[Official Guidance]

Text of Agency FAQs About ACA Implementation, Part 47 (PDF)

"Are plans and issuers required to provide coverage without cost sharing for items or services that the USPSTF recommends should be received by a participant, beneficiary, or enrollee prior to being prescribed anti-retroviral medication as part of the determination of whether such medication is appropriate for the individual and for ongoing follow-up and monitoring? ... May a plan or issuer use reasonable medical management techniques to restrict the frequency of benefits for services specified in the USPSTF recommendation for PrEP, such as HIV and STI screening, in a manner specified under other existing USPSTF recommendations, or otherwise? ... When may a plan or issuer use reasonable medical management techniques with respect to coverage of PrEP?"  MORE >>

U.S. Department of Health and Human Services [HHS]; U.S. Department of Labor [DOL]; and U.S. Treasury Department

[Guidance Overview]

COBRA Premium Assistance Requirements for Exempt Employers

"[F]or an exempt employer, which either must pay an amount of premium or is a mere intermediary for its collection and remittance, there is no affirmative requirement under ARPA to make up any deficit in the premium assistance amount. Instead, the insurer, which is entitled to the PAC, must treat the assistance-eligible individual as having paid the full amount of the premium for purposes of claiming the employment tax credit."  MORE >>

Bloomberg Law

[Guidance Overview]

New Hampshire Adopts Paid Leave Program

"The voluntary program, called the Granite State Paid Family Leave Plan, provides New Hampshire workers with 60 percent wage replacement for up to six weeks of work per year if they take time off for personal health or family reasons."  MORE >>

Jackson Lewis P.C.

The Budgetary Effects of the Tax Credit for Employer-Paid Sick and Family Leave During the Coronavirus Pandemic

"The actual budgetary cost of the provisions that provided this credit remains uncertain ... Data on self-employed individual claims of this credit are not yet available, and ... the 'IRS continues to process a paper return backlog, which makes the data … incomplete, particularly for small employers.' In addition, taxpayers may still file additional claims and update the amounts on prior claims."  MORE >>

Congressional Budget Office [CBO]

[Opinion]

Biden's July Executive Order Includes Drug Pricing Provisions. But Will They Do Enough?

"[Of] all the policy ideas aimed at reducing the cost of drugs, importation seems the least likely to happen.... It does seem likely ... that the newly appointed FTC chair would be sympathetic to cracking down on market conduct that delays the entry of generic drugs or biosimilars. Still, reducing drug prices by 60% would require legislation[.]"  MORE >>

Kaiser Health News

[Guidance Overview]

Phone Call Recordings May Be Requested by Claimants If They're Deemed Relevant to a Benefits Claim

"The DOL ... concluded that recordings of conversations with participants would not be excluded from any disclosure just because the claims administrator or plan doesn't include that recording within its own administrative record, doesn't treat the transcript or recording as a part of the claim's activity history through which the claim is developed, tracked, and administered or because that transcript or recording was created for quality assurance."  MORE >>

ERISAPros

[Guidance Overview]

Don't Overlook This Tax Planning Opportunity: One-Time IRA-to-HSA Rollover

"[T]he Health Opportunity Patient Empowerment Act of 2006 ... allows for a one-time penalty- and tax- free rollover of money from your traditional IRA to a health savings account (HSA).... This strategy allows you to just shift funds already in your traditional IRA to an HSA, without taking money from your non-retirement accounts.... [T]he transfer from the IRA will have removed some of the money, though a relatively small amount, out of the required minimum distribution (RMD) calculation."  MORE >>

EisnerAmper

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Ending Health Coverage in Anticipation of a Qualifying Event

HUB International

Employer-Provided Health Coverage Is a Bargain for U.S. Taxpayers

American Benefits Council

Enhancing Cybersecurity When Employees Work Remotely

Godfrey & Kahn S.C.