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Health & Welfare Plans Newsletter

August 24, 2021

3 New Job Opportunities


[Guidance Overview]

CMS Delays Enforcement of Key Parts of Price Transparency Rule by Six Months

"[CMS] announced the change in a new guidance released [August 19] ... Even though the rule goes into effect Jan. 1, 2022, CMS will not enforce the requirement that plans publicly disclose their in-network, out-of-network amounts and billed charges for plan years until July 1. Any plan year that begins after July 1 must post the files in the 'month in which the plan year (in the individual market, policy year) begins.' "  MORE >>


[Guidance Overview]

New Guidance Delays Certain Key Health Benefit Effective Dates

"[The FAQs delay] several of the most challenging 2021 and 2022 compliance requirements under the Consolidated Appropriations Act, 2021 (CAA) and the [ACA]: so-called 'advanced explanations of benefits' (EOBs) providing good-faith estimates of the out-of-pocket costs for scheduled medical services; a 'price comparison tool' to enable participants to compare cost-sharing amounts for specific network providers; extensive drug cost information that was to have been reported to the federal regulators in December 2021; and public pricing disclosures related to in-network rates, out-of-network allowed costs, and prescription drug prices."  MORE >>

Ogletree Deakins

[Guidance Overview]

Alert (High Risk Issue) icon Large Fines Assessed Under Chicago and Cook County Paid Sick Leave Ordinances

"These penalties illustrate the difficulties even sophisticated employers face when trying to comply with the ordinances and, in light of recent amendments, also underscore the need to review and potentially update current policies."  MORE >>

Quarles & Brady LLP

Alert (High Risk Issue) icon DOL Intends to Shine a Light on Mental Health Parity

"[The case] serves as a signal to plan sponsors that the DOL intends to take the new MHPAEA disclosure requirements under the CAA very seriously.... Employers should not assume that carriers and TPAs are able to effectively apply the MHPAEA standards across all of their business units, subcontractors, lines of business, networks and claims processes." [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 >>

Holland & Hart LLP

Employee Injured on the Job? Don't Forget Potential FMLA Rights

"The court noted that workers compensation benefits are not a substitute for FMLA leave.... Indeed, an absence under workers compensation and leave under the FMLA may run concurrently. The same principle applies to a light-duty assignment as well." [Ramji v. Hospital Housekeeping Systems Inc., No. 19-13461 (11th Cir. Apr. 6, 2021)]  MORE >>


Open Enrollment: Here Are Important Emails to Send

"Give a heads up open enrollment is coming ... Call attention to plan features or changes ... Announce your benefits decision support software ... One-on-one coaching ... Celebrate the employer incentives being offered ... Announce open enrollment kickoff ... Help employees take advantage of their benefits ... Send a satisfaction survey."  MORE >>

Tango Health

Lifestyle Spending Accounts: Compliance Considerations

"[C]ompliance for [lifestyle spending accounts (LSAs)] is relatively simple compared to tax-advantaged account-based offerings such as HSAs, FSA, and HRAs. Employers' main LSA compliance concerns will be taxation of the LSA and ensuring the LSA does not inadvertently trigger group health plan or other unintended legal requirements."  MORE >>

ABD Insurance & Financial Services

The Uninsurance Rate Held Steady During the Pandemic as Public Coverage Increased

"Between March 2019 and April 2021, the share of nonelderly adults reporting employer-sponsored insurance declined from 65.0 percent to 62.3 percent, a decrease of approximately 5.5 million adults. Over the same period, the share reporting public coverage increased from 13.6 percent to 17.5 percent, an increase of approximately 7.9 million adults. The national uninsurance rate held steady at approximately 11 percent."  MORE >>

Robert Wood Johnson Foundation


How Biden's Executive Order on Promoting Competition May Impact Health Insurance

"The Order includes renewed proposals for importing prescription drugs and increased support for generic and biosimilar drugs, which can provide low-cost options for patients.... This Order makes it clear that the FTC and Department of Justice will have considerable oversight and enforcement power to stop mergers of, and potentially break up, large health insurance carriers, healthcare providers and pharmaceutical companies[.]"  MORE >>

Corporate Synergies

Benefits in General

Businesses Rely on Steady Cash Flow, Boosted Employee Benefits

"All 18 benefits tracked by the survey (everything from retirement savings to pet insurance) made gains. A greater percentage of businesses plan to increase each of the benefits in the next 12 months.... Employers are choosing certain benefits to address specific needs. Paid family or medical leave is a popular choice to attract and retain employees and improve employee satisfaction and well-being.... Six in 10 businesses currently offer financial wellness benefits or a program."  MORE >>

Principal Financial Group

Employee Benefits Jobs

View job as Senior Defined Benefit Plan Specialist
for TPS GROUP Senior Defined Benefit Plan Specialist


Remote / North Haven CT

View job as Senior Defined Benefit Plan Specialist

View job as Retirement Plan Consultant / Administrator
for Carpenter Morse Group Retirement Plan Consultant / Administrator

Carpenter Morse Group

Remote / Longwood FL

View job as Retirement Plan Consultant / Administrator
for Carpenter Morse Group

View job as Compliance Administrator II
for Associated Pension Consultants Compliance Administrator II

Associated Pension Consultants


Press Releases

Transamerica Launches New Retirement Plan Exchange featuring UBS Retirement Plan Manager


LifeYield Integrates Powerful Retirement Income Optimizer with Franklin Templeton


Nicole Cervi-McKeever Joins Rebalance as Director of Retirement Services Continuing Firm's Rapid Growth in the Small Business Retirement Savings Marketplace


Webcasts and Conferences
(Health & Welfare Plans)

Employee Benefits and Executive Compensation Reps, Warranties, and Indemnification Clauses in M&A Deals

November 3, 2021 WEBCAST


Last Issue's Most Popular Items

Can You Offer COVID-19 Vaccine Incentives to Your Employees?


Why Hospitals and Health Insurers Don't Want You to See What Hospitals Charge

The New York Times; subscription may be required

Important Reminder: Special COBRA Notice Deadline Is Approaching Fast

Spencer Fane

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

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