Health & Welfare Plans Newsletter

November 18, 2020

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View job as Benefits Plan Director for Taft-Hartley Trusts Benefits Plan Director

Taft-Hartley Trusts
San Jose CA

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Pension Benefit Guaranty Corporation [PBGC]
Telecommute / Washington DC

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Stones River Consulting
Telecommute / TN

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[Guidance Overview]

Exceptional Usefulness and Quality and Usefulness iconFinal Health Plan Transparency Regs to Phase In (2022-2024)

"[If] an employer with a self-funded plan enters into a contract with a TPA to have the TPA handle these disclosures, the employer, through its group health plan, is still ultimately responsible. By contrast, employers with insured plans may contract with their health insurance carrier to provide these disclosures and the carrier will ultimately be responsible. Therefore, contractual amendments will likely be coming in 2021." Icon to read more

HUB International

[Guidance Overview]

Navigating the COBRA Deadline Extension

"Earlier this year, the COBRA notice, election and premium payment deadlines were extended from March 1 until 60 days after the end of the ongoing COVID-19 national emergency.... [T]he IRS and EBSA have not addressed whether administrators should correct previously sent COBRA election notices. The fact that COBRA election notices are not required until the end of the extension period suggests that interim corrections are not required. However, while the usual statutory penalties for COBRA violations should not apply, failing to notify COBRA qualified beneficiaries of their rights may increase the likelihood of a breach of fiduciary duty claim." Icon to read more

Cohen & Buckmann, P.C.

Text of District Court Opinion Overturning DOL Advisory Opinion on Health Benefit Program Offered by Limited Partnership to Its Limited Partners (PDF)

30 pages. "Because the Limited Partners are working owners and bona-fide partners, they may participate in the single employer welfare benefit plan set up by DMP, so long as DMP employs at least one common-law employee. Accordingly, [DOL Advisory Opinion 2020-01A] is set aside as arbitrary and capricious under the APA and contrary to law under ERISA and Defendants are ENJOINED from refusing to acknowledge the ERISA-status of the Plan or refusing to recognize the Limited Partners as working owners of DMP." [Data Marketing Partnership, LP v. DOL, No. 19-800 (N.D. Tex. Sep. 28, 2020)] Icon to read more

U.S. District Court for the Northern District of Texas

Start Planning for the New Healthcare Price Transparency Rules Now

"These price transparency rules: [1] will up-end almost every type of contract out there in the health insurance industry, [2] will release a treasure trove of data into the marketplace, and [3] will take an enormous amount of effort and money to implement. Love them, hate them, or somewhere in between, you'd be hard-pressed to say they aren't bold and disruptive, and they are coming at the employee benefits industry fast!" Icon to read more

MZQ Consulting, LLC

Final Transparency Rule Adds to Health Plans’ Disclosure Requirements

"[T]hese cost estimates will at first be required for only 500 of the most shoppable items and services, which are listed in the final rule. For the remainder, plans will have until January 1, 2024. This disclosure must include ... [1] Estimated cost-sharing liability; [2] Accumulated amounts; [3] Negotiated rates, expressed as dollar amounts ... [4] Out-of-network allowed amounts; [5] A list of items and services included in any bundled payment arrangement; [6] A notice of prerequisites (such as prior authorization), if applicable; and [7] A disclosure notice." Icon to read more

HR Daily Advisor

ACA Round-Up: Record-High Medical Loss Ratio Rebates, Pass-Through Funding, Preventive Services

"Overall, insurers owe record-high rebates of nearly $2.46 billion to more than 11.2 million consumers. This represents an average of $219 in rebates per person. Consistent with prior years, the rebates are most significant in the individual market, where insurers owe $1.7 billion to an estimated 5.1 million consumers. These rebates are up significantly from the $1.37 billion owed to nearly 9 million consumers last year, which was a record high relative to prior years." Icon to read more

Katie Keith, via Health Affairs Blog

Benefits in General

[Official Guidance]

Department of the Treasury 2020-2021 Priority Guidance Plan (PDF)

31 pages; employee benefits items begin on page 11. Icon to read more

Internal Revenue Service [IRS]

Coordinating Termination of Benefits with Termination of Employment

"[1] Confirm termination dates for various benefits and make sure your systems are in place.... [2] Be sure your employee handbook and benefits plan documents address the end of benefits in the same way.... [3] Understand any job abandonment provisions contained in the employee handbook to properly administer these provisions.... [4] Develop a defined process for employees returning from leaves of absence and timeline for terminating employees who fail to follow or engage in the specified process." Icon to read more

HUB International

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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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