Health & Welfare Plans Newsletter

December 28, 2020

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[Guidance Overview]

Upcoming Deadline iconJanuary 1, 2021 Deadline for Hospitals to Make Transparency Clear

"Effective January 1, 2021, hospitals operating in the United States are required to have detailed pricing information prominently displayed on their websites. They must post their standard charges online. Standard charges are 'the regular rate[s] established by the hospital for an item or service provided to a specific group of paying patients.' ... These include the hospital's gross charges, payer-specific negotiated charges, de-identified minimum and maximum negotiated charges, and discounted cash prices." Icon to read more

Akerman

[Guidance Overview]

DOL's FFCRA Regs: Three Takeaways for Employers

"[T]he DOL has been actively pursuing employees' individual and collective claims based on the FFCRA.... Employers may require employees to provide documentation of their FFCRA leaves at (or around) the same time they provide notice of their FFCRA leave ... Employees are not entitled to FFCRA leave during furlough or days when work is not available.... Employers may, at their option, offer intermittent FFCRA leaves to employees who are either (a) teleworking or (b) taking leave based on a school closure or childcare unavailability." Icon to read more

Hall Benefits Law

[Guidance Overview]

Upcoming Deadline iconColorado Employers Receive a Holiday 'Gift' in the Form of More Paid Sick Leave for 2021

"[Recent Colorado] guidance includes two unexpected interpretations: [1] Employers of all sizes must provide Public Health Emergency Paid Sick Leave in 2021; and [2] Employers must provide up to 80 hours of Public Health Emergency Paid Sick Leave in 2021 regardless of whether they already supplied paid leave related to COVID-19 in 2020." Icon to read more

Fisher Phillips

Exceptional Usefulness and Quality iconHoliday Surprise for Health Care Providers: Spending Package Includes Surprise Billing Fix

"Most of the new requirements take effect with plan years beginning January 1, 2022, and they apply to group health plans (including self-insured plans) and health insurance issuers of group and individual plans.... The new law includes some 'wins' for providers and is intended to bring greater certainty to providers, payers and patients regarding out-of-network reimbursement." Icon to read more

Hall Render

2020 in Review: PBMs Continue Integration, Face More Regulatory Challenges

"The PBM space has consolidated to the point that five firms ... manage the lion's share of the pharmacy benefits offered to U.S. health plan members. Beyond their deepening integration with the payers that own them, these firms are working to expand their data and direct-to-consumer operations." Icon to read more

AISHealth

Open the Floodgates: Supreme Court Decides ERISA Does Not Preempt Arkansas State Law Regulating PBMs

"Many view the ruling as a blow to PBMs, as PBMs have often taken the position that ERISA preempts the myriad of state laws seeking to regulate PBM practices, particularly with respect to PBMs' negotiated rates with pharmacies. This decision will likely pave the way for a flood of new state-level PBM regulating legislation in 2021 and beyond. In the meantime, the Supreme Court's decision in this case is instructive when analyzing whether ERISA preempts certain state laws regulating PBMs." [Rutledge v. Pharmaceutical Care Mgmt. Assoc., No. 18-540 (S. Ct. Dec. 10, 2020)] Icon to read more

Hall Render

Benefits in General

[Guidance Overview]

Exceptional Usefulness and Quality iconYear-End COVID-19 Stimulus Legislation Becomes Law, Includes Numerous Employee Benefit and Executive Compensation Provisions

"The Act includes numerous provisions affecting health and welfare plans -- including, most notably, extensive group health plan requirements on surprise medical billing ... The Act requires plans and insurers to provide price comparison tools by telephone and through the plan's website.... Under the Act, for plan years ending in 2020, health flexible spending arrangements (health FSAs) and dependent care FSAs may permit participants to carry over any unused amounts or contributions from the 2020 plan year to the plan year ending in 2021.... The Act expands the ERISA Section 408(b)(2) service provider compensation disclosure rules to group health plans....

"The Act includes the following retirement plan-related provisions: [1] Permits distributions to individuals in certain industries during working retirement. [2] Provides temporary relief from the partial plan termination rules. [3] Provides special disaster relief for distributions and loans from qualified retirement plans. [4] Clarifies the applicability of coronavirus-related distributions and loans to money purchase pension plans. [5] Provides relief for defined benefit plans relating to certain 'qualified future transfers." Icon to read more

Thomson Reuters Practical Law

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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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