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Health & Welfare Plans Newsletter

August 26, 2021

5 New Job Opportunities


[Guidance Overview]

Agencies Issue FAQs to Explain Implementation Timing of Group Health Plan Reforms

"Given the potential for duplicative and overlapping requirements between the cost transparency regulations and the CAA, the Departments have delayed enforcement of the machine-readable file requirement for healthcare services to July 1, 2022.... [B]ecause group health plans have been working toward implementation of the first phase (i.e., price comparison of a sub-set of healthcare services) on January 1, 2023, the Departments will not enforce the CAA's requirements until at least that date."  MORE >>

Nixon Peabody LLP

[Guidance Overview]

Enforcement Delayed Under the New Healthcare Cost Disclosure Requirements

"The regulations and statutory provisions ... mandate substantial disclosure obligations and reporting requirements of health care providers, health plans, and health insurers. The FAQs released on August 20 relate to the communication and reporting obligations and not the restrictions on charges, balance billing and cost-sharing obligations addressed in the Interim Final Regulations. The FAQs provide transitional non-enforcement relief from numerous new disclosure rules."  MORE >>

Ballard Spahr LLP

[Guidance Overview]

New Guidance on Transparency Requirements, Advanced Explanations of Benefits, and More

"The guidance addresses requirements regarding transparency in insurance ID cards; good faith estimates and advanced explanations of benefits (EOB); gag clauses; accurate information on provider networks; continuity of care; and pharmacy benefit and drug cost reporting."  MORE >>

Katie Keith, in Health Affairs Blog

[Guidance Overview]

New Missouri Law Requires Leave and Accommodations for Victims of Domestic and Sexual Violence

"Effective on Aug. 28, 2021, Missouri's new Victims Economic Safety and Security Act (VESSA) requires Missouri employers with at least 20 employees to provide leave and reasonable safety accommodations to employees who experience domestic or sexual violence. The new statute also includes notice obligations ... Missouri joins 34 other states that have enacted similar protections for employees in recent years."  MORE >>

Armstrong Teasdale

[Guidance Overview]

San Francisco Makes Updates to the 2022 HCSO Requirements

"As of January 1, 2022, the required [health care expenditure (HCE)] amount ... for large businesses (those with 100 or more workers) is $3.30 per payable hour ... For medium-sized businesses (those with 20 to 99 workers), the HCE is $2.20 per payable hour ... On July 19, 2021, the Board issued an amendment related to teleworkers and the ESR calculation."  MORE >>


Delta's Extra $200 Insurance Fee Shows Vaccine Dilemma for Employers

"Legally speaking, insurance surcharges are more complicated than simple employment mandates, which are widely considered legally sound.... 'You are dealing with the overlap of at least three different laws,' [said attorney Rob Duston], referring to [ERISA], the [ACA], and the [EEOC's] wellness plan and COVID-19 guidelines. The companies will have to abide by the Americans With Disabilities Act and health privacy laws, too."  MORE >>

The New York Times; subscription may be required

Eighth Circuit Holds That Maine Ban on Discretionary Authority in Health Plans Does Not Apply to AD&D Insurance Policy

"The court found that the statute does not apply because the AD&D policy does not meet the requirements of a health plan under Maine law. Specifically, it does not provide for the financing or delivery of health care services nor is it subject to the federal [ACA]. Because Maine's ban on discretionary clauses applies only to health plans, the court reviews Unum's decision for an abuse of discretion." [Williams v. Unum Life Ins. Co. of America, No. 20-1694 (8th Cir. Aug. 24, 2021)]  MORE >>

Roberts Disability Law

U.S. Chamber of Commerce Files Lawsuit Challenging HHS's Health Plan Price Transparency Rule

"The Chamber seeks declaratory and injunctive relief arguing that the regulation 'runs afoul of long-established protections against the forced disclosure of confidential commercial information, including trade secrets, and is detrimental to the business community as a whole.' " [Chamber of Commerce of U.S. v. HHS, No. 21-309 (E.D. Tex. complaint filed Aug. 10, 2021)]  MORE >>

Troutman Sanders

Colorado Supreme Court Joins Other States in Banning Use-It-or-Lose-It Vacation Policies

"[A chart] includes a sampling of states with relatively clear positions on vacation forfeiture. In some cases, the law requires payout at termination but allows a clearly stated use-it-or-lose it provision, as long as the policy gives employees a reasonable amount of time to use earned vacation before losing it ... In other cases, earned vacation cannot be forfeited at any time ... but in other states, the issue remains unclear." [Nieto v. Clark's Market, No. 19SC553 (Colo. Jun. 14, 2021)]  MORE >>


Colorado Employers May Need to Pay Out Accrued Vacation on Termination

"The key to the Court's analysis is whether vacation time/pay that has accrued is the equivalent of accrued wages under the [Colorado Wage Claim Act (CWCA)], and therefore not subject to forfeiture. The Court applied a broad interpretation of the term 'accrued,' which, based on the facts of the Nieto case, includes vacation time subject to a time-vesting formula that is subject to a future event (the manner of termination)." [Nieto v. Clark's Market, No. 19SC553 (Colo. Jun. 14, 2021)]  MORE >>


Employee Benefits Jobs

View job as 401(k) Consultant/Account Manager
for TPS Group 401(k) Consultant/Account Manager

TPS Group


View job as 401(k) Consultant/Account Manager
for TPS Group

View job as Experienced Plan Consultant
for Randall & Hurley Inc Experienced Plan Consultant

Randall & Hurley Inc

Remote / Liberty Lake WA / Helena MT

View job as Experienced Pension Actuary
for Randall & Hurley Inc Experienced Pension Actuary

Randall & Hurley Inc

Remote / Liberty Lake WA

View job as Retirement Plan Consultant
for Definiti Retirement Plan Consultant


Remote / The Woodlands TX / AR / CA / FL / PA / WI

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

Press Releases

Israel Goldowitz Recognized by Best Lawyers® as Washington, D.C. 2022 'Lawyer of the Year' in Employee Benefits (ERISA)

Wagner Law Group P.C.

Healthcare Bluebook Launches Prescription Drug Quality and Cost Navigation

Healthcare Bluebook

Webcasts and Conferences
(Health & Welfare Plans)

Mandatory Vaccination Policies: Managing Medical and Religious Exemption Requests

August 31, 2021 WEBCAST

Ogletree Deakins

COVID-19 Vaccination Mandates: Employer Considerations

September 1, 2021 WEBCAST

Nixon Peabody LLP

New Data and Evolving Trends in Employer-Sponsored Family Care Support

September 23, 2021 WEBCAST

McDermott Will & Emery LLP

Last Issue's Most Popular Items

Delta Air Lines Imposing $200/Month Premium Surcharge for Workers Who Refuse COVID Vaccine


September 15 Is Final Deadline for ARPA COBRA Subsidy Expiration Notices

Brownstein Hyatt Farber Schreck LLP

New Health Plan Guidance Regarding Transparency Regs and Last Year's Budget Act

McAfee & Taft

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

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