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[Guidance Overview]

EEOC Proposes New Rules for Permissible Level of Incentives in Health-Contingent Workplace Wellness Programs

"[T]he EEOC's Proposed Rules, with limited exception discussed below, permit employers that wish to incentivize participation in health-contingent wellness programs to use only an exceedingly small carrot.... Employers will still need to consider whether the de minimis incentives they offer for wellness program participation fall within the tax exclusion for de minimis fringe benefits, or other tax exclusion." Icon to read more

Epstein Becker Green

[Guidance Overview]

Summary of Select Provisions of HHS' Final 2022 Notice of Benefit and Payment Parameters (PDF)

"HHS finalized allowing states to end state-sponsored online enrollment portals (e.g., opt out of 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." Icon to read more

Wakely Consulting Group

[Guidance Overview]

Oakland, California Retroactively Extends Emergency Paid Sick Leave Ordinance

"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." Icon to read more


[Guidance Overview]

California Issues APL on Implementing Senate Bill 855

"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." Icon to read more

Manatt, Phelps & Phillips, LLP

[Guidance Overview]

Upcoming Deadline iconNew Jersey Requires Reporting by Any Employer That Provides Health Insurance to State Residents

"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." Icon to read more

OneDigital Health and Benefits

[Guidance Overview]

Upcoming Deadline iconUpcoming Deadline for Michigan Public Schools to Participate in Proposed IRS Closing Agreement on 3% Retiree Healthcare Contributions

"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." Icon to read more

Miller Johnson

EBSA Report on MHPAEA Investigations for Fiscal Year 2020 (PDF)

"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." Icon to read more

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

Fifth Circuit Criticizes OCR's HIPAA Enforcement Process, Vacates $4.3 Million Civil Penalty

"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)] Icon to read more

Thomson Reuters / EBIA

Majority of Federal Courts Now Agree on Standard for Willful Violations of FMLA

"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)] Icon to read more


Employer Onsite Clinics Willing and Able to Do Vaccinations, See Increase in Behavioral Health and Telehealth Services (PDF)

"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." Icon to read more

National Association of Worksite Health Centers [NAWHC]

Benefits in General

[Guidance Overview]

Exceptional Usefulness and Quality iconConsolidated Appropriations Act, 2021: Understanding the Health & Welfare and Retirement Provisions (PDF)

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. Icon to read more

Trucker Huss

Press Releases

Most Popular Items in the Previous Issue

Text of CMS Extension of Non-Enforcement of ACA-Compliance with Respect to Certain Policies (PDF)
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

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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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