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Health & Welfare Plans Newsletter January 8, 2021 |
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Newly Posted Getting the Most for Your Money: Auditing Your Employee Benefits Program
Heath Savings Accounts (HSAs) - How Can Three Little Letters be so Complicated?
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Discussions |
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This Newsletter:
BenefitsLink Retirement Plans Newsletter:
Message Boards Digest:
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[Guidance Overview]
"The 2021 Consolidated Appropriations Act that ... requires group health plans to evaluate compliance under the federal [MHPAEA] with regard to specific types of treatment limits imposed on mental health and substance use disorder benefits and to maintain written documentation of the analysis performed to ensure compliance under MHPAEA. On and after February 10, 2021, group health plans will be required to make such compliance documentation available to federal regulators upon request. This new law also requires federal regulators to review such MHPAEA compliance analysis from at least 20 different group health plans every year, and institute a formal process where noncompliance is found, including a corrective action period for plans." Mercer |
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[Guidance Overview]
"Section 203 of the Act parallels compliance requirements that already exist in some states and that have been urged on regulators by several prominent behavioral health advocacy groups. Nonetheless, the fact that states have already tested out these requirements does not mean plans or issuers will be able to comply with the new federal requirements easily." Manatt, Phelps & Phillips, LLP |
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[Guidance Overview]
"[1] Removal of gag clauses on price and quality information ... [2] Disclosure of compensation to brokers and consultants ... [3] Mental health parity and substance use disorder benefits ... [4] Reporting on pharmacy benefits and drug costs." Society for Human Resource Management [SHRM]; membership may be required to view article |
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[Guidance Overview]
"To date, approximately 22 states have enacted protections against surprise billing.... [S]tates cannot regulate ERISA health plans and thus cannot fully protect all consumers. The No Surprises Act will therefore extend surprise billing protections to ERISA plan beneficiaries, as well individuals in states without protections.... [S]tates are explicitly empowered to enforce the No Surprises Act and if they do so, they will be the primary mechanism of enforcement." Proskauer |
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[Guidance Overview]
"[T]he text of the act requires consideration of several factors that payers have long argued should be the basis for resolving payment disputes. These payer-favored provisions are paired with some provider-favored provisions on top of an [independent dispute resolution (IDR)] process designed to incentivize both sides to come to a meaningful compromise." Manatt, Phelps & Phillips, LLP |
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[Guidance Overview]
"On December 29, 2020, the [DOL] issued two guidance documents addressing: [1] telemedicine visits as qualifying treatment visits under the Family and Medical Leave Act (FMLA), and [2] satisfaction of FMLA workplace posting requirements through electronic notifications. The new requirements reflect the evolving workplace landscape, support social distancing and infection control efforts, and facilitate the availability of health care." Ballard Spahr LLP |
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[Guidance Overview]
"On January 5, 2021, California's 2021 emergency paid sick leave landscape became clearer as San Jose enacted a revised emergency paid sick leave ordinance, and Los Angeles County directed staff to prepare a proposal to revise its currently expired ordinance. Additionally, officials in Santa Rosa and Oakland have calendared discussions concerning what to do with their expired laws." Littler |
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[Guidance Overview]
"The recently revised guidance from the DFML applies to intermittent and reduced schedule leaves taken for the employee's own serious medical condition or for qualifying exigency leaves.... For these types of leaves, the minimum increment when taking intermittent leave may not exceed one hour. The rule will apply in this manner for both public and private plans." OneDigital Health and Benefits |
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"The Report examines OCR's findings from HIPAA audits the agency conducted during 2016-2017 of 166 healthcare providers and 41 business associates.... Based on ... the results from the audits, the Report concludes covered entities generally demonstrated compliance in only two of the seven areas audited: [1] timeliness of breach notification and [2] prominent posting of the notice privacy practices on their websites." Jackson Lewis |
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"Prior to the pandemic, some states had policies in place to control health care prices directly. With provider consolidation likely to continue in the coming months, these policies will become increasingly important to protect consumers from the effects of large price increases.... [1] Policies to control prices through cost growth benchmarks ... [2] Policies to limit hospital prices directly ... [3] Policies to limit hospital price growth ... [4] A combined approach." Health Affairs Blog |
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Press Releases |
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Most Popular Items in the Previous Issue |
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Text of EEOC Proposed Rule: Amendments to Regs Under the Americans with Disabilities Act
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Plan Sponsors Face a Tough Year for Compliance (PDF)
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EEOC Provides Proposed Wellness Rules for Review
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