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Health & Welfare Plans Newsletter

September 1, 2021

5 New Job Opportunities


[Guidance Overview]

Alert (High Risk Issue) icon Wellness Plans Incentivizing COVID-19 Vaccinations Could Trigger ACA Penalties

"The clear language of the existing regulations ... would result in any wellness program incentivizing a COVID-19 vaccination to increase the amount the employer must report to the IRS on line 15 of the Form 1095-C by the amount of the penalty being imposed on employees who are not vaccinated.... [E]ven a fully vaccinated employee would have to have his/her amount that is to be reported by the employer on line 15 of the Form 1095-C increased by the amount of the penalty as the wellness program would not relate to tobacco use! ... This would have a dramatic impact on who would be eligible to receive a premium tax credit as a result of the employer's offer of coverage not meeting the ACA's affordability definition."  MORE >>


[Guidance Overview]

Delay of Some Key Provisions of the Consolidated Appropriations Act and the ACA's Transparency Requirements (PDF)

"[The delay] is great news for plan sponsors, who seemed unable to obtain contract provisions from third-party administrators (TPAs) that stated the TPA would comply with these rules.... [P]laintiffs' lawyers [may] use this information as the basis to bring lawsuits claiming that plans are overcharging participants for healthcare coverage.... [H]ow drugs are priced remains in a black box for most employers. This information would allow an employer to compare what its health plan paid for prescription drugs against another employer health plan."  MORE >>

Trucker Huss

Eleventh Circuit: Employer Did Not Violate ERISA Section 510 When It Terminated Employee for Cause

Hawthorn's claim for interference with his right to severance benefits arises under ERISA, which governs the Plan. ERISA prohibits an employer from discharging a participant in an employee benefit plan for the purpose of interfering with the attainment of any right to which the participant may become entitled under the plan. 29 U.S.C. §1140.... Hawthorn attempts, but fails, to establish pretext[.]  MORE >>

Roberts Disability Law

Weekly COVID-19 Testing of Employees: An Employee Benefits Perspective

"A weekly COVID-19 testing program ... can be expected to involve ongoing administration and therefore is likely to be [an employer group health] plan.... A weekly COVID-19 testing program does not comply with the ACA's requirements for preventive services. In order to avoid penalties, then, employers will want their testing program to provide only excepted benefits. There are two categories of excepted benefits relevant here: on-site medical clinics and employee assistance programs (EAPs)."  MORE >>

Venable LLP

Senate Version of Drug Pricing Bill May Not Apply to Those with Job-Based Insurance

"Democrats' signature drug pricing measure ... would allow [HHS] to negotiate lower drug prices, a long-held Democratic goal. The House measure would apply those lower negotiated prices not only to seniors on Medicare, but also to the roughly 150 million Americans who get health insurance through their employers. But in the Senate, the push is running into an obstacle from the complicated rules in the upper chamber."  MORE >>

The Hill

2021 Medicare Trustees Report (PDF)

"The estimated depletion date for the [hospital insurance (HI)] trust fund is 2026, the same as in last year's report. As in past years, the Trustees have determined that the fund is not adequately financed over the next 10 years. HI income is projected to be lower than last year's estimates due to lower payroll taxes." [Also available: 2021 Expanded and Supplementary Tables and Figures (ZIP)]  MORE >>

Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Medicare Part A Funds to Run Out in 2026

"The trust fund for Medicare Part A will be able to pay full benefits until 2026 before reserves will be depleted. That's the same year as predicted in 2020 ... Reserves for the Hospital Insurance Trust Fund fell by $60 billion, to $134 billion, at the end of 2020. This drop was related to the expansion of the Medicare Accelerated and Advance Payments Program because of COVID-19."  MORE >>


Exceptional Usefulness and Quality icon When an Employee Takes FMLA Leave During a Holiday Week, How Much FMLA Leave Is Actually Taken?

"First, it's critical to understand that the term 'workweek,' as defined under the FMLA, is the employee's normal schedule (hours/days per week) prior to the start of FMLA leave.... Second, we apply this normal workweek when calculating how much the FMLA leave the employee has used during the holiday week.... In other words, when making the FMLA calculation, we do not back out the Labor Day holiday from our normal workweek."  MORE >>

FMLA Insights

Employee Benefits Jobs

View job as Retirement Plan Analyst
for M2B Retirement Consulting LLC Retirement Plan Analyst

M2B Retirement Consulting LLC

Remote / Wexford PA

View job as Retirement Plan Analyst
for M2B Retirement Consulting LLC

View job as DB/DC Consultant
for Campbell Albrecht DB/DC Consultant

Campbell Albrecht

Woodland Hills CA

View job as Distribution and Loan Specialist
for Campbell Albrecht Distribution and Loan Specialist

Campbell Albrecht

Woodland Hills CA

View job as Defined Contribution Plan Administrator
for American Retirement Plan Services, LLC Defined Contribution Plan Administrator

American Retirement Plan Services, LLC

Remote / Hunt Valley MD

View job as Client Service Associate
for TRI-AD Client Service Associate


Escondido CA / AZ / CO / FL / IN / NC / NV / OK / OR / TX / UT

Press Releases

Grant Mulkey Joins Stinson's Labor, Employment & Benefits Practice in Washington, D.C.


Webcasts and Conferences
(Health & Welfare Plans)

Benefit Considerations: Medicare and Group Health Plans

September 15, 2021 WEBCAST

NFP Corp.

Last Issue's Most Popular Items

Vaccine Mandates: Denying Requests for Religious Accommodation in the Name of Safety

Foley & Lardner LLP

Employer Vaccine Requirements: Frequently Asked Questions

Husch Blackwell

Should You Offer Cheaper Health Plan Coverage in 2022 for Vaccinated Employees?


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

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