[Guidance Overview]
"[E]mployers with calendar-year plans can't rely on the higher [federal poverty levels (FPLs)] for 2021 affordability testing. Instead, calendar-year plan sponsors must use the 2020 FPL amounts.... [T]he 2021 FPL safe-harbor monthly employee contribution limits for the lowest-cost, self-only [minimum essential coverage (MEC)] with minimum value [are]: Noncalendar-year plans beginning in 2021: $105.51 ... 2021 calendar-year plans: $104.53[.]"
Mercer
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[Guidance Overview]
"Because the FMLA requires the employee to actually perform work to earn the hours necessary to be eligible for FMLA leave, it means that furloughed hours do not count toward eligibility. It also means the employee who was forced off work due to symptoms of COVID-19 was not actually working for the employer. The result remains the same even if you paid the employee for the time they took (or were forced) off work."
FMLA Insights
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[Guidance Overview]
"The Biden-Harris Administration will open a Special Enrollment Period for Americans to sign up for health coverage and roll back attacks on the [ACA], Medicaid, and access to reproductive health care."
The White House
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[Guidance Overview]
"Beginning in 2021, employers sponsoring a group health plan with employees who are residents of California enrolled in the plan will be subject to the new California individual mandate reporting requirements. These employers must ... furnish Forms 1095-C to employees by February 1, 2021. The same IRS Form 1095-C provided to individuals under the [ACA] will satisfy California's requirement. While the IRS extended the federal deadline to March 2, 2021 ... California has not extended its deadline."
Miller Johnson
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[Guidance Overview]
"While the proposed rules ultimately may be revised before being finalized, they provide insight into the EEOC's perspective on defining incentives under a participatory wellness program in order for those incentives to be considered voluntary."
Calfee, Halter & Griswold LLP
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[Guidance Overview]
"Now that the leave requirements of the FFCRA (and by extension, California state required supplemental sick leave) have expired, many local agencies are reviewing the supplemental sick leave ordinances that were adopted in 2020. Some agencies have extended the date by which employees may use benefits so that the ordinances have survived beyond the expiration of the FFCRA. Others have expanded the scope of local ordinances to provide for leave for all employees who work in that jurisdiction, not just employees who were previously excluded from the FFCRA."
Jackson Lewis P.C.
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"[T]he court found that the Security Rule did not require M.D. Anderson to have a 'bulletproof' mechanism, nor was it required to enforce the mechanism 'rigorously.' ... Under the court's pained interpretation of the Privacy Rule, M.D. Anderson's loss of ePHI via theft and loss did not qualify as a disclosure.... [T]he court held that the regulation required OCR to prove that someone outside the covered entity actually received the ePHI, and that OCR had failed to do so here." [Univ. of Texas M.D. Anderson Cancer Center v. HHS, No. 19-60226 (5th Cir. Jan. 14, 2021)]
McGuireWoods
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"In these consolidated cases, a coalition of entities affiliated with the Catholic Church and the State of North Dakota challenged the implementation of Section 1557 of the [ACA] contending that the [HHS and the EEOC] interpreted Section 1557 and related antidiscrimination laws in a way that compelled them to perform and provide insurance coverage for gender transitions and abortions.... The court concluded that RFRA entitled the Catholic Plaintiffs to permanent injunctive relief from the provision or coverage of gender-transition procedures." [Religious Sisters of Mercy v. Azar, No. 16-0386 (D.N.D. Jan. 19, 2021)]
Kantor & Kantor
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"[T]he Court found that the employer had discretionary control over participant contributions since the contributions were deposited in an employer account. It found that the owner was a fiduciary because, at the time the health plan lapsed, he was the only one with authority over the company's bank accounts ... Instead of paying the health bill, the Court determined that the company's funds (including the participant contributions) were used to pay corporate expenses. The Court found this use of participant contributions was a breach of fiduciary duty by the company and the primary owner." [Hammer v. Johnson Senior Ctr., No. 19-027 (W.D. Va., Nov. 30, 2020)]
HUB International
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"On Thursday, January 14, 2021, President Biden's administration announced ... its proposed $1.9 trillion COVID-19 stimulus relief plan.... [which] proposes to require all employers of any size to provide paid leave and to significantly extend the required paid sick and family leave benefits to essentially all workers through September 30, 2021. The new administration estimates the Plan could provide emergency paid leave to an additional 106 million Americans. To implement coverage, the Plan will impose substantial new burdens on employers by removing prior exemptions under the FFCRA."
Husch Blackwell
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"2018 drug prices in the United States were substantially higher than those in each of 32 comparison countries when considering all drugs together. Compared with all comparison countries combined, U.S. prices were 256 percent of those in other countries.... U.S. prices for most subsets of drugs, and particularly brand-name originator drugs, were higher than those in comparison countries. The one exception was unbranded generic drugs, for which U.S. prices were on average 84 percent of those in other countries."
RAND Corporation
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"New Jersey's struggling small businesses have prioritized paying for employee health insurance premiums as the country faced its biggest public health crisis in modern history. Now small employers who purchase insurance through Members Health Plan NJ are looking at a 5.5 percent monthly COVID surcharge -- and it has prompted Assemblyman Kevin J. Rooney to sound the alarm."
InsiderNJ
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[Opinion]
"Given the magnitude of the Medicare HI Trust Fund shortfall, a combination of revenue increases and spending reductions may be necessary to avoid policies that would increase the financial burden on beneficiaries or have an adverse effect on financially fragile health care institutions such as rural hospitals."
JAMA Network
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