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Health & Welfare Plans Newsletter

July 12, 2021

5 New Job Opportunities


[Guidance Overview]

New Surprise Billing Rules Require Significant Effort by Healthcare Plans and Their Claim Payers

"The new rules impose significant and detailed new notice obligations on the part of group healthcare plans, with one notice going to affected enrollees and another going to the out-of-network provider.... [The qualifying payment amount (QPA)], and how to calculate it, is the focus of most of the new rules' complexity and nuance.... The plan sponsor will want to take steps to ensure its plan's claim payor (the insurer or TPA) can make these calculations and do so correctly."  MORE >>


[Guidance Overview]

Washington State Long Term Care Program: Employers Must Collect Employee Premiums Starting in January

"The law imposes a new employee-paid premium of $0.58 per $100 of earnings. There is no employer-paid portion of the premium. Employers are responsible for collecting, remitting, and reporting these premiums, and employers will face penalties if they do not. The benefits offered under the WA Cares Fund are limited."  MORE >>


Few Adults Are Aware of Hospital Price Transparency Requirements

"Seven in ten (69%) say they are unsure whether hospitals are required to disclose the prices of treatments and procedures and an additional one in five (22%) say hospitals are not required to disclose this information. About one in ten (9%) are aware hospitals are required to disclose the prices of treatments and procedures on their websites."  MORE >>

The Peterson-Kaiser Health System Tracker

Executive Order Calls for DOJ, FTC to Review Hospital Merger Guidelines

"[The executive order on Promoting Competition in the American Economy directs] the federal government to review and revise guidelines for hospital mergers that can lead to higher prices. [It also calls for] federal agencies to work with states to safely import prescription drugs from Canada and create new regulations that ban 'pay for delay' agreements that stifle generic drug competition."  MORE >>


New Alzheimer's Drug Clouds Outlook for Medicare Premiums Next Year

"Aduhelm will be administered by healthcare providers, and thus will be covered under Part B, rather than the Part D prescription drug program. And the impact on Part B finances could be huge. The premium paid by enrollees -- which covers 25% of program costs -- could rise sharply. So could the remainder of Part B costs, which are covered by all taxpayers."  MORE >>


Qualified Transportation Plans: An Overview for Employers (PDF)

"These benefits are not subject to [ERISA] and its related provisions, and therefore come with fewer compliance requirements.... The Code permits employers to provide four types of transportation benefits to employees on a tax-free basis."  MORE >>

VCG Consultants


P4ESC Letter to Agencies on Timelines and Obligations for Implementation of the Transparency in Coverage Final Rule (PDF)

"[P4ESC is] very concerned about employers' ability to comply with the machine-readable files requirement by January 1, 2022... Because the employer does not own this network and drug pricing information, they must request it from the TPA/PBM or request that the TPA/PBM directly provide a compliant solution on the employer's behalf. The employer is at the mercy of the TPA/PBM's prerogative and schedule to obtain the information or provide a compliant solution."  MORE >>

Partnership for Employer-Sponsored Coverage [P4ESC]

Employee Benefits Jobs

View job as Sr. Actuarial Consultant
for Maxus Plan Solutions Sr. Actuarial Consultant

Maxus Plan Solutions

Telecommute / Charlotte NC

View job as ERISA Regulatory Consultant
for Voya Financial ERISA Regulatory Consultant

Voya Financial

Telecommute / AZ / CA / CT / DC / FL / GA / MA / MD / MN / NY / OR / PA / TX / WA

View job as Plan Document Specialist
for Voya Financial Plan Document Specialist

Voya Financial


View job as DB / DC Consultant
for Nova 401(k) Associates DB / DC Consultant

Nova 401(k) Associates

Telecommute / Houston TX / AZ

View job as Compliance Consultant
for Corporate Synergies Group Compliance Consultant

Corporate Synergies Group

Telecommute / Camden NJ

Press Releases

Regional Printing Affiliates Announce Print and Graphics Retirement Plan, A Multiple Employer Plan 401(k) Program

Printing Industries Alliance [PIA]

Last Issue's Most Popular Items

State of the States: Paid Family Leave Overview (PDF)

Voya Financial

The CAA Mental Health Parity Comparative Analysis Requirement

ABD Insurance & Financial Services

Surprise Billing Rules and Requirements

HUB International

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

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