[Guidance Overview]

Mental Health Parity Compliance Returns to Forefront for Group Health Plan Sponsors

"Effective as of February 10, 2021, ... employers must be ready to prove their compliance with MHPAEA standards, particularly for 'non-quantitative treatment limitations' (NQTL).... These standards used for MH/SUD benefits must be comparable to and applied no more stringently than standards used for medical and surgical benefits."  MORE >>

Jackson Lewis P.C.

[Guidance Overview]

DOL Issues New MHPAEA FAQs on Comparative Analyses Requirements

"The Department will likely request comparative analyses on [nonquantitative treatment limitations] that have been subject to a complaint or possible violation. Other areas of focus include prior authorization requirements, concurrent review, standards for provider admission to a network and out-of-network reimbursement rates."  MORE >>

Faegre Drinker

[Guidance Overview]

The Final 2022 Payment Notice: Exchanges, Medical Loss Ratios, Special Enrollment Periods, and More

"The most significant shift from the proposed rule is the decision not to finalize the Trump administration's methodology for calculating the premium adjustment percentage.... CMS also does not finalize many of the changes to direct enrollment and offers enforcement flexibility to states regarding reporting on state-mandated benefits. CMS does finalize many other proposed changes, including various special enrollment period (SEP) changes, and confirms ... that those who lose COBRA subsidies under the American Rescue Plan will qualify for an SEP."  MORE >>

Katie Keith, in Health Affairs Blog

[Guidance Overview]

Administration Finalizes Lower Out-of-Pocket Costs for Exchange Plans, Targets Health Equity and Access

"The Department of Health and Human Services (HHS) anticipates additional rulemakings on the 2022 Payment Notice later this year. The rulemaking announced changes to out-of-pocket costs, special enrollment periods, risk adjustment, and HHS's audit and oversight of exchanges ... The Payment Notice declined to finalize several proposed changes to the risk adjustment methodology."  MORE >>

Sheppard Mullin

Tips to Reduce Your 2021 ACA Penalty Risk Due to Premium Tax Credits

"Review your [minimum essential coverage (MEC)] risk monthly ... Separate employees likely Medicare-eligible ... Sort employees based on Income ... Check for other coverage."  MORE >>

Tango Health

How Carve-Outs Can Lower Self-Insured Health Plan Costs

"In addition to reducing the costs of providing employee health coverage, employers also use carve-outs to: [1] Ensure consistent access to medical care; [2] Provide comprehensive health care; and [3] Minimize bureaucracy. Carve-out areas typically include products that may be considered too costly under a regular group policy."  MORE >>

Employee Benefits Report

Sponsors of Blue Cross Blue Shield Health Plans May Benefit Under Recent Settlement

"If your company had an administrative services agreement with a Blue Cross Blue Shield (BCBS) licensee in the past six years or a health insurance policy with a BCBS licensee in the past 13 years, your company may benefit from the settlement of [an Alabama] court case ... The plaintiffs in the case alleged that the BCBS licensees violated antitrust laws by limiting competition and the BCBS defendants denied the allegations. The settlement ends the case without a court decision on the antitrust issue."  MORE >>

Vorys

Biden Seeks Paid Leave, Dependent Care Help in Sweeping Family Aid Plan

"The Biden administration unveiled a sweeping 'American Families Plan' ... that includes proposals to create a national paid family and medical leave program and to make permanent recently enacted temporary expansions of the dependent care tax credit and [ACA] subsidies for marketplace coverage."  MORE >>

Mercer

GAO Report: Behavioral Health -- Patient Access, Provider Claims Payment, and the Effects of the COVID-19 Pandemic

"GAO found that there have been longstanding concerns about the availability of behavioral health treatment, particularly for low-income individuals.... Evidence collected during the pandemic suggests the prevalence of behavioral health conditions has increased, while access to in-person behavioral health services has decreased." [GAO-21-437R, published Mar. 31, 2021, released Apr. 30, 2021]  MORE >>

U.S. Government Accountability Office [GAO]

Does the Individual Mandate Affect Insurance Coverage? Evidence from Tax Returns

"[T]he actual penalty paid per uninsured month is less than half the statutory amount.... [The authors] find visually clear and statistically significant responses to both extensive margin exposure to the mandate and to marginal increases in the mandate penalty ... [and] substantial heterogeneity in who responds; men are especially responsive.... [The] estimates imply fairly small quantitative responses to the individual mandate, especially in the Health Insurance Exchanges."  MORE >>

American Economic Association

[Official Guidance]

Text of IRS Disaster Relief Notice AL-2021-01, for Victims of Severe Storms, Straight-Line Winds, and Tornadoes in Alabama

"Victims of severe storms, flooding, landslides and mudslides that began March 25, 2021 now have until August 2, 2021, to file various individual and business tax returns and make tax payments.... Individuals and households affected by severe storms, straight-line winds, and tornadoes that reside or have a business in Bibb, Calhoun, Clay, Hale, Jefferson, Perry, Randolph, and Shelby counties qualify for tax relief."  MORE >>

Internal Revenue Service [IRS]

[Official Guidance]

Text of IRS Disaster Relief Notice KY-2021-01, for Victims of Severe Storms, Flooding, Landslides and Mudslides in Kentucky

"Victims of severe storms, flooding, landslides and mudslides that began February 27, 2021 now have until June 30, 2021, to file various individual and business tax returns and make tax payments ... Individuals and households affected by severe storms, flooding, landslides and mudslides that reside or have a business in Boyd, Breathitt, Carter, Casey, Clay, Cumberland, Elliott, Estill, Floyd, Franklin, Jackson, Johnson, Knott, Knox, Lawrence, Lee, Lincoln, Magoffin, Marion, Martin, Mason, Morgan, Ohio, Pike, Powell, Rockcastle, and Wolfe counties qualify for tax relief."  MORE >>

Internal Revenue Service [IRS]

Employers Have Options to Help Employees with Student Loan Debt

"The employer can pay off the principal and interest on the employee's student loan, and the amount paid on behalf of the employee is excluded for income tax purposes and for payroll tax purposes.... [In 2018] the IRS issued a private letter ruling to Abbott Laboratories that authorized Abbott to make an employer contribution ... to its 401(k) Plan on behalf of those employees who were paying off their student loans but not making a 401(k) deferral into the 401(k) Plan.... In 2019, the IRS signaled that it was going to turn the Abbott private letter ruling into a revenue ruling[.]"  MORE >>

Friday Eldredge & Clark LLP

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The Cerrado Group Announces TSC as Newest Member Firm

The Cerrado Group

Arconic Reduces Gross Pension Obligation by $1 Billion with Purchase of Group Annuity Contract

MassMutual

UNITE HERE Launches Website for Beneficiaries of Pension Plans Taken Over by Athene

UNITE HERE

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Saving for Health Care in Retirement: How HSAs and 401(k)s Fit Together

June 9, 2021 WEBCAST

EBRI [Employee Benefit Research Institute]

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CMS Fact Sheet: Notice of Benefit and Payment Parameters for 2022, Part 2

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

The New ARPA COBRA Subsidy: Special Notice Required by May 31

Cohen & Buckmann, P.C.

Mental Health Services Wane as Insurers Appear to Skirt Parity Rules During Pandemic

Kaiser Health News