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[Guidance Overview]
13 pages; Jan. 7, 2021. "CMS issued this toolkit to help health insurance issuers and Medicare Advantage plans identify the issues that need to be considered and addressed in order to provide coverage and reimbursement for vaccine administration. Because COVID-19 vaccines will be federally purchased, this toolkit primarily focuses on vaccine administration.... This toolkit: - Provides a list of operational considerations for issuers and Medicare Advantage plans as they design their approach to promoting COVID-19 vaccinations, and information on how issuers and Medicare Advantage plans can communicate with providers and enrollees on vaccinations and coverage;
- Outlines legislative and regulatory provisions applicable to issuers that ensure that enrollees can receive a COVID-19 vaccine in a convenient setting, with no out-of-pocket costs;
- Encourages
issuers and Medicare Advantage plans to implement streamlined processes to quickly administer COVID-19 vaccine coverage; and
- Describes how issuers and Medicare Advantage plans can maximize the number of their enrollees who get vaccinated once a COVID-19 vaccine becomes available."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]
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[Guidance Overview]
"What are the types of employee wellness programs under the new proposed ADA rule? ... What does it mean to be 'voluntary' under the new proposed ADA rule? ... What incentives may employers offer under the new proposed ADA rule? ... What are the confidentiality protections under the new proposed ADA rule? ... What does it mean to be 'voluntary' under the new proposed GINA rule? ... What incentives may employers offer under the new proposed GINA rule?"
Fisher Phillips
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[Guidance Overview]
"The ADA proposed rule maintains the spirit of the EEOC's basic position on voluntariness -- allowing too high an incentive would make employees feel coerced to disclose protected medical information. But, by modifying an earlier position on the ADA 'safe harbor,' the EEOC proposes to more closely harmonize its position with the ACA/HIPAA rules.... The GINA proposed rule would permit an employer to provide an incentive to employees in return for their family members' providing information about the family members' manifestation of diseases or disorders, provided that: [1] the incentive is de minimis (see discussion of ADA proposed rules), and [2] the other rules for offering health or genetic services are satisfied, including satisfying the authorization
requirement."
Jackson Lewis P.C.
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[Guidance Overview]
"The new law provides a strong incentive to covered entities and business associates to adopt 'recognized cybersecurity practices' and risk reduction frameworks when complying with the HIPAA privacy and security standards to reduce risk associated with security threats and HHS enforcement determinations."
Health Law Advisor, Epstein Becker Green
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[Guidance Overview]
"[S]ervice providers are required to disclose to a plan's fiduciary the direct and indirect compensation, including commissions and other incentive compensation they (or their affiliates and subcontractors) receive from insurance and other service providers for encouraging plan sponsors and fiduciaries to choose such providers or their products. These new requirements will apply to contracts for services executed, extended or renewed on or after December 27, 2021[.]"
Ballard Spahr LLP
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[Guidance Overview]
"Whether employers elect to continue offering EPSL or EFML, they should keep in mind the interplay with paid COVID-19-related leave under state and local law, as well as paid and unpaid leaves available under the [FMLA] ... Where state and local laws provide paid leave for reasons that overlap with the FFCRA, it makes sense for employers to continue to offer EPSL and EFML in order to obtain the payroll tax credit that is not available when leave is provided only under state or local law. Employers should be sure to designate the leave as EPSL/EFML in such circumstances, and properly document it."
Brownstein Hyatt Farber Schreck LLP
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Article provides links to a dozen compliance guides covering various aspects of health plan benefit design and administration.
ABD Insurance & Financial Services
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Benefits in General
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[Guidance Overview]
"The DOL's new rule seeks to streamline the fact-intensive determination of independent contractor status. The rule: [1] revises the 'economic reality' test, which has long been used by the DOL to distinguish FLSA-covered employees from independent contractors, to specify how the factors should be weighed; [2] clarifies that determining economic dependence turns on whether a worker is in business for himself or herself or is economically dependent on an employer for work; [3] modifies the DOL's approach to what it means to be part of an integrated production process; and [4] provides that the parties' actual practice is more relevant than what is contracted for or theoretically
possible."
Ballard Spahr LLP
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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2021 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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