[Official Guidance]

Text of CMS 2022 Unified Rate Review Instructions (PDF)

52 pages. "Changes in the URR instructions for 2022 are minor edits meant to improve clarity and include: [1] A more detailed explanation of the 'Benefits in Addition to EHB' field ... [2] Clarification that the risk adjustment transfer amount should include risk adjustment data validation adjustments."  MORE >>

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

[Guidance Overview]

ARPA's New COBRA Rules

"Which plans are subject to the new ARPA rules? Good question. We don't know.... [M]any employers ... just sent out required notices of the 'paused' COBRA deadlines, but that doesn't mean it's not time to send out yet another set of notices."  MORE >>

Kushner & Company

[Guidance Overview]

Free and Extended COBRA Coverage Under ARPA

"Given that there are tax credits being provided to help offset the employer's costs, and that an employer can be subject to liability for failure to offer free COBRA coverage, ... it would be wise for employers to be cautious when determining that an offer of free COBRA coverage does not have to be made because an employee's termination of employment was voluntary."  MORE >>

Squire Patton Boggs

[Guidance Overview]

COBRA, Affordability, and Dependent Care Changes Under the American Rescue Plan Act (PDF)

"[ARPA] temporarily expanded eligibility for individuals to qualify for premium tax credits when enrolling in coverage through an Exchange or Marketplace.... Employers who have been tying their affordability calculations close to the affordability threshold ... will want to pay close attention to additional guidance that may be issued."  MORE >>

Sherman Howard

[Guidance Overview]

Employee Benefits Issues Implicated by Incentivizing COVID-19 Vaccinations

"[A] COVID-19 vaccine incentive program ... will likely be considered a 'wellness program' which implicates ... issues under the Americans with Disabilities Act (ADA), Genetic Information Nondiscrimination Act (GINA) and [HIPAA]."  MORE >>

Bond, Schoeneck & King

[Guidance Overview]

Hitting the 'Reset' Button on Paid Leave Under the American Rescue Plan

"Employees who are working from home may have large accruals in their leave banks, particularly if the employer has adopted a PTO plan. An employer who voluntarily adopts FFCRA leave under [ARPA] would be required to grant 10 additional days of COVID-related sick leave beginning April 1 that may be used until September 30, 2021, on top of other available paid leave."  MORE >>

Lane Powell

[Guidance Overview]

New COVID-19 Vaccine Paid Leave for New York Employees

"The EEOC has issued guidance permitting employers to request vaccination proof from employees, with certain exceptions, but New York State has not opined on the subject to date."  MORE >>

Mintz

[Guidance Overview]

Wage and Leave Guidance Announced for Employer Vaccination Programs in Illinois

"[EEOC] published and then withdrew proposed regulations that would have endorsed only 'de minimis' incentives ... [The Illinois DOL recently] published guidance ... explicitly recommending vaccination incentives that include paid leave or other compensation covering time off to get up to two doses of the COVID-19 vaccine."  MORE >>

Armstrong Teasdale

How Insurance Policy Ambiguity Can Expand Employee Insurance Coverage

"[A recent Tenth Circuit decision about coverage under a disability plan] is a textbook illustration of the doctrine that construes ambiguities in insurance policies in favor of the insured and against the insurer." [Carlile v. Reliance Standard Life Ins. Co., Nos. 19-4123, 20-4005 (10th Cir. Feb. 22, 2021)]  MORE >>

DeBofsky Sherman Casciari Reynolds P.C.

Major Issues Continue to Linger for Employer ACA Reporting

"For any month in which the employer leaves line 16 blank instead of utilizing one of the affordability safe harbor codes it is leaving itself exposed to a potential section 4980H penalty. This is unnecessary, unacceptable, and easily correctable with the proper software."  MORE >>

Accord

Congress Guides Self-Insured Health Plans to Implement Recognized Security Practices

"While it does not mandate specific practices or establish a complete safe harbor from HIPAA enforcement, [a recent HITECH amendment] does offer organizations a chance to mitigate financial penalties and other negative regulatory actions that may result from a data breach."  MORE >>

HUB International

The 'State' of Telehealth: Utah Leading the Way

"While ... many states [have created] greater access to telehealth services in efforts to address the current public health crisis, Utah is one of the first states to expand telehealth coverage to address the mental well-being of its citizens."  MORE >>

Sheppard Mullin

COVID to Extract Double-Digit Hit to Health Plans

"A bout of COVID can cause the per-member-per-month cost of an otherwise healthy employee to jump by 163%."  MORE >>

BenefitsPro; free registration required

[Guidance Overview]

Plan Administrators, (Re)start Your Timers: Deadlines Extended by COVID Have One-Year Limit

"[P]erhaps more importantly than the deadline guidance, [EBSA Disaster Relief Notice 2021-01] notes that plan fiduciaries must make 'reasonable accommodations' to minimize the possibility of individuals losing benefits/rights because of a failure to comply with deadlines."  MORE >>

Poyner Spruill LLP

One Year Into the Pandemic, COVID-19 Fatigue Takes Hold

"Twenty-six percent of people reported symptoms of anxiety disorder, more than three times the 8 percent ... in the second quarter of 2019.... [O]ne-quarter of individuals [claimed] to have experienced [depressive disorder symptoms], up from 6.5 percent in 2019.... 76 percent say their company should be doing more."  MORE >>

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

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Coverage of Non-Employee Directors by Health Plan?

"Does covering non-employee directors under an employer-sponsored health plan make the plan a MEWA? Does it make a difference if the plan is fully insured or self-insured?"

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COVID-19 Vaccine: What Employers Should Expect

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COBRA, Flexible Spending Accounts and Other Welfare Benefit Changes – What You Need to Know (and Do) Now

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Administering and Communicating the New COBRA Subsidy

Nixon Peabody LLP

The COBRA Premium Subsidy Law: Understanding Your Compliance Obligations (PDF)

Proskauer

ARPA's COBRA Subsidies: Similar to ARRA, But Some Important Differences

Eversheds Sutherland