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Health & Welfare Plans Newsletter

September 2, 2021

7 New Job Opportunities


[Guidance Overview]

Using Wellness Programs to Incentivize COVID-19 Vaccinations

"Although there is potential for conflict with a myriad of federal statutes -- including the ACA, HIPAA, ADA, and GINA -- this arrangement may be structured legally if done through a properly designed wellness program."  MORE >>

Nelson Mullins

[Guidance Overview]

Upcoming Deadline icon It's Not Over 'Til It's Over: The COBRA Premium Subsidy Is Ending

"Although the subsidy will end earlier than September 30, 2021, for some individuals, plan administrators likely will need to send a large number of expiration notices to AEIs with subsidies that will end as of September 30, 2021.... [In] most cases, notices need to be sent by September 15, 2021."  MORE >>

Ogletree Deakins

[Guidance Overview]

Missouri's New Leave and Accommodation Law for Victims of Domestic or Sexual Abuse

"The new statute ... applies to all employers in Missouri with at least 20 employees, and it contains a number of provisions that Missouri employers may want to note, including an October 27, 2021, deadline to provide notice to employees[.]"  MORE >>

Ogletree Deakins

[Guidance Overview]

Paid Leave Rights Once Again Front and Center as COVID Variants Spike

"The paid leave rights of parents afforded under the federally enacted [FFCRA] expired on December 31, 2020. Since that time, a handful of states have passed paid leave rights, but not all guarantee coverage for school closures. Given the circumstances, time off for working parents remains a contentious issue."  MORE >>

McDonald Hopkins

Eighth Circuit: Maine's Anti-Discretion Law Does Not Apply to Accident Policies

"The plan did not 'provide[ ] for the financing or delivery of health care services,' which is how Maine defines health plans, and the plan was not subject to the requirements of the [ACA], which lists 'coverage only for accidents' as an 'excepted benefit.' " [Williams v. Unum Life Ins. Co. of America, No. 20-1694 (8th Cir. Aug. 24, 2021)]  MORE >>

Kantor & Kantor

Prioritizing Your Open Enrollment Benefits Communications

"How to identify your 'big two' priorities ... What to prioritize ... What to deprioritize ... Strategies for successful open enrollment marketing.... Creating an effective benefits communications calendar.... Getting the most out of open enrollment season."  MORE >>

Tango Health

Should You Join a Benefits Captive If You're Already Self-Funded?

"[E]mployers who choose self-funding recognize that the years with lower claims cost will outweigh the years with high claims cost over a 5+ year period, leading to an overall lower healthcare cost for the employer.... While stop loss policies are not profitable for insurers every year, they are profitable in most years.... [By] joining a captive, the employer will receive a captive profit distribution when the stop loss captive policy is profitable."  MORE >>


Drivers of 2022 Health Insurance Premium Changes (PDF)

9 pages. "For the 2021 rating cycle, the COVID-19 pandemic introduced new and significant uncertainties into the development of premium rates.... While much of those initial uncertainties have resolved, the 2022 rating cycle may see some related, secondary impacts of the pandemic such as the potential for ending of the public health emergency and the [ARPA] enhanced subsidies ... [C]arriers are more likely to include adjustments in their 2022 rates. However, those impacts are not expected to be material."  MORE >>

American Academy of Actuaries

COVID Medical Bills Are About to Get Bigger

"Federal law still requires insurers to cover testing at no cost to the patient when there is a medical reason for seeking care, such as exposure to the disease or a display of symptoms. But more of the tests sought now don't meet the definition of 'medical reason' and are instead for monitoring. And insurers are now treating COVID more like any other disease, no longer fully covering the costs of care."  MORE >>

The New York Times; subscription may be required

Medicare's Hospital Fund Is Running Out of Money; Here Are Reforms That Could Help

"[1] Shifting who pays for home health services.... [2] Targeting record Medicare Advantage [MA] profits.... [3] Changing how MA payments are calculated.... [4] Changing provider reimbursements.... [5] Controlling high-cost drugs administered in hospitals."  MORE >>



Effective Transparency Tools Come at a Price

"[W]hat's preventing plan members from seeking the lowest cost, highest quality providers for shoppable services like an MRI or knee replacement? ... Some of these platforms are simply not user-friendly and lack sufficient incentives to price shop.... Giving consumers the insight and tools to make educated decisions regarding the value of various services is of equal or greater importance."  MORE >>

Chelko Center for Benefits Management

Benefits in General

Seventh Circuit: ERISA Does Not Cover Charter School Teachers

"[T]he court discussed the nature of charter schools and what distinguishes them from purely private schools, which led the court to find: '[A] charter school in Illinois is part of the set of public educational offerings, which makes it appropriate to conclude that the school district may include charter-school teachers in its pension and welfare plans without losing its exemption under ERISA.' " [Graham v. Board of Ed. of City of Chicago, No. 19-2745 (7th Cir. Aug. 10, 2021)]  MORE >>

DeBofsky Sherman Casciari Reynolds P.C.

Employee Benefits Jobs

View job as Operations Manager & Compliance Consultant
for Advanced Benefits Consulting Operations Manager & Compliance Consultant

Advanced Benefits Consulting

Remote / Saint Louis MO / TX

View job as DC Administrator
for MGKS DC Administrator


Remote / Phoenix AZ

View job as DC Administrator
for MGKS

View job as Plan Administrator/Assistant
for National Employers Retirement Trust Plan Administrator/Assistant

National Employers Retirement Trust

Remote / Bethesda MD / DC / PA / VA / WV

View job as Implementation Project Manager
for TRI-AD Implementation Project Manager


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

View job as Associate Consultant, Health Consulting
for Segal Associate Consultant, Health Consulting



View job as Consultant, Health Consulting
for Segal Consultant, Health Consulting


New York NY

View job as Economist
for Employee Benefits Security Administration [EBSA] Economist

Employee Benefits Security Administration [EBSA]

Remote / Washington DC

Press Releases

Health-E Commerce Launches New Line of Generic, Over-The-Counter Medications Through Private Label Caring Mill Brand

Health-E Commerce

DOL Obtains Final Order Against John J. Koresko for Involvement in Nationwide Employee Benefit Plan Scheme

U.S. Department of Labor [DOL]

Webcasts and Conferences
(Health & Welfare Plans)

Fall Policy Outlook: What the Budget Might Mean for Health and Retirement Plans

September 9, 2021 WEBCAST

Groom Law Group

Last Issue's Most Popular Items

Wellness Plans Incentivizing COVID-19 Vaccinations Could Trigger ACA Penalties


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

Venable LLP

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

Trucker Huss

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

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