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Health & Welfare Plans Newsletter

July 21, 2021

8 New Job Opportunities


[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

[Guidance Overview]

Exceptional Usefulness and Quality icon 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

Upcoming Deadline icon 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 >>


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

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

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

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

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

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

Employee Benefits Jobs

View job as HR Specialist - Compensation & Benefits
for American Century Investments HR Specialist - Compensation & Benefits

American Century Investments

Kansas City MO / KS

View job as HR Specialist - Compensation & Benefits
for American Century Investments

View job as Distribution Specialist
for Spectrum Employee Benefits, Inc. Distribution Specialist

Spectrum Employee Benefits, Inc.

Remote / MN / ND / SD / WI

View job as Distribution Specialist
for Spectrum Employee Benefits, Inc.

View job as DB/DC Combo-Plan Administrator
for Retirement Plan Specialists, Inc. DB/DC Combo-Plan Administrator

Retirement Plan Specialists, Inc.

Remote / Oviedo FL

View job as 401(k) Recordkeeping Manager
for July Business Services 401(k) Recordkeeping Manager

July Business Services

Remote / Woodway TX

View job as MEP/PEP Relationship Manager
for Nova 401(k) Associates MEP/PEP Relationship Manager

Nova 401(k) Associates

Remote / Houston TX / Dallas TX / Scottsdale AZ

View job as Health Insurance Specialist
for Centers for Medicare & Medicaid Services [CMS] Health Insurance Specialist

Centers for Medicare & Medicaid Services [CMS]

Remote / Woodlawn MD

View job as Benefits Manager
for Merchants Bank of Indiana Benefits Manager

Merchants Bank of Indiana

Carmel IN

View job as Retirement Plan Administrator
for Spectrum Employee Benefits, Inc. Retirement Plan Administrator

Spectrum Employee Benefits, Inc.

Remote / MN / ND / SD / WI

Press Releases

Empower Retirement to Acquire Full-Service Retirement Business of Prudential Financial, Inc.

Empower Retirement

Allianz Life Announces Entry into Defined Contribution Market with Launch of Allianz Lifetime Income+ Annuity


Morgan Stanley at Work Creates Powerful Retirement Recordkeeper Value Proposition for Plan Sponsors Through Partnership with Vestwell

Morgan Stanley

Webcasts and Conferences
(Health & Welfare Plans)

Hot Topics in Group Health Plan Administration


Knowledge Group

Annual Forum

November 8, 2021 in VA

National Alliance of Healthcare Purchaser Coalitions

Last Issue's Most Popular Items

No Surprises Act: HHS Issues Interim Final Rule


FAQs Address Coverage of PrEP, Related STI Screening and Hepatitis Testing, and More

Thomson Reuters Practical Law

Mental Health Parity Compliance: FAQs and Conducting Comparative Analyses


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

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