Health & Welfare Plans Newsletter

February 12, 2021

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[Guidance Overview]

Arbitration Provisions of the Federal No Surprises Act

"The Act sets forth a detailed procedural process for providers and payors to elect to arbitrate out-of-network payment disputes, delineating: [1] the arbitration style; [2] much of the criteria for arbitrators to consider; [3] cost shifting to the losing party; [4] how cases may be batched for arbitration; and [5] public reporting of arbitration outcomes."

K&L Gates

Court Dismisses Putative COBRA Class Action

"The District Court concluded that the plaintiff's failure to identify a concrete and particularized injury that was fairly traceable to any alleged defect in the COBRA notice deprived plaintiff of standing to sue." [Carter v. Southwest Airlines Co. Bd. of Trustees, No. 20-1381 (M.D. Fla. Dec. 14, 2020)]

Holland & Knight

Seventh Circuit Rules USERRA May Require Employers to Provide Paid Military Leave

"[The court] held that USERRA requires employers to provide short-term paid military leave, if they provide paid leave for comparable non-military absences, such as for jury duty or bereavement leave.... The potential impact of [this] decision on employers with large reservist workforces is significant, as the denial of paid leave is a prime candidate for class action treatment." [White v. United Airlines, Inc., No. 19-2546 (7th Cir. Feb. 3, 2021)]

Akin Gump

Federal District Court Order Provides Guidance for Disciplining Employees Who Abuse Leaves of Absence

"The court did not find a pattern of antagonism ... The court found that DuPont had stated a legitimate, nondiscriminatory reason for surveilling Snyder, noting that several employees had cast doubt on her disability leave[.]" [Snyder v. E.I. DuPont de Nemours, Inc. and Company, No. 18-1266 (D. Del. Feb. 5, 2021)]

Ogletree Deakins

Effects of Employer-Offered High-Deductible Plans on Low-Value Spending in the Privately Insured Population

"[F]irm offer of a high-deductible plan leads to a 13.7% ($5.23) reduction in average enrollee spending on low-value outpatient services and a 5.2% ($105.77) reduction in overall outpatient spending.... [O]ffering high-deductible plans disproportionately reduces low-value spending relative to overall spending, indicating that deductibles may be a way to incentivize value-based decision making."

RAND Corporation

Impact of Consumer-Directed Health Plans on Low-Value Healthcare

"Switching to a CDHP was associated with a $231.60 reduction in annual outpatient spending; however, no significant reductions were observed in annual spending on the 26 low-value services or on these low-value services relative to overall outpatient spending ... CDHPs in their current form may represent too blunt an instrument to specifically curtail low-value healthcare spending."

RAND Corporation

Biden Justice Department Formally Changes Positions in ACA Supreme Court Case

"The letter is unlikely to have a substantive impact on the Court's decision ... Briefing has long been complete, and oral argument was held three months ago ... The ACA was well defended by a coalition of Democratic attorneys general ... Even so, the Biden administration clearly felt it was important to make its position known to the Court." [California v. Texas, No. 19-840; Texas v. California, No. 19-1019 (cert. pet. granted Mar. 2, 2020; oral arg. Nov. 10, 2020)]

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David Rhett Baker, J.D., Editor and Publisher
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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2021 BenefitsLink.com, 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 BenefitsLink.com, 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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