million." Icon to read more

U.S. Department of Health and Human Services [HHS]

State Efforts to Affect Access to Health Insurance

Interactive map. Select a state and an action to learn what the individual insurance market stabilization strategies states may be pursuing. Icon to read more

The Commonwealth Fund

Tighter Municipal Budgets Shrink Retiree Health Benefits

"For all 50 states combined, revenue declines for 2020 and 2021 could reach 13% cumulatively, according to Moody's Analytics projections, while the average cost of an employer health-care plan for an individual increased 4% in 2020 to $7,470, according to the Kaiser Family Foundation nonprofit." Icon to read more

The Wall Street Journal; subscription may be required

Press Releases

DATAIR adds Text Alert Option to the FlexPlus System
DATAIR Employee Benefit Systems, Inc.

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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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