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Health & Welfare Plans Newsletter
July 21, 2021
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► 8 New Job Opportunities
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[Guidance Overview]
Administration Issues Part I of Surprise Billing Rule
"Along with the IFR, the Departments released model notices that group health plans and issuers (as well as providers and facilities) must make publicly available, post on a website, and include on each explanation of benefits and other related materials.... The regulations apply to group health plans and insurance issuers offering group or individual coverage, including grandfathered plans. The regulations do not apply to retiree-only plans; excepted benefits; short-term, limited duration insurance; health reimbursement accounts (HRAs); and other account-based group health plans (e.g., healthcare flexible spending accounts)." MORE >>
Morgan Lewis
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[Guidance Overview]
IRS Guidance on COBRA Premium Assistance: What We Know Now
"Eligibility for another group health plan includes circumstances in which the spouse or dependent child would be required to pay the full cost of that group health plan coverage. Similarly, Notice 2021-31 confirms that if an individual is eligible for Medicare but not enrolled in Medicare, they are ineligible for premium assistance.... An individual whose original qualifying event was a reduction in hours or involuntary termination, and who elected COBRA (and remained enrolled in COBRA) and then experienced a second qualifying event (e.g., a divorce), disability extension or an extension under State mini-COBRA is eligible for the COBRA premium assistance to the extent the additional periods of coverage fall between April 1 and September 30, 2021." MORE >>
Trucker Huss
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PCORI Fee Deadline Fast Approaching
"The fee and the related IRS Form 720 are due no later than July 31st (note that July 31 falls on a Saturday in 2021). The updated form can be found here, and the PCORI fee reporting can be found in Part II, Line 133." MORE >>
Graydon
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CMS to Permanently Cover Audio-Only Telemedicine for Mental Health
"CMS has historically been reluctant to cover audio-only technology out of concern it could lead to inappropriate overutilization of services and concern that audio-video visualization is necessary to fulfill the full scope of service elements of CPT codes. Yet, given the widespread use of audio-only services during the PHE, CMS reconsidered its position and altered its policy to respond to changing patient needs and evolving clinical practices." MORE >>
Foley & Lardner LLP
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DOJ's Recent Telehealth Enforcement Action Highlights Increased Abuse of COVID-19 Waivers
"On May 26, 2021, the Department of Justice (DOJ) announced a coordinated law enforcement action against 14 telehealth executives, physicians, marketers, and healthcare business owners for their alleged fraudulent COVID-19 related Medicare claims resulting in over $143 million in false billing.... The cases announced by both the DOJ and CMS allegedly sought to exploit these expanded policies by submitting false claims to Medicare for telemedicine encounters that never actually occurred." MORE >>
Health Law Advisor, Epstein Becker Green
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Medical Debt in the United States, 2009-2020
"This study provides an estimate of the amount of medical debt in collections in the US based on consumer credit reports from January 2009 to June 2020, reflecting care delivered prior to the COVID-19 pandemic ... In June 2020, an estimated 17.8% of individuals had medical debt (13.0% accrued debt during the prior year), and the mean amount was $429 ($311 accrued during the prior year)." MORE >>
JAMA Network
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Effectiveness of Combining Antiobesity Medication with an Employer-Based Weight Management Program for Treatment of Obesity
"Clinically meaningful superior mean weight loss was achieved when access to [antiobesity medication (AOMs)] was provided in the real-world setting of an employer-based [weight management program (WMP)], compared with the WMP alone. Such results may inform employer decisions regarding AOM coverage and guide best practices for comprehensive, interdisciplinary employer-based WMPs." MORE >>
JAMA Network
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Benefits in General |
Health and Retirement Benefit Obligations for California Public Agency Seasonal Workers
"The number of seasonal workers you hire may impact whether your agency is subject to certain ACA obligations.... [S]easonal workers may be entitled to paid sick leave under California's Healthy Workplaces, Healthy Families Act.... Careful consideration is required when determining whether 'seasonal' workers are entitled to membership in the Public Employees' Retirement System (PERS)." MORE >>
Liebert Cassidy Whitmore
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IRS Form 5500 Reminders for Employers Maintaining Employee Benefit Plans
"[This article describes] a few common issues to keep in mind and tips that are aimed at lessening the chances of examination and/or the imposition of penalties.... Do not blindly rely on the individual who may have entered the data onto the form. Understand it is your filing under penalty of perjury, and that it should be complete and accurate." MORE >>
Hawley Troxell
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Employee Benefits Jobs |
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Press Releases |
Empower Retirement to Acquire Full-Service Retirement Business of Prudential Financial, Inc.
Empower Retirement
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Allianz Life Announces Entry into Defined Contribution Market with Launch of Allianz Lifetime Income+ Annuity
Allianz
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Morgan Stanley at Work Creates Powerful Retirement Recordkeeper Value Proposition for Plan Sponsors Through Partnership with Vestwell
Morgan Stanley
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Webcasts and Conferences (Health & Welfare Plans) |
Hot Topics in Group Health Plan Administration
RECORDED
Knowledge Group
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Annual Forum
November 8, 2021 in VA
National Alliance of Healthcare Purchaser Coalitions
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Last Issue's Most Popular Items |
No Surprises Act: HHS Issues Interim Final Rule
OneDigital
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FAQs Address Coverage of PrEP, Related STI Screening and Hepatitis Testing, and More
Thomson Reuters Practical Law
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Mental Health Parity Compliance: FAQs and Conducting Comparative Analyses
OneDigital
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BenefitsLink Retirement Plans Newsletter, ISSN no. 1536-9587.
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