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Health & Welfare Plans Newsletter

May 6, 2021

6 New Job Opportunities

 

[Guidance Overview]

Agency FAQs Provide Clarity on Mental Health Parity Comparative Analysis

"Whether the analysis is determined to be sufficient or not, if an agency audit determines that any financial, quantitative, or non-quantitative treatment limitations (NQTLs) do not comply with the parity requirements, the plan may be required to take corrective action (e.g., reprocess claims and refund participants when applicable). In addition, non-compliant plans could be subject to a penalty of up to $100/day per affected individual, and if disclosures are not available upon request, general ERISA penalties could apply."  MORE >>

EPIC

[Guidance Overview]

'2022 Benefit and Payment Parameters Part Two' Includes Revised Cost-Sharing Limits, Rules for COBRA-Related Exchange Special Enrollments

"The maximum annual limit on cost-sharing for 2022 will increase to $8,700 for self-only coverage and $17,400 for other than self-only coverage. Note that this is $400 less than the proposed limits of $9,100 for self-only coverage and $18,200 for other than self-only coverage ... The regulations finalize a variety of rules for special enrollment periods, including some that impact COBRA coverage."  MORE >>

Thomson Reuters / EBIA

Update on the Blue Cross Blue Shield Antitrust Settlement

"A recent Blue Cross Blue Shield antitrust lawsuit resulted in a proposed settlement of $2.67 billion dollars.... Multiple different damages classes including fully insured and self-funded plans are eligible to receive payment under the settlement. Individuals and plans who wish to seek payment must take action to file a claim or opt out to retain the right to sue."  MORE >>

EPIC

Second Circuit: Aetna Did Not Abuse Discretion Denying Accidental Death Benefit in Airliner Cabin Pressure Claim

"The insured died from pulmonary thromboemboli and phlebothrombosis caused by cabin pressure. The court explained that cabin pressure does 'not qualify as a sudden external trauma that is unexpected and unforeseen during an airline flight' ... Regarding the benefit amount, [the court found that the text] is ambiguous but another provision in the policy clarifies its meaning." [Tyll v. Stanley Black & Decker Life Ins. Program, No. 20-1060 (2d Cir. May 4, 2021, unpub.)]  MORE >>

Roberts Disability Law

House HELP Subcommittee Hearing: Lower Drug Costs Now

Recorded video with testimony by [1] Mariana P. Socal, M.D., Ph.D., Johns Hopkins Bloomberg School of Public Health; [2] David E. Mitchell, Patients For Affordable Drugs; [3] Douglas Holtz-Eakin, Ph.D., American Action Forum; and [4] Frederick Isasi, J.D., M.P.H., Families USA.  MORE >>

Health, Employment, Labor, and Pensions [HELP] Subcommittee; Committee on Education and Labor, U.S. House of Representatives

It's 2021: Do You Know Where Your Employees Are?

"If the 'workplace' only requires a laptop and a stable internet connection, employees can perform their jobs from any place -- indeed many places -- without notice to, or consent from, their employers.... [S]ick leave, disability leave, and even parental leave, are distinctly regional ... [E]mployers are now faced with a somewhat unprecedented quandary: How do you know where your employees are working?"  MORE >>

Bloomberg Law

Summer Is Near: How to Combat FMLA Abuse

"[Employers] know full well the lengths employees go to misuse FMLA leave for their personal benefit. How can employers minimize the chances of getting stung by FMLA leave abuse? ... [H]ere are a number of tools that have worked for [employers] as they have fought FMLA leave abuse, especially as summer nears."  MORE >>

FMLA Insights

Guide to Curbing Intermittent FMLA Leave Abuse (PDF)

[An] employee's ability to take small increments of FMLA leave sporadically generally result in administrative ... headaches for employers ... The FMLA offers a number of tools -- many of which are not widely known ... that you can use to discourage abuse of intermittent leave.  MORE >>

Greensfelder

Georgia Law Grants Paid Parental Leave to State, Public School Employees

"The new law provides 120 hours of paid parental leave for state employees after the birth of a child, adoption of a child or placement of a child in foster care in their home, regardless of gender. Previously, state employees had to use sick leave or vacation time, or go unpaid to take time off after a child's arrival.  ... An employee must have worked for the state or a local school district for six months prior to qualify. "  MORE >>

FOX 5 Atlanta

OPM Implements Paid COVID Leave for Federal Employees

"[T]he law sets up a $570 million fund that is available for leave taken between March 11 and Sept. 30 or whenever the leave fund dries up, whichever occurs first. Once the money is depleted, employees would have to take one of their other forms of paid leave or leave without pay."  MORE >>

