[Guidance Overview]

IRS Information Letters Explain Post-Termination Health FSA Reimbursement Under COBRA and COVID-19 Relief

"While they do not break new ground or include any surprises, they may be helpful to those on the 'front lines' of cafeteria plan administration, who are sometimes asked to explain the reasons for plan operating rules and decisions. The letters also serve as a reminder that health FSAs are not typical group health plans and can present special COBRA administration challenges."  MORE >>

Thomson Reuters / EBIA

DOL Settles Unprecedented Lawsuit Against United Healthcare for Violations of the Mental Health Parity and Addiction Equity Act

"[T]wo settlement agreements filed on August 11 provide that United Healthcare Insurance Co., United Behavioral Health, and Oxford Health Insurance Inc. will together pay more than $15.6 million to settle allegations they violated the federal mental health parity law.... The enforcement actions reflect the first instance in which DOL has initiated litigation to enforce MHPAEA against a health insurance issuer, health plan, or administrative service provider in the 13 years since the initial passage of the statute.' [Walsh v. United Behavioral Health and UnitedHealthcare Ins. Co., No. 21-4519 (E.D.N.Y. settlement agreement filed Aug. 11, 2021); Walsh v. UnitedHealth Group Inc. and Oxford Health Ins. Inc., No. 21-4519 (E.D.N.Y. settlement agreement filed Aug. 11, 2021)]  MORE >>

Epstein Becker Green

What a Difference Discretion Makes

"The appellate court explained that the California statute could be read to apply if a policy covered even one California resident, even if the claimant was not a California resident himself. However, the Court concluded that such an interpretation would violate the Commerce Clause and thus be unconstitutional. [That] interpretation would also be a logistical nightmare since the standard of review in any one case would depend on the residence of all the other plan participants.' [Mayer v. Ringler Assocs. Inc., No. 20-1281 (2d Cir. Aug. 12, 2021)]  MORE >>

Kantor & Kantor

Employer's Leave Policies Required It to Provide Paid Military Leave

"[T]he court observed that under [the USERRA's] broad application of the terms ['benefit,' 'benefit of employment', or 'rights and benefits'], military leave is comparable to the other types of leave for which the employer granted paid leave. Therefore, the court concluded that the employee was entitled to the benefit of paid leave under these circumstances.' [Travers v. Federal Express Corp., No. 20-2073 (3d Cir. Aug. 10, 2021)]  MORE >>

The Wagner Law Group

AHA Presses for Meeting with Federal Agencies as Scrutiny of Hospital Deals Ramps Up

"The American Hospital Association (AHA) wants to make its case to the Biden administration that hospital mergers are not negatively impacting prices or quality ... The hospital advocacy group wrote a letter Wednesday to the leaders of [HHS, DOJ and the FTC] offering updated industry-funded studies on the impact of mergers. The letter comes more than a month after President Joe Biden signed an executive order calling for the DOJ and the FTC to review merger guidelines for hospitals."  MORE >>

FierceHealthcare

Biden Brings Plan for Prescription Drug Pricing Reform to Congress

"Biden promised the proposed steps would see some of the market's priciest drugs fall by tens of thousands of dollars per year in cost -- but how feasible is his plan likely to be?"  MORE >>

Pharmaceutical Technology

Most Private Insurers Are No Longer Waiving Cost-Sharing for COVID-19 Treatment

"[W]hile a handful of states required or created agreements with insurers to waive COVID-19 out-of-pocket treatment costs for their fully-insured plan enrollees, there is no federal mandate requiring insurers to do so. Earlier in the pandemic, ... the vast majority (88%) of people enrolled in fully-insured private health plans nonetheless would have had their out-of-pocket costs waived if they were hospitalized with COVID-19.... 72% of the two largest insurers in each state and DC (102 health plans) are no longer waiving these costs, and another 10% of plans are phasing out waivers by the end of October."  MORE >>

The Peterson-Kaiser Health System Tracker

[Opinion]

Three Steps to Achieving More Affordable Health Insurance in the Individual Market

"In this post, [the author explains] how ACA policies inflated premiums while failing to provide an efficient way to expand coverage, and [proposes] three steps to create a more affordable, competitive, and efficient individual market for people of all incomes.... [1] Fixed premium subsidies.... [2] A federal reinsurance program.... [3] Codification of individual coverage health reimbursement arrangements."  MORE >>

Health Affairs Blog

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Seven Attorneys from The Wagner Law Group to Be Recognized in 2022 Edition of the Best Lawyers in America©

Wagner Law Group P.C.

ShareBuilder 401(k) Issues Reminder as Important 401(k) Deadline Approaches, Offers Price Break to Businesses That Set Up New Plans in August and September

Sharebuilder 401k

The Best Lawyers in America 2022 Recognizes 18 Groom Attorneys

Groom Law Group

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Yet Another Required Notice: COBRA Subsidy Expiration Date and Notice Requirement Approaching

Wyrick Robbins Yates & Ponton LLP

Prof. Jonathan Forman Dies

BenefitsLink Message Boards

Never Fear: More COBRA Subsidy Guidance Is Here

Seyfarth