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Health & Welfare Plans Newsletter

July 28, 2021

2 New Job Opportunities


[Guidance Overview]

Can Employers Offer COVID-19 Vaccine Incentives for Employees?

"Incentives may take many forms, such as a one-time bonus, a gift card or a few extra vacation hours. Employers can get creative. There are two issues to consider when implementing a vaccine incentive program for purposes of complying with employment and benefits laws: the concepts of coercion and reasonable accommodation."  MORE >>

McDermott Will & Emery

[Guidance Overview]

Exceptional Usefulness and Quality icon Employer Responsibilities Upon Receipt of a National Medical Support Notice

"The [National Medical Support Notice (NMSN)] serves as legal notice that the employee is obligated by a court or administrative child support order to provide health coverage for the child(ren). Employers need to promptly respond and complete the enrollment to satisfy their obligations under the NMSN."  MORE >>

ABD Insurance & Financial Services

[Guidance Overview]

New Guidance on PrEP: Support Services Must Be Covered Without Cost-Sharing

"The new federal guidance confirms that cost sharing protections extend to the ancillary and support services that are needed for an effective PrEP regimen. This means that all non-grandfathered private health plans must cover those services, alongside PrEP medication, without cost sharing. This clarification will reduce patient out-of-pocket costs and thus increase access to PrEP for high-risk individuals."  MORE >>

Katie Keith, in Health Affairs Blog

Eighth Circuit: Employer's Attendance Policy Outweighs Former Employee's ADA, FMLA Claims

"Regular attendance at the worksite can be an essential job function, the U.S. 8th Circuit Court of Appeals recently reminded employers, upholding the termination of an employee who had violated the employer's attendance policy. As a result, the former employee can no longer pursue her Americans with Disabilities Act (ADA) or Family and Medical Leave Act (FMLA) claims." [Evans v. Cooperative Response Center, Inc., No. 19-2483 (8th Cir. May 4, 2021)]  MORE >>

HR Daily Advisor

Legal Risk for Plan Sponsors Remains Following Challenges to Cross-Plan Offsetting

"Once standing was established, the Lutz court found the practice of cross-plan offsetting violated ERISA's duty of loyalty and ban on representing both sides in a transaction. More challenges to cross-plan offsetting will follow in the wake of these cases, leading to decisions on when and how the practice violates ERISA fiduciary duties."  MORE >>


HHS and DOJ Issue Guidance on How Disability Nondiscrimination Laws Apply to Those Affected by 'Long COVID'

"[T]he guidance states that 'the so-called long COVID does not automatically qualify as a disability' and specifies that, as is the case with other disability determinations, an 'individualized assessment is necessary' to determine if the person's condition or any of its symptoms is a physical or mental impairment that substantially limits one or more major life activities."  MORE >>

Smith, Gambrell & Russell, LLP

Free COBRA Coverage Sign-Up Window Closes This Week for Many Laid-Off Workers

"[P]eople ... who lost their jobs before April 1 ... have 60 days from the date their employer notified them of the COBRA subsidy to sign up for it -- that's July 31 if their employer notified them at the end of May. People notified earlier may have already missed their opportunity.... Those laid off or furloughed after April 1 have 60 days to sign up for regular COBRA coverage and the temporary financial assistance."  MORE >>

Kaiser Health News

Legislation Introduced to Fix Health Insurance 'Birthday Rule'

"[The Empowering Parents' Healthcare Choices Act (HR 4636)] would do away with 'the birthday rule' and a 'coordination of benefits policy' that trips up first-time parents up when it's time to sign up a new baby for insurance.... For Charlie Kjelshus, the birthday rule meant her dad's plan -- with a $12,000 deductible, a high coinsurance obligation and a network focused in a different state -- was deemed her primary coverage. Her mom's more generous plan was secondary. Confusion over the two plans caused a tangle of red tape for the family that took almost two years and national media attention to resolve."  MORE >>

Kaiser Health News

CMS Proposes Expansion of Telehealth Coverage

"This temporary extension of Medicare covered telehealth services will also see additional services added to the coverage list, allowing more data to be collected on the efficacy of these services. CMS has noted however, that it does not intend to permanently add these proposals as they do not meet the criteria for Medicare coverage that are currently on the books."  MORE >>

Sheppard Mullin

Fringe Benefits: What's All the Fuss About?