Government Executive

Potential Congressional Action on Telehealth

"To date in the 117th Congress, there have been at least 25 bills introduced on telehealth expansion. While some proposals stem from long-standing policy proposals from previous years, others build off the foundation of the PHE waivers and CARES Act policies and aim to make them permanent."  MORE >>

Brownstein Hyatt Farber Schreck LLP

[Opinion]

Health Plan Compensation Disclosure Requirements Will Be a Positive Force for Employee Benefit Specialists and Consumers

"[The CAA] will require disclosure of commissions and consulting fees paid for welfare plans ... [This] will be good for our industry: [1] 'Clean hands' on cost transparency issues.... [2] Help employers put value on our services.... Employers knowing what we make promotes competition.... [4] Fix issues with cost disclosure for self-funded plans.... [5] What are you doing to earn your compensation? ... [6] Mitigate misaligned incentives."  MORE >>

MZQ Consulting, LLC

Benefits in General

Supreme Court Ruling on Social Security Claim Has Implications for ERISA Claims

"The U.S. Supreme Court ruled last month ... that issue exhaustion is not mandatory in Social Security disability benefit claims.... [ERISA] provides for a 'full and fair review' of benefit denials as a precondition to claimants being allowed to litigate disputes over benefits.... Such requirements are comparable to similar requirements mandated under the Social Security Act[.]" [Carr v. Saul, No. 19-1442 (S. Ct. Apr. 22, 2021)]  MORE >>

DeBofsky Sherman Casciari Reynolds P.C.

Blanket Release Might Not Protect Against All ERISA Claims

"Because the employer did not deny the life insurance coverage until after the release was executed, the court held the employee's ERISA claim was not within the scope of the release and denied the employer's motion to dismiss." [Anastos v. IKEA Property, Inc., No. 19-3702 (N.D. Ga. Mar. 17, 2021)]  MORE >>

Haynes and Boone, LLP, via Lexology; free registration required

How Employee Benefits Can Become an Employer's Burden

"Employers should develop and implement the most compliant and risk adverse benefits plans, but the plaintiff's bar will still search for loopholes. Investment fees and loss, COBRA litigation and healthcare claims are only a few of the issues facing employers in 2021." [Video]  MORE >>

Jackson Lewis P.C.

Employee Benefits Jobs

View job as Sr. Actuarial Analyst
for Newport Sr. Actuarial Analyst

Newport

Chicago IL

View job as Employee Benefits Associate
for Thompson Hine Employee Benefits Associate

Thompson Hine

Atlanta GA / Chicago IL / Cincinnati OH / Cleveland OH / Columbus OH / New York NY / Washington DC / Dayton OH

View job as 3(16) Services Team Leader
for Compass 360, LLC 3(16) Services Team Leader

Compass 360, LLC

Stratham NH

View job as Retirement Plan Specialist
for SS&C Technologies Retirement Plan Specialist

SS&C Technologies

Rockland ME / Quincy MA / Dublin OH / Kansas City MO / DC / KS

View job as Installation Coordinator
for Ascensus Installation Coordinator

Ascensus

Telecommute

View job as Account Manager
for MAP Retirement Account Manager

MAP Retirement

Telecommute / Appleton WI

Selected New Discussions

Charge Document Restatement Fees to a Fully Insured H&W Plan?

"Is it possible to charge administration expenses to a fully-insured H&W plan? We are updating the plan docs and SPDs, which is an administrative expense, thus this question."

BenefitsLink Message Boards

Press Releases

Lockton Fortifies Its New England Presence with the Addition of Patrick J. Haraden

Lockton

FuturePlan by Ascensus Appoints Mark Wiggins as Divisional Vice President for the Southeast and Southwest Regions

Ascensus

J.P. Morgan and Nationwide Launch First Professionally Managed Annuity

JPMorgan Chase & Co.

Global Atlantic Appoints Edward Root to Oversee Pension Risk Transfer Business, Continues to Grow Reinsurance Strategy

Global Atlantic Financial Group

OneDigital Acquires Clearview Advisory

OneDigital Health and Benefits

Webcasts and Conferences
(Health & Welfare Plans)

Urgent Health Plan Priorities - COBRA Subsidies, and Health and DCAP FSA Extensions and Expansions

May 19, 2021 WEBCAST

Wagner Law Group P.C.

Last Issue's Most Popular Items

DOL Announces Intent to Withdraw Independent Contractor Rule

U.S. Department of Labor [DOL]

Rethinking Employee Benefits for Permanently Remote Workers

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

State of Washington Adds Tight Exemption Timeline to Long-Term Care Law

Mercer

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

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