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Health & Welfare Plans Newsletter

April 8, 2021

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[Guidance Overview]

DOL Issues Guidance on COBRA Subsidy

"One of the most important questions answered by the new FAQs helped address how the subsidy interacts with the previous guidance providing extensions to elect COBRA or pay for COBRA coverage.... The FAQs further clarified that the subsidy election period does not cut off an individual's pre-existing right to elect COBRA continuation coverage, including under the extended time frames provided under the Joint Notice and [EBSA Disaster Relief Notice 2021-01]."  MORE >>

Graydon

[Guidance Overview]

Model ARPA COBRA Notices Have Arrived!

"While this guidance answers important questions on the administration of the subsidies, it does not ... cover important nuances such as what is an 'involuntary termination' in order to qualify for subsidized coverage, how existing separation agreement commitments to subsidize COBRA should be viewed, or details on how the corresponding payroll tax credit will work."  MORE >>

Jackson Lewis P.C.

[Guidance Overview]

COBRA Subsidy Forms and Guidance Issued

"While the Model Notices are available, they are not mandated and can be modified. There may be good reasons for an employer to consider modifying the notices. If an employer chooses to draft their own forms or modify the model forms, the FAQs specify what information must be included in the notices."  MORE >>

Jackson Walker

[Guidance Overview]

DOL Issues COBRA Subsidy Model Notices

"[T]he DOL clarified that the COVID relief on timing of providing notices under EBSA Disaster Relief Notice 2021-01 does not apply to the notice and election periods related to the COBRA subsidy of ARPA.... [U]ltimately the penalties for non-compliance are on you as the plan sponsor even if you are using a third-party COBRA administrator."  MORE >>

Graydon

[Guidance Overview]

Federal Agencies Explain New Mental Health Parity Requirements

"The Agency Guidance [notes] that, in the near term, the [DOL] expects to focus its enforcement efforts on: [1] prior authorization requirements, [2] concurrent review requirements, [3] standards for provider admission to participate in a network (including reimbursement rates) and [4] out-of-network reimbursement rates."  MORE >>

Bond, Schoeneck & King

[Sponsor]

2021 Onsite Employee Health Clinics Summit (June 24-25, Chicago)

The Leading Forum on Building & Expanding On-Site Health Clinics – Incorporating Strategies that Reduce Costs, Ensure Employee Satisfaction and Positively Impact Patient Behavior! Register now at 2021onsitehealth.com

Sponsored by World Conference Forum

[Guidance Overview]

Philadelphia Extends Paid COVID-19 Leave for Workers

"Under the new ordinance, which will remain in effect for the duration of the pandemic, covered employers must immediately provide up to 80 hours of paid sick leave to qualifying employees for certain COVID-19-related reasons."  MORE >>

Morgan Lewis

[Guidance Overview]

Upcoming Deadline icon San Francisco Postpones HCSO Reporting Deadline

"San Francisco has postponed its Health Care Security Ordinance (HCSO) annual reporting obligation for the 2020 calendar year from the end of this month to at least Oct. 31, 2021.... In 2020, the city eliminated outright the reporting obligation for the 2019 calendar year, and is considering doing the same this year, for 2020 calendar year reports."  MORE >>

Lockton

[Guidance Overview]

New Wisconsin Law Regulates PBM and Other Stakeholders Involved in Drug Pricing

"The Act requires a PBM to obtain a license from OCI under the licensure framework that currently applies to employee benefit plan administrators ... The Act specifies that a PBM must submit an annual report to OCI that contains the aggregate rebate amount that the PBM received from all pharmaceutical manufacturers but retained and did not pass through to health benefit plan sponsors and the percentage of the aggregate rebate amount that is retained rebates."  MORE >>

Quarles & Brady LLP

Reducing Spending on Prescription Drugs with Limited Clinical Evidence

"A primary concern is that insurers and government are paying high prices for drugs that have not demonstrated they improve health outcomes for patients. Policymakers are considering options to create financial incentives for manufacturers to more quickly complete confirmatory studies that show drugs can advance health and well-being."  MORE >>

The Commonwealth Fund

A Public Option for Health Insurance in the Nongroup Marketplaces: Key Design Considerations and Implications

"CBO describes the key design considerations for a federally administered nongroup health insurance plan -- often referred to as a public option -- and some of their major implications."  MORE >>

Congressional Budget Office [CBO]

A Policy Anniversary Is Not a Renewal Date for Purposes of Triggering Statutory Ban on Discretionary Clauses

"[T]he Eighth Circuit [held] that [1] a policy anniversary is not a renewal and thus is insufficient to trigger a State ban on discretion and [2] absent evidence of insufficient training or experience, an opinion from a nurse constitutes a full and fair review." [Roebuck v. USAble Life, No. 19-1855 (8th Cir. Apr. 1, 2021)]  MORE >>

Kantor & Kantor

Benefits in General

ERISA's Fee-Shifting Provision Does Not Support a Fee Award Against Counsel

"The Eleventh Circuit agreed with Peer's attorney that ERISA's fee-shifting provision is not to sanction attorney misconduct and cannot be used as a basis to assess fees against Peer's attorney." [Peer v. Liberty Life Assurance Co. of Boston, No. 19-13974 (11th Cir. Apr. 6, 2021)]  MORE >>

Roberts Disability Law

Employee Benefits Jobs

View job as Defined Benefit Plan Administrator
for Pension Investors Corp of Orlando Inc View job as Defined Benefit Plan Administrator
for Pension Investors Corp of Orlando Inc

Defined Benefit Plan Administrator

Pension Investors Corp of Orlando Inc

Telecommute / Altamonte Springs FL

View job as DB/DC Plan Consultant
for Small NY Actuarial TPA Firm

DB/DC Plan Consultant

Small NY Actuarial TPA Firm

Telecommute / CT / NJ / NY

View job as Enrolled Actuary
for Loren D. Stark Company (LDSCO)

Enrolled Actuary

Loren D. Stark Company (LDSCO)

Telecommute / Houston TX

View job as Sales Operations Specialist for Retirement 401(k) Plans (Entry Level)
for Newport

Sales Operations Specialist for Retirement 401(k) Plans (Entry Level)

Newport

Walnut Creek CA

View job as Employee Benefits Associate
for Allen, Gibbs & Houlik, L.C.

Employee Benefits Associate

Allen, Gibbs & Houlik, L.C.

Wichita KS

Press Releases

HUB International Acquires the Assets of Georgia-based Plan Sponsor Consultants

HUB International

Webcasts and Conferences
(Health & Welfare Plans)

Don’t Become a Statistic: ERISA Litigation Trends and Planning Steps You Can Take to Avoid Them

April 22, 2021 WEBCAST

Hunton Andrews Kurth

Last Issue's Most Popular Items

Text of DOL Model Notices for COBRA Premium Subsidy

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

Text of DOL FAQs About COBRA Premium Assistance Under the American Rescue Plan Act of 2021 (PDF)

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

If You Quit, You Might Not Get the COBRA Subsidy

Holland & Hart LLP

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BenefitsLink Retirement Plans Newsletter, ISSN no. 1536-9587.

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