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[Official Guidance]

Text of HHS Final Regs: Notice of Benefit and Payment Parameters for 2022; Updates to State Innovation Waiver (Section 1332 Waiver) Implementing Regulations

"This final rule sets forth provisions related to user fees for federally-facilitated Exchanges and State-based Exchanges on the Federal Platform. It includes changes related to acceptance of payments by issuers of individual market Qualified Health Plans and clarifies the regulation imposing network adequacy standards with regard to Qualified Health Plans that do not use provider networks. It also adds a new direct enrollment option for federally-facilitated Exchanges and State Exchanges and implements changes related to section 1332 State Innovation Waivers.... This final rule addresses only a subset of the policies and proposed regulatory revisions addressed in the proposed 2022 Payment Notice[.]" Icon to read more

Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS], and U.S. Department of the Treasury

[Guidance Overview]

Surprise Medical Billing Protections Coming in 2022

"Why do participants get surprise medical bills? ... What is the difference between a participating provider and a nonparticipating provider? ... Under what circumstances will the CAA shield participants from surprise medical bills? ... How will disagreements between plans and nonparticipating providers be resolved? ... Can a nonparticipating provider ask a participant to waive surprise medical billing protections? ... Now what?" Icon to read more


[Guidance Overview]

Top Considerations for Adopting FSA Funding Relief

"Employers have flexibility to implement and tailor one or more of the available options.... Some administrators have adopted the rules unless employers opt out of them. Pay attention to communications from your administrators to ensure you do not lose flexibility ... [1] Carryover eligibility.... [2] Amount.... [3] HSA eligibility.... [4] Ordering rules.... [5] Aged-out dependents.... [6] COBRA considerations.... [7] Fiscal year plans.... [8] Employee communications.... [9] Plan amendments." Icon to read more

Society for Human Resource Management [SHRM]; membership may be required to view article

[Guidance Overview]

New Year, New CMS Price Transparency Rule for Hospitals

"[CMS] has promulgated a new rule for hospital pricing, effective January 1, 2021, that would require disclosure of a wide range of hospital prices. This blog post reviews the history, requirements, and scope of the CMS rule, industry criticisms of the rule and the lawsuit challenging it, and the prospects for compliance. While the CMS rule will not single-handedly normalize health care pricing, it at least promises to make it more transparent." Icon to read more

Health Affairs Blog

Cost Comparison of Two Approaches to Chiropractic Care for Patients with Acute and Sub-Acute Low Back Pain Care Episodes

"[This study] compared cost outcomes for patients of two cohorts of chiropractors within health care system: Cohort 1 a general network of providers, and Cohort 2 a network providing conservative evidence-based care for rapid resolution of pain.... In general, providers in Cohort 2 were found to be significantly associated with lower costs for patient care as compared to Cohort 1. Utilization of a clinical model characterized by a patient-centered clinic approach and standardized, best-practice clinical protocols may offer lower cost when compared to non-standardized clinical approaches to chiropractic care." Icon to read more

Chiropractic & Manual Therapies

2020 Progress Report for HERO Health and Well-Being Best Practices Scorecard (PDF)

36 pages. "Most employers are aware that a comprehensive approach is needed to improve the effectiveness of workplace health and well-being initiatives, but it can be overwhelming for employers to try to tackle all of the practices listed on the HERO Scorecard at once. This study recognizes the critical role of organizational and leadership support in driving successful initiatives, and this article identifies ten specific strategies employers can focus on to ensure they are getting the most value from their investment in employee health and well-being." Icon to read more


Modeling the Effects of Health Plan Enrollee Choice

"This study uses health care encounter data to simulate the choices faced by health insurance shoppers under a variety of conditions and measures the simulated effect of increased consumer choice and consumer information on medical loss ratios and, as a consequence, insurer profitability." Icon to read more

Society of Actuaries

Benefits in General

Top Employee Benefits Trends for 2021 (PDF)

"[1] Workplace giving and volunteer programs to help employees support their community and the causes important to them.... [2] Increased help with student debt for women, employees of color.... [3] Resources to help employees create an emergency savings fund.... [4] More self-directed brokerage windows in 401(k) and 403(b) plans.... [5] Broader support for employee total well-being with an increased focus on employee caregiving roles.... [6] Emotional/mental health support for employees in a 'virtual' work environment." Icon to read more

Fidelity Investments

DOL Appoints New Members to the 2021 ERISA Advisory Council

"The appointees and the expertise they represent are: [1] Employers: Megan Broderick is Senior Director for Global Retirement and Financial Wellbeing at PepsiCo.... [2] Corporate Trust: Dave Gray is Head of Workplace Retirement Offerings and Platforms at Fidelity Investments.... [3] General Public: Mercedes D. Ikard is Director of Retirement Planning for Atrium Health.... [4] Employee Organizations: Anthony Marc Perrone is the International President of the United Food and Commercial Workers International Union (UFCW).... [5] Investment Management: Edward A. Schwartz is President of Schwartz & Co., a registered investment advisor and broker-dealer.... Current member Glenn Butash will serve as the chair of the 2021 Council. Butash is Managing Counsel, U.S. Compensation and Benefits, at Nokia.... Current member James Haubrock will serve as the vice chair of the council. Haubrock is a shareholder with Clark Schaefer Hackett." Icon to read more

Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

Press Releases

McGivney, Kluger, Clark & Intoccia, P.C. Welcomes Jose M. Jara
McGivney, Kluger, Clark & Intoccia, P.C.

OneDigital Acquires Area Financial Services
OneDigital Health and Benefits

OneDigital Acquires Vertical Financial Group
OneDigital Health and Benefits

Most Popular Items in the Previous Issue

Updated Summary Report of 2017 Benefit Year Risk Adjustment Data Validation Adjustments to Risk Adjustment Transfers (PDF)
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

View COVID-19 News and Resources, Inc.
56 Creeksong Road
Whittier, North Carolina 28789
(407) 644-4146

Lois Baker, J.D., President
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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