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Fall Employee Benefits Briefing
November 17, 2020 WEBCAST
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Flattening the Caregiver Crisis Curve
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[Guidance Overview]

Final Transparency Rule for Group Health Plans and Insurers

"In addition to the technical side of the disclosure rule, plan sponsors will need to revisit contracts with service providers and inform plan participants about how to use the new tools the rule requires. The rule contains several enforcement safe harbors which are only available if the plan is exercising good faith and reasonable diligence.... [T]he federal agencies generally require plans to create a compliance plan for implementation to demonstrate good-faith compliance with complicated requirements such as these." Icon to read more


[Guidance Overview]

Colorado Voters Approve Employer/Employee Funded Paid Family and Medical Leave Insurance Program

"Commencing on Jan. 1, 2023, employers and employees will be required to contribute to a payroll premium fund to finance paid family and medical leave insurance benefits. Eligible employees will be allowed to take up to 12 weeks of paid family and medical leave insurance benefits annually beginning on Jan. 1, 2024 ... receiving up to $1,100 per week for up to 12 weeks for qualifying reasons." Icon to read more

Armstrong Teasdale

Transcript of Supreme Court Oral Argument in Case Challenging ACA (PDF)

135-page transcript of oral argument, held Nov. 10, 2020, on issues of standing and severability. "Justice Alito [to Acting U.S. Solicitor General Jeffrey Wall]: At the time of the first case [NFIB v. Sebelius], there was strong reason to believe that the individual mandate was like a part in an airplane that was essential to keep the plane flying so that if that part was taken out, the plane would crash. But now the part has been taken out and the plane has not crashed. So if we were to decide this case the way you advocate, how would we explain why the individual mandate in its present form is essential to the operation of the Act?" Also available: audio recording (MP3). [California v. Texas, No. 19-840; Texas v. California, No. 19-1019 (cert. pet. granted Mar. 2, 2020)]  Icon to read more

Supreme Court of the United States

ACA Looks Primed to Survive Latest Turn at High Court

"Whether the provision itself will survive was unclear [at oral argument], but at least five members of the court appeared inclined to leave the bulk of the law intact while likely employing the legal doctrine known as severability. 'It does seem fairly clear the proper remedy would be to sever the mandate provision and leave the rest of the law in place,' Justice Brett Kavanaugh said[.]" [California v. Texas, No. 19-840; Texas v. California, No. 19-1019 (cert. pet. granted Mar. 2, 2020; oral arg. Nov. 10, 2020)] Icon to read more

Courthouse News Service

The Supreme Court Wrestles (Again) with the Constitutionality of the ACA

"Justice Thomas pressed the attorney for the House of Representatives on how he could argue that the mandate is severable when, in 2012, he had argued that it was the 'heart and soul' of the law. On the other hand, many Court observers honed in on statements from Chief Justice Roberts and Justice Kavanaugh, both of whom seemed to express reservation at 'reading into' Congressional intent rather than simply looking to the actions taken by Congress in zeroing out the individual mandate (while leaving the rest of the law intact)." [California v. Texas, No. 19-840; Texas v. California, No. 19-1019 (cert. pet. granted Mar. 2, 2020; oral arg. Nov. 10, 2020)] Icon to read more

Seyfarth Shaw LLP

District Court Orders Expansive Remedies in Class Actions Challenging Insurer’s Processing of Mental Health Claims

"[T]he court found that [United Behavioral Health (UBH)] had long breached its fiduciary duties to the class members and as a result, 'each and every adverse benefit determination' within the class should be remanded to UBH for reprocessing under the manners consistent with the FFCL -- and all at UBH's expense, including the payment of interest. The court further concluded that class members had the right to submit new and additional information that supported their claim for benefits." [Wit v. United Behavioral Health, Nos. 14-2346, 14-5337 (N.D. Cal. Nov. 3, 2020)] Icon to read more

Kantor & Kantor

Virus Has Employees Paying Closer Attention to Health Insurance Benefits

"Over half of employees (54%) view their insurance benefits as more valuable compared to before the pandemic. Millennials in particular (64%) now place more value on their benefits. Approximately two-thirds of employees (66%) say they are paying more attention to the benefits their company offers and the coverages provided. Almost as many (64%) employees indicate that they are more likely to consider signing up for certain benefits." Icon to read more

Employers to Experience Lower Health Benefit Costs in 2020 Due to COVID-19 Impact

"While carrier responses varied significantly, 2020 medical claims are projected to increase at a rate that is on average 5 percentage points lower than initially projected by U.S.-based insurance carriers due to COVID-19 ... [C]arriers forecast COVID-19 will increase U.S. employer medical claims by an additional 2 percentage points on average above normal trends in 2021. This will include costs for care that was postponed or skipped in 2020 as well as COVID-19 prevention and treatment that will be delivered next year." Icon to read more


Benefits in General

Make the Most of Your Employer's Benefits Package

"The [DOL] estimates that your employer-sponsored benefits are worth roughly 30 percent of your salary.... Even if you think you're maxing out your benefits, you owe it to yourself to look at your employer's most recent benefits package. Thirty-four percent of companies increased offerings from mid-2017 into 2018[.]" Icon to read more


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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, 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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