[Official Guidance]

Interim Summary Report on Risk Adjustment for the 2020 Benefit Year (PDF)

11 pages. "[T]he data released in this report may be useful to issuers seeking additional information about the progress of the risk adjustment program prior to publication of the annual summary report ... This report also contains data, such as billable member months and statewide average premiums, which may have utility beyond risk scores or risk adjustment. " [Also available: Appendix A: Interim 2020 Benefit Year Risk Adjustment State Averages with State Billable Member Months (XLSX) and Appendix B: HHS-operated Interim 2020 Benefit Year Risk Adjustment Geographic Cost Factor (GCF) (XLSX)]  MORE >>

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

[Guidance Overview]

COBRA Subsidies in COVID-19 Rescue Plan Require Employer Action

"The COBRA subsidy program requires immediate employer action, including creating subsidy-related notices, coordinating with vendors and insurers, revising COBRA notice and payroll processes, and deciding whether to offer subsidy-eligible individuals the option to move to less expensive coverage. Important dates are noted in [a] timeline."  MORE >>

Mercer

[Guidance Overview]

No Fooling Around: New Six-Month COBRA Subsidy Starts April 1, Requires Immediate Action

"[O]nly the portion of the COBRA premium otherwise payable by an AEI is eligible for the subsidy. This means that any additional subsidy voluntarily provided by a plan sponsor is ignored ... [P]lan sponsors will need ... to make certain that there otherwise is adequate consideration for any applicable separation agreements entered into by a terminating employee."  MORE >>

Brownstein Hyatt Farber Schreck LLP

[Guidance Overview]

'Free' COBRA for Some Employees: Employers May Benefit, Too

"[It] appears that employers would claim the credit on their quarterly IRS Form 941 or in advance on IRS Form 7200 if the actual or estimated amount of the credit exceeds the employer's Medicare taxes for any calendar quarter.... Social Security taxes may not be available as a source for the new COBRA tax credits, since the ARP was enacted under budget reconciliation rules which prohibit any changes to Social Security."  MORE >>

Berry, Dunn, McNeil & Parker, LLC

[Guidance Overview]

Does FFCRA Leave Exhaust FMLA Leave?

"[T]he employer might consider choosing to provide 10 days of EPSL only, and not EFML, which ensures its risk is effectively zero.... As to whether EFML should count against FMLA classic leave, the employer must determine its risk tolerance."  MORE >>

FMLA Insights

[Guidance Overview]

Personal Protective Equipment Now FSA/HRA/HSA Eligible Medical Expense

"This addition is optional for the health FSA and HRA, and therefore employers must amend the plans if they would like them to reimburse employees' COVID-19 PPE expenses.... [No] amendment is required to an HSA because ... the ability to reimburse COVID-19 PPE on a tax-free basis applies automatically by virtue of its inclusion under Section 213(d)."  MORE >>

ABD Insurance & Financial Services

Equitable Relief Available to Participant's Estate May Equal the Cost of Forgone Heart Transplant

"The magistrate reasoned that if plaintiff were successful in proving that the defendants breached their fiduciary duties in the dilatory manner in which they processed Mr. Holman's claims as he was dying, surcharge in the amount that the PSA Defendants were unjustly enriched -- presumably equal to the cost of the heart transplant -- could be an available remedy." [Rose v. PSA Airlines, Inc. Group Insurance Plan, No. 19-695 (W.D.N.C. mag. rep. Mar. 25, 2021)]  MORE >>

Kantor & Kantor

Access to Marketplace Plans with Low Premiums: The Uninsured and the American Rescue Plan

"Under the ARP, [HHS estimates] that the availability of zero-premium plans has increased by 19 percentage points and low-premium plans by 16 percentage points, respectively, among uninsured non-elderly adults potentially eligible for Marketplace coverage in HealthCare.gov states."  MORE >>

Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

DOL Guidance Clarifies Expiration of COVID-19 Deadline Extension for Employee Benefit Plans

"The IRS also indicated in informal conversations that individuals will continue to be entitled to regulatory relief as long as they experience a deadline-triggering event during the national emergency period, even if the event occurs on March 1, 2021, or later."  MORE >>

Ogletree Deakins

Top Employee Benefits Issues to Watch in 2021 (PDF)

24 pages. "[1] Changes to fiduciary rules; [2] ACA pivot; [3] Transparency for health plans; [4] Benefits go remote; [5] Increased focus on data security risks; [6] Changes to retirement policy; [7] Increasing ERISA litigation; [8] Momentum on multiemployer pension plan reform; [9] Employee mental health and well-being."  MORE >>

DLA Piper

Courts Split on Class Action Waivers, Arbitration Provisions in ERISA Litigation

"Courts have struggled over the years when considering the enforceability of mandatory class action waivers and arbitration provisions contained within [ERISA] plans and other employment-related agreements.... This alert discusses recent application of these different approaches by several courts."  MORE >>

Holland & Knight

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HFSA, Grace Period, Annual Contribution Limit, and Taxable Amounts

"Does a grace period affect the amount that can be contributed to a HFSA in a year and still not be taxable?"

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Marpai Health to Acquire Continental Benefits Launching the First Smart Health Plan System

Marpai Health

► View More Press Releases

COBRA Subsidies Under ARPA: Employer Action Needed

Hunton Andrews Kurth LLP

Summary of Key Provisions Within the American Rescue Plan Act of 2021

GrayRobinson, P.A.

FSAs, HRAs, and HSAs May Reimburse PPE Expenses

Nixon Peabody LLP