Health & Welfare Plans Newsletter

December 9, 2020

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View job as Retirement Plan Administrator for Carpenter Morse Group
View job as Retirement Plan Administrator for Carpenter Morse Group Retirement Plan Administrator

Carpenter Morse Group
Telecommute / Longwood FL

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TRA, Inc.
Telecommute

View job as Plan Document / Compliance Specialist for PCS Retirement Plan Document / Compliance Specialist

PCS Retirement
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PCS Retirement
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View job as Senior Pension Administrator for Associated Pension Consultants, Inc. Senior Pension Administrator

Associated Pension Consultants, Inc.
Telecommute / Plainview NY

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[Guidance Overview]

Exceptional Usefulness and Quality and Usefulness iconThe Dreaded IRS '226-J' Letter -- Why an Employer Might Get One and How to Respond

"While a 226-J letter contains a proposed penalty amount, it is not a bill. It's merely an estimate of what the IRS thinks a business might owe. If a company agrees with their assessment, they can pay it right away, but the proposed penalty amount is not final. The information and estimates offered in 226-J letters are also not guaranteed to be accurate. Proposed penalty amounts are often wrong, and there is a straightforward process for employers to respond to the IRS." Icon to read more

MZQ Consulting, LLC

[Guidance Overview]

Upcoming Deadline iconMassachusetts Paid Family and Medical Leave and Benefits Available to Employees on January 1

"Beginning on January 1, 2021, Massachusetts employees will be eligible for up to 26 weeks per year of paid leave ... Employees may take paid leave for their own serious health conditions, to bond with a child, to manage family affairs while a family member is on active duty, and to care for a family member who is a covered service member.... [E]mployers should take immediate steps to make sure they are complying with the MPFML, including implementing leave policies, updating handbooks, and submitting private plan exemption applications." Icon to read more

Morgan Lewis

[Guidance Overview]

Upcoming Deadline iconEmployers with Pittsburgh-Based Employees Face New Requirements to Provide COVID-19-Related Paid Sick Leave

"With the federal [FFCRA] set to expire on December 31, 2020, absent an extension by the federal government, the Ordinance appears to be the City's effort to provide paid leave rights for qualifying reasons relating to COVID-19. However, the Ordinance considerably exceeds the FFCRA in the scope of covered employers." Icon to read more

Reed Smith

Appeals Court Rules Insurer and PBM Are Not Fiduciaries When Setting Drug Prices

"The Second Circuit ... dismissed an appeal by the plaintiffs in a consolidated class action suit against Anthem Inc. and Express Scripts Inc. that alleged the defendants violated their fiduciary responsibilities under [ERISA], instead ruling that health companies are not acting as ERISA fiduciaries when setting prescription prices. The plaintiffs originally alleged that an agreement between the two defendants resulted in higher drug prices, the costs of which they say were passed on to beneficiaries of the company's ERISA benefits plan." [Doe v. Express Scripts, No. 18-346 (2d Cir. Dec. 7, 2020)] Icon to read more

Law|Street

Health Insurer and PBM Did Not Breach ERISA's Fiduciary Duties in Setting Prescription Drug Prices

"The ability to set prescription drug prices, the Second Circuit reasoned, was a contractual provision -- not the ability to exercise authority over plan assets. Affirming, the Second Circuit agreed with the district court that a PBM does not exercise discretionary authority in a manner that triggers ERISA fiduciary status when it sets prescription drug prices pursuant to contractual terms." [Doe v. Express Scripts, No. 18-346 (2d Cir. Dec. 7, 2020)] Icon to read more

Thomson Reuters Practical Law

The 2019 Health Insurance Medical Loss Ratio and Rebates Results: A Brief Summary

"[This report] summarizes key findings from the HHS report, with a focus on health plan performance as it relates to the Medical Loss Ratio and related rebates due to customers.... For 2019, Texas led the country with nearly $280 million in MLR rebates, a significant increase from $93 million in 2018. While Missouri was not the top state for rebate disbursements, the total amount of Missouri's rebates represented a high percentage of total adjusted premiums at 2.8%, up from 0.87% in 2018. " Icon to read more

Mark Farrah Associates

Benefits in General

[Official Guidance]

IRS Announces Tax Relief for Puerto Rico Severe Storm and Flooding Victims

"Victims of a severe storm and flooding on September 13, have until January 15, 2021, to file various individual and business tax returns and make tax payments ... Individuals and households who reside or have a business in Arecibo parish qualify for tax relief.... [C]ertain deadlines falling on or after September 13, 2020, and before January 15, 2021, are postponed through January 15, 2021. This includes individual and business tax filers that had a valid extension to file their 2019 return due to run out on October 15, 2020." Icon to read more

Internal Revenue Service [IRS]

Press Releases

Steidle Pension Solutions Named Best Places to Work 2020
Steidle Pension Solutions, LLC, [SPS]

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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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