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Health & Welfare Plans Newsletter

May 7, 2021

8 New Job Opportunities


[Official Guidance]

Text of CMS 2022 Final Letter to Issuers in the Federally-Facilitated Exchanges (PDF)

20 pages. "This 2022 Final Letter provides updates on operational and technical guidance for the 2022 plan year for issuers seeking to offer qualified health plans (QHPs), including stand-alone dental plans (SADPs), in the Federally-facilitated Exchanges (FFEs) or the Federally-facilitated Small Business Health Options Programs (FF-SHOPs). It also describes how parts of this 2022 Final Letter apply to issuers in State-based Exchanges on the Federal Platform (SBE-FPs). Issuers should refer to these updates to help them successfully participate in any such Exchange in 2022."  MORE >>

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

[Official Guidance]

Text of CMS Final 2022 Actuarial Value Calculator Methodology (PDF)

24 pages. "The first part of this document provides background that includes an overview of the regulation that allows HHS to make updates to the AV Calculator as well as the updates that are incorporated into the final 2022 AV Calculator. The second part of the document provides a detailed description of the development of the standard population and the AV Calculator methodology.... [CMS] We did not make changes to the 2022 AV Calculator between the draft and final versions." [Also available: Final 2022 Actuarial Value Calculator (XLS)]  MORE >>

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

[Guidance Overview]

HHS Announces ACA Maximum Out-of-Pocket Limit for 2022; Allows for Marketplace Enrollment When COBRA Subsidy Ends

"The final [out of pocket (OOP)] limits are $400 less than the proposed numbers due to HHS changing the methodology in determining the cost of living adjustments.... The new rule would allow a COBRA beneficiary to move to marketplace coverage when their former employer stops subsidizing COBRA costs under a severance agreement. Likewise, when the ARPA COBRA subsidy expires, the individual will get an enrollment right to add marketplace coverage.."  MORE >>


[Guidance Overview]

Upcoming Deadline icon Employers Must Notify Workers About New COBRA Continuation Coverage Rights by May 31

"Many employers still have questions about who should receive this notice. This alert provides a step-by-step guide ... to determine who should receive the special Extended Election Period Notice."  MORE >>

Troutman Sanders

[Guidance Overview]

PCORI Fee Deadline Is Just Around the Corner (PDF)

"PCORI fees are based on the average number of covered lives under the plan or policy. Covered lives generally include employees (and retirees) and their enrolled spouses and dependents. Individuals who are receiving COBRA or other continuation coverage must be included in calculating the PCORI fee."  MORE >>

VCG Consultants

[Guidance Overview]

Final Transparency Rule Provides Clarity to Medical Pricing and Charges Through Online Pricing Tool

"Insured health plans will have the option to enter into agreements with their insurer or another third-party administrator (TPA) to meet these disclosure requirements ... [which] shifts potential ... liability for any noncompliance to the insurer.... Self-funded plans may enter into written agreements with service providers, but the liability remains with the self-funded plan sponsor to ensure compliance with the final rule."  MORE >>

Withum Smith+Brown, PC

[Guidance Overview]

De-Identifying PHI to Avoid HIPAA's Use and Disclosure Restrictions

"Covered entities and business associates generally must remove 18 specific identifiers for PHI to be de-identified and therefore no longer subject to HIPAA's use and disclosure restrictions."  MORE >>

ABD Insurance & Financial Services

Reminder: Employer Obligations Regarding Employee Life Insurance Coverage

"[Two recent court cases remind employers to] ensure their plan documents, summary plan descriptions, and other benefit descriptions accurately reflect life insurance coverage provisions, especially for provisions on continued eligibility during a leave of absence and when coverage ends after termination of employment, and confirm who is responsible for sending conversion notices when coverage is lost."  MORE >>

Haynes and Boone, LLP, via Lexology

Benefits in General

Couple Retiring Today Will Need $300,000 During Retirement to Cover Medical Expenses, an 88% Increase Since 2002

"[A] 65-year old, opposite-gender couple retiring this year can expect to spend $300,000 in health care and medical expenses throughout retirement. For single retirees, the 2021 estimate is $157,000 for women and $143,000 for men.... 82% of Americans say the pandemic has impacted their retirement plans. For those within 10-years of retirement, one-in-five (22%) say they are accelerating their timeline to leave the workforce. Of this group, 80% are under the age of 65, meaning they will need to bridge their health care options before eligibility for Medicare kicks in."  MORE >>


Court Allows Discovery in ERISA Case Based on 'Information and Belief' Allegations That Plaintiff Merely Believed to Be True

"[W]hile the Supreme Court has made it more difficult under some circumstances for ERISA plaintiffs to withstand motions to dismiss, district courts may still favor discovery over dismissal. Individual district courts may decide to encourage settlement and preclude appellate review by allowing claims to continue, even when the allegations are based on information that a plaintiff merely believes to be true." [Teamsters Local Union No. 727 Health and Welfare Fund v. De La Torre Funeral Home & Cremation Services, Inc., No. 19-6082 (N.D. Ill. Mar. 5, 2021)]  MORE >>


Matchmaker, Matchmaker, Make Me a 401(k) Match ... Based on My Student Loan Repayments

"Among other provisions, SECURE 2.0 would permit employers to make matching contributions under a 401(k) plan, 403(b) plan or SIMPLE IRA with respect to 'qualified student loan payments.' ... The proposed provisions in SECURE 2.0 would ... give employers a clear path to follow in providing this benefit."  MORE >>

Holland & Hart LLP

Employee Benefits Jobs

View job as Sales Support Specialist - Pensions & Benefit Solutions Consultant
for / Wolters Kluwer Sales Support Specialist - Pensions & Benefit Solutions Consultant / Wolters Kluwer

Telecommute / IL

View job as Sales Support Specialist - Pensions & Benefit Solutions Consultant
for / Wolters Kluwer

View job as Employee Benefits H & W Compliance Consultant
for Benefit Comply, LLC Employee Benefits H & W Compliance Consultant

Benefit Comply, LLC


View job as Employee Benefits H & W Compliance Consultant
for Benefit Comply, LLC

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 Associate - Employee Benefits
for Bass, Berry & Sims Associate - Employee Benefits

Bass, Berry & Sims

Nashville TN / Memphis TN

View job as Defined Benefit Actuarial Analyst - CONTRACTOR
for Empower Retirement Defined Benefit Actuarial Analyst - CONTRACTOR

Empower Retirement


View job as Plan Manager
for OneAmerica Plan Manager


Indianapolis IN / Wauwatosa WI / San Diego CA

View job as DC Administrator
for MGKS DC Administrator


Telecommute / Phoenix AZ

View job as Plan Installation Specialist
for Employee Fiduciary, LLC Plan Installation Specialist

Employee Fiduciary, LLC

Telecommute / Mobile AL

Press Releases

NWPS Adds to Its Business Development Team with Industry Professional Mike Cohen AIF


Webcasts and Conferences
(Health & Welfare Plans)

Health Action Alliance: The Last Mile for Vaccines

May 13, 2021 WEBCAST

National Alliance of Healthcare Purchaser Coalitions

Mental Health Index April Results

May 21, 2021 WEBCAST

National Alliance of Healthcare Purchaser Coalitions

Leadership Summits

June 7, 2021 WEBCAST

National Alliance of Healthcare Purchaser Coalitions

Last Issue's Most Popular Items

Update on the Blue Cross Blue Shield Antitrust Settlement


Agency FAQs Provide Clarity on Mental Health Parity Comparative Analysis


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

Bloomberg Law

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

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