[Guidance Overview]
"HHS finalized allowing states to end state-sponsored online enrollment portals (e.g., opt out of Healthcare.gov) and allow for enrollees to only have the ability to enroll into an on-Exchange plan through direct enrollment (DE) entities.... HHS lowered user fees to issuers to 2.25% for issuers in the Federally-facilitated Exchanges (FFE) and 1.75% in State-based Exchanged that utilize the Federal Platform (SBE-FPs).... HHS incorporated its 2018 guidance on 1332 Waiver into regulation."
Wakely Consulting Group
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[Guidance Overview]
"The extension is effective retroactively from December 31, 2020 -- the law's original sunset date -- through the end of the city's COVID-19 Emergency Declaration, unless the city council further extends the law. As an emergency ordinance, the amendment takes effect immediately."
Littler
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[Guidance Overview]
"SB 855 ... expand[s] state coverage requirements for mental health and substance use disorder services, and it requires health plans and insurers to adopt a standardized definition of 'medical necessity' for those treatments. [All Plan Letter 21-002] provides an overview of SB 855, identifies clinical criteria and guidelines that health plans must apply when determining the medical necessity of behavioral health treatments under the new law, and outlines compliance filing requirements."
Manatt, Phelps & Phillips, LLP
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[Guidance Overview]
"New Jersey will require all businesses that provided both fully-insured and self-funded health coverage to New Jersey residents in 2020 to file detailed coverage information with the state to help enforce it by March 31, 2021. They also need to send coverage documentation statements to covered state residents by March 2, 2021."
OneDigital Health and Benefits
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[Guidance Overview]
"February 5, 2021 is the deadline for Michigan public school districts to submit a Form 2848 to the State of Michigan Office of Retirement Services to participate in and be covered by the proposed IRS closing agreement related to 3% retiree healthcare contributions. Michigan public school employees who did not opt out of retiree health coverage under the Michigan Public School Employees Retirement System Act are required to make 3% contributions to ORS for retiree health coverage.... For a limited time, the IRS is allowing Michigan public school districts to participate in a closing agreement that favorably resolves the tax treatment of these contributions. The IRS indicated that the closing agreement will provide that the retiree healthcare contributions are exempt from federal income and FICA taxes."
Miller Johnson
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"This enforcement fact sheet summarizes EBSA's and CMS's investigations and public inquiries related to MHPAEA during FY 2020.... EBSA and CMS investigated MHPAEA violations in the following categories: [1] Annual dollar limits ... [2] Aggregate lifetime dollar limits ... [3] Benefits in all classifications ... [4] Financial requirements ... [5] Treatment limitations ... [6] Cumulative financial requirements and QTLs."
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]
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"Although this case is still working its way through proceedings, this strongly worded opinion calls into question some fundamental principles of OCR's enforcement approach. For example, OCR has consistently asserted that an unauthorized disclosure occurs whenever PHI is publicly accessible through an internet search--regardless of whether it can demonstrate that anyone actually accessed the PHI in that way. It will be harder for OCR to establish privacy rule violations if it has to prove that an unauthorized recipient actually accessed PHI." [Univ. of Texas M.D. Anderson Cancer Ctr. v. HHS, No. 19-60226 (5th Cir. Jan. 14, 2021)]
Thomson Reuters / EBIA
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"The U.S. Court of Appeals for the Ninth Circuit recently became the seventh federal appellate court to hold that the standard for 'willful' violations under the Family and Medical Leave Act is whether the employer knows or shows reckless disregard for whether its conduct violates the FMLA." [Olson v. United States, No. 19-35389 (9th Cir. Nov. 23, 2020)]
Seyfarth
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"When compared from March to November, 30% of centers have higher utilization ... Telephonic COVID-19 screening has remained high with 83% in November and 86% in March supporting this service.... 97% intend to either offer onsite vaccinations or will work with vendors and local health departments in getting their employees protected against COVID-19. Over 60% see their centers expanding telehealth and other services in the future."
National Association of Worksite Health Centers [NAWHC]
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Benefits in General
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[Guidance Overview]
110 presentation slides. Topics: [1] Permitted changes to health FSAs and dependent care FSAs. [2] No Surprises Act. [3] Transparency. [4] Qualified disaster-related relief provisions. [5] New COVID-19 pandemic-related relief provisions.
Trucker Huss
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