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January 14, 2021 logo logo
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[Guidance Overview]

EEOC Issues New Guidance on Nondiscrimination for Wellness Programs

"The two sets of proposed regulations replace rules the EEOC withdrew in 2018 after a federal district court invalidated key provisions on incentive limits on the grounds that the EEOC had not appropriately justified the limits it set.... [If] finalized, the new rules will prohibit participatory wellness programs (programs that provide no incentive that is based on a health outcome or activity that someone may not be able to perform for health reasons) from offering more than a de minimis incentive." Icon to read more

Ballard Spahr LLP

[Guidance Overview]

Proposed Changes to Privacy Regs Would Clarify Individual Access Rights and Make Other Targeted Changes

"The proposal would require covered entities to act on access requests 'as soon as practicable' and would shorten the deadline for action from 30 to 15 days.... Health plan participants could, however, instruct their health plan to request EHRs from covered health care providers, which would then be required to disclose the requested EHRs directly to the plan.... The proposal would clarify that health plans' care coordination and case management activities -- whether based on broad populations or particular individuals -- are considered health care operations." Icon to read more

Thomson Reuters / EBIA

SCOTUS Greenlights State Regulation of Pharmacy Benefit Manager Drug Reimbursement

"The Court's decision provides a potential avenue for states to increase regulation of PBMs and other service providers that help administer ERISA-regulated group health plans ... It also lays the foundation for states to play an even greater role in regulating drug pricing and reimbursement activities of various entities involved in the pharmaceutical supply chain." [Rutledge v. Pharmaceutical Care Mgmt. Assoc., No. 18-540 (S. Ct. Dec. 10, 2020)] Icon to read more

Ropes & Gray LLP


New Year Brings More Price Hikes from Big Pharma

"Drug manufacturers have already raised the price of at least 582 brand-name drugs this year, with an average increase of 4%. Pfizer, for example, increased the prices of more than 130 drugs, including Xeljanz, a popular treatment for rheumatoid arthritis. GlaxoSmithKline raised prices on more than 30 drugs, including Zejula, a cancer treatment, while Sanofi raised prices on more than a dozen drugs." Icon to read more

America's Health Insurance Plans [AHIP]

Benefits in General

[Official Guidance]

Text of DOL Federal Civil Penalties Inflation Adjustment Act Annual Adjustments for 2021

30 pages. "This rule implements the 2021 annual inflation adjustments, as required by the Inflation Adjustment Act, for civil monetary penalties assessed or enforced by the Department, including H-2B civil monetary penalties. The Inflation Adjustment Act provides that the increased penalty levels apply to any penalties assessed after the effective date of the increase.... The cost-of-living adjustment multiplier for 2021, based on the Consumer Price Index (CPI-U) for the month of October 2020, not seasonally adjusted, is 1.01182. In order to compute the 2021 annual adjustment, the Department multiplied the most recent penalty amount for each applicable penalty by the multiplier, 1.01182, and rounded to the nearest dollar. This resulted in increases to all but four of the penalties administered by the Department." [Includes table of effective dates, penalty amounts for employee benefit plan provisions administered by EBSA, and FMLA penalties administered by WHD.] Icon to read more

U.S. Department of Labor [DOL]

[Guidance Overview]

Overview of the Consolidated Appropriations Act's Impact on Employee Benefit Plans

"[This article] is an overview of the law's key provisions affecting pension, welfare and fringe benefit programs." Icon to read more


[Guidance Overview]

Major Employee Benefit Reforms Included in COVID-19 Stimulus Package

"[T]his legislation makes the most significant changes to health plans since the [ACA], offers employers and employees additional flexibility for cafeteria plan benefits, and provides additional retirement plan relief.... Action steps for employers include: [1] Coordinate with insurers and/or third-party administrators of health plans to ensure compliance with the surprise billing rules; [2] Request ERISA Section 408(b)(2) disclosures from health plan brokers and consultants, and review those disclosures for reasonableness ... [3] Decide whether to offer some or all of the cafeteria plan and FSA relief ... [4] Evaluate whether layoffs implemented during the pandemic caused a partial plan termination; and [5] Decide whether to offer a qualified disaster distribution or loan option." Icon to read more

Spencer Fane

[Guidance Overview]

Changes to Limited-Scope Audits of Employee Benefit Plan Financial Statements Are Extended

"Initially, the new standards were to apply to audits of plan years ending on or after December 15, 2020, which means they would apply to 2020 plan year audits performed in 2021. However, due to the COVID-19 pandemic, the AICPA changed the effective date of the standards to plan years ending after December 15, 2021, extending the implementation of the standards for one year. Plan sponsors of plans subject to ERISA should be aware of the new responsibilities the standards impose on auditors, as these changes also indirectly create new responsibilities for plan sponsors." Icon to read more


Best Practices for ERISA Plan Fiduciary Governance (PDF)

"Are my delegations of authority accurate and up to date? ... Do I need a committee charter for my ERISA fiduciary committee? ... Do I have to have a committee? How many committees do I need? ... How often should my committee meet? ... Should I have minutes of the committee meetings? If so, what should they contain? ... What is the function of an ERISA appeals committee (or subcommittee), and how should one operate? ... How does my employer's board fulfill its ERISA fiduciary duty to monitor the activities of the committees? ... Should committee members get training on fiduciary duties?" Icon to read more

Winston & Strawn LLP, via Defined Contribution Insights

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David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager

BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2021, 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, 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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