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Health & Welfare Plans Newsletter

August 30, 2021

2 New Job Opportunities


[Guidance Overview]

PCORI Deadline Just Passed; What Happens If You Missed It?

"If you discover you've made an error on your Form 720 -- errors are easy to make, as the instructions for calculating and paying the fee are complicated -- the IRS has a Form 720-X that can be used to correct a prior filing.... [If] you discover you've failed to timely file Form 720, the prudent practice would be to file as soon as you can, albeit late. Filing a late Form 720 -- as opposed to not filing at all -- might help your argument later that you did not willfully neglect to file and might reduce any ultimate late filing penalty[.]"  MORE >>


[Guidance Overview]

FAQs on Transparency Rules Provide Some Flexibility

"[T]here are many overlapping transparency requirements that are coming into effect over the next few years.... Recognizing [these] and the challenges of developing the necessary technical infrastructure, the Departments of Treasury, Labor, and Health and Human Services issued a set of FAQs providing some delayed effective dates. However, plan sponsors are encouraged to continue their good faith efforts in this area as some of the delays are not very long."  MORE >>

HUB International

[Guidance Overview]

Vaccination Incentives as Wellness Programs: Providing Incentives for Getting Back to Business

"There are limits following HIPAA and PPACA on the incentives that can be rewarded to employees under an outcome-based wellness program.... The EEOC's regulations are noteworthy, as violation of EEOC limits has the potential to impact damages in an employment law discrimination suit (ADA, Title VII), while violation of the IRS limits under PPACA and HIPAA result in a per-person penalty per day as a tax."  MORE >>

Jackson Walker

Evolving Issues for Employers Related to Mandatory COVID-19 Vaccines and Mask Requirements in the Workplace (PDF)

"It appears that vaccine mandates are permitted under federal law provided that employers make reasonable accommodations for individuals with disabilities and for those with sincerely held religious objections. Employers need to be mindful that some states and localities are considering legislation to prohibit vaccine mandates and/or vaccine passports in some circumstances."  MORE >>


States Are Pushing to Shed Light PBM Business Practices

"More than 100 bills targeting pharmacy benefit managers have been introduced across the country this year, after the three biggest PBMs processed roughly 77% of all U.S. prescription claims in 2020.... [A]ttorneys general from 33 states and Washington, D.C., filed an amicus brief in support of a North Dakota law that would impose state oversight and require PBMs to disclose some financial information.... [M]ultiple states are investigating the business practices of PBMs, particularly how they manage state health plans."  MORE >>

Morning Consult

His Hospital Bill Was $24,000 Higher for the 2nd Jaw Surgery. Why?

"[Group health plan participant Ely Bair] hit two maddening pitfalls of the U.S. health system: He expected his new health plan to behave like his previous one from the same insurer -- and he expected his mouth to be treated like the rest of his body. Neither common-sense notion appears true in America's health insurance system."  MORE >>

National Public Radio [NPR]


Why Policymakers Should Use Audited Financial Statements to Assess Health Systems' Financial Health

"This paper presents a replicable method for a comprehensive analysis of the financial performance of hospitals in the context of their membership in health systems. It identifies a broader range of policy-relevant financial indicators of hospital financial health than those reported in an income statement ... by standardizing information provided in audited financial statements [AFSs] ... A national data base of AFSs with standardized reporting would be an important tool for more informed and socially beneficial policymaking."  MORE >>

Journal of Health Care Finance


The ACA After a Decade: Industrial Organization of the Insurance Exchanges

"[The authors] revisit the inherent market failures in health care markets that necessitate key ACA exchange regulations and investigate whether they have succeeded in their goals of expanding coverage, creating robust marketplaces, providing product variety, and generating innovation in health care delivery. [They also] discuss empirical IO research to date and also highlight shortcomings in the existing research that can be addressed moving forward [and] conclude with a discussion of IO research-based policy lessons for the ACA exchanges and, more generally, for managed competition of private insurance in health care."  MORE >>

National Bureau of Economic Research [NBER]; purchase required for full document

Benefits in General

[Official Guidance]

ERISA Advisory Council to Meet September 30

"[T]he 208th open meeting of [the ERISA Advisory Council] will be held via a teleconference on Thursday, September 30, 2021.... The purpose of the open meeting is for the members of the ERISA Advisory Council to discuss potential recommendations for the Secretary of Labor on the issues of: [1] Gaps in Retirement Savings Based on Race, Ethnicity and Gender, and [2] Understanding Brokerage Windows in Self-Directed Retirement Plans."  MORE >>

Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

Employee Benefits Jobs

View job as Pension Administrator
for Retirement Plan Administrators, LLC Pension Administrator

Retirement Plan Administrators, LLC

Atlanta GA / Savannah GA / Augusta GA

View job as 3(16) Analyst
for Sunwest Pensions 3(16) Analyst

Sunwest Pensions

Remote / Mesa AZ

Press Releases

iJoin Adds Fingage’s Unique Advisor-Centric 401(k) Solution to its Managed Account Marketplace


Snow Benefits Group, Inc. Joins OneDigital


Webcasts and Conferences
(Health & Welfare Plans)

New Transparency Rules Surprise Billing Protections for 2022

September 29, 2021 WEBCAST

Morgan Lewis

Last Issue's Most Popular Items

Legal Considerations for Premium Differentials Based on COVID-19 Vaccinations


Can an Employer Charge Unvaccinated Employees a Higher Health Plan Premium?

Warner Norcross & Judd LLP

Extension of Group Health Plan Compliance Dates


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

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