"Some fringe benefits are tax-free and excludable from the employee's compensation. Most employers and employees are aware of these standard benefits and their tax treatment.... What about the not-so 'cookie cutter' benefits employers provide? Here is where a lot of the confusion arises[.]"  MORE >>

Withum Smith+Brown, PC

Health Reform Should Build on Current Employer-Provided System, Voters Say

"Eighty-five percent of voters like their current health care coverage.... 79 percent gave an excellent or good rating for high quality care; and 77 percent gave an excellent or good rating for choice in doctors.... 65 percent gave a negative rating for costs that are affordable; and 62 percent provided a negative rating for transparency in pricing.... Employer-provided health care coverage ... came out on top across all measures polled, particularly on choice, quality, and comprehensive coverage."  MORE >>

Wolters Kluwer; free registration required

The Effect of the Minimum Wage on Employer-Sponsored Insurance for Low-Income Workers and Dependents

"This study found robust evidence that minimum wage increases lead to reductions in employer-sponsored insurance (ESI) coverage in families below 300% of the federal poverty level, with a nominal $1 increase in the minimum wage reducing the probability of ESI coverage by 1 percentage point. Reductions in coverage were also observed both for workers and for their dependents."  MORE >>

RAND Corporation


Employer-Sponsored Insurance Delivers $1.5 Trillion in Value for Employees, U.S. Economy

"The significant retention of employer-sponsored coverage during the pandemic further proves its value to individuals and families; as employment dropped over the course of the past year (at one point to 20%), the number of people with employer-sponsored insurance only incrementally fell by only 1% or 2%. It is particularly ironic that after such affirming statistics, some still support shifting individuals into Medicare or a public option."  MORE >>

U.S. Chamber of Commerce

Benefits in General

[Guidance Overview]

Form 5500 and New Audit Standard SAS 136

"The AICPA postponed the mandatory effective date of the new audit standard, SAS 136, until next year, but the DOL had already updated Form 5500 to incorporate the new reporting rules. So now what?"  MORE >>

Belfint Lyons Shuman

President Biden Nominates Lisa Gomez for DOL Assistant Secretary for EBSA

"Lisa M. Gomez is a partner with the law firm Cohen, Weiss and Simon LLP and the Chair of the Firm's Management Committee. Since 1994, she has developed her deep technical and practical experience in the multifaceted field of employee benefits law, representing various Taft-Hartley and multiemployer pension and welfare plans, single employer plans, jointly administered training program trust funds, a federal employees health benefit (FEHB) plan, supplemental health plans, and VEBAs."  MORE >>

Executive Office of the President

Employee Benefits Jobs

View job as 401(k) / DB Sales
for Farmer & Betts, Inc. 401(k) / DB Sales

Farmer & Betts, Inc.

Tacoma WA / GA

View job as 401(k) / DB Sales
for Farmer & Betts, Inc.

View job as Lead Pension Administrator
for CBIZ Lead Pension Administrator


Philadelphia PA

Press Releases

NAGDCA Announces Winners of 2021 Leadership Awards

National Association of Government Defined Contribution Administrators [NAGDCA]

Webcasts and Conferences
(Health & Welfare Plans)

COBRA for Employers

August 17, 2021 WEBCAST

ABD Insurance & Financial Services

Last Issue's Most Popular Items

IRS Reiterates FSA Debit Card Substantiation Rules

Kushner & Company

Surprise Billing Regs: Impact on Out-of-Network Providers

K&L Gates

CRS Report on Surprise Billing in Private Health Insurance: Overview of Federal Consumer Protections and Payment for Out-of-Network Services

Congressional Research Service [CRS]

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

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