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Health & Welfare Plans Newsletter

September 13, 2021


[Official Guidance]

Text of Agency Proposed Regs: Certain Provisions of the No Surprises Act Related to Air Ambulance Services, Agent and Broker Disclosures, and Provider Enforcement

"These proposed rules would implement certain provisions of the No Surprises Act that would increase transparency by requiring group health plans and health insurance issuers in the group and individual markets, and FEHB carriers, to submit certain information about air ambulance services to [HHS, Treasury and OPM], as applicable, and by requiring providers of air ambulance services to submit certain information to the Secretaries of HHS and Transportation. These proposed rules also include HHS-only proposed rules that would increase transparency by requiring a health insurance issuer offering individual health insurance coverage or short-term, limited-duration insurance to disclose to policyholders and to report to HHS any direct or indirect compensation provided by the issuer to an agent or broker associated with enrolling individuals in such coverage. These proposed rules would also provide the process by which HHS would investigate complaints and potential violations ... and, if warranted, take enforcement action, including the imposition of civil money penalties, against providers and facilities, including providers of air ambulance services.... These proposed rules would also establish the process by which HHS would impose civil money penalties if a provider of air ambulance services fails to submit some or all required data to HHS." [Also see CMS Press Release and Fact Sheet]  MORE >>

U.S. Department of Health and Human Services [HHS]; U.S. Department of Labor [DOL]; U.S. Treasury Department; and Office of Personnel Management [OPM]


SBEN Hosts the Future of Benefits is in Atlanta, Sept 22-24

Discover how to overcome challenges facing the Benefits Industry. This event was designed by benefits professionals for benefits professionals. Learn from and network with leading Benefits Professionals in the South. Register now.

Sponsored by Southeast Benefits Education Network [SBEN]

[Guidance Overview]

IRS Reminder: Cost of Home Testing for COVID-19 Is Reimbursable Under FSAs, HSAs

"[T]he cost of home testing for COVID-19 is an eligible medical expense that can be paid or reimbursed under health flexible spending arrangements (health FSAs), health savings accounts (HSAs), health reimbursement arrangements (HRAs), or Archer medical savings accounts (Archer MSAs).... [T]he costs of personal protective equipment, such as masks, hand sanitizer and sanitizing wipes, for the primary purpose of preventing the spread of COVID-19 are eligible medical expenses that can be paid or reimbursed under health FSAs, HSAs, HRAs, or Archer MSAs."  MORE >>

Internal Revenue Service [IRS]

HHS ASPE Issue Brief: Air Ambulance Use and Surprise Billing

"This report reviews ... evidence on the number of air ambulance providers and suppliers, utilization rates by patients, and average costs, as well as the potential for balance billing for air ambulance transport, particularly for privately insured and uninsured patients."  MORE >>

Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS]

Employers Need to Start Preparing for Vaccine Mandates Now

"In addition to private sector employers, the president's EO covers federal employees and federal contractors. [A chart] outlines some of the requirements outlined in the EO and the federal agencies charged with issuing guidance.... When will rules go into effect -- and what should employers be doing now?"  MORE >>


Path Out of the Pandemic: Considerations for Employers and Government Contractors

"An employer that provides or otherwise pays for vaccination or testing for employees will need to consider the following issues: Does paying for vaccination/testing create a group health benefit that is subject to ERISA, COBRA and HIPAA? If so, how will the employer comply with the plan documentation, employee disclosure, COBRA, HIPAA privacy and other compliance requirements applicable to group health plans? Will HIPAA require that the employer obtain an authorization from each employee to receive or use the vaccination or testing results for employment purposes?"  MORE >>

Thompson Hine


Register for the 2021 CCA Annual Meeting before Sept. 24 and Save

Register for CCA’s Annual Meeting by the early bird deadline & save $100. The program offers world-class education & networking that is mindful of the health challenges we face due to the pandemic. The program offers 65 sessions and 37.6 credits.

Sponsored by Conference of Consulting Actuaries [CCA]

Employers Considering Health Strategy Changes

"Employers continue to have significant concerns about the affordability of employer-provided health coverage for employees and their families ... Most employers view potential health reforms favorably overall ... Employers viewed a public option most favorably if pricing is available to all plan sponsors[.]"  MORE >>

National Alliance of Healthcare Purchaser Coalitions

House Democrats Reveal Health, Paid Leave Policies in Budget Package

"Draft bills to add new benefits to Medicare, create a government-run paid family and medical leave benefit for US workers, and boost penalties for mental health parity violations were unveiled ... by key House committees.... A major concern for employers is whether [any proposal to] let the government negotiate drug prices will extend those negotiated prices to private plans."  MORE >>


CRS 'In Focus': Provisions Related to Universal Paid Family and Medical Leave developed by the House Committee on Ways and Means in response to Reconciliation Directives

"The reconciliation language developed by the House Ways and Means Committee in response to reconciliation directives included in S.Con.Res. 14 includes provisions related to universal paid family and medical leave. The reconciliation language, often referred to as the Build Back Better Act, proposes a new federal cash benefit for eligible individuals engaged in certain types of family and medical caregiving (including self-care). The reconciliation language would amend the Social Security Act by adding Title XXII: Paid Family and Medical Leave Benefits." [IF11922 Sep. 13, 2021]  MORE >>

Congressional Research Service [CRS]


Value-Based Pricing of Prescription Drugs Benefits Patients and Promotes Innovation

"The ability of drug companies to price their products based on their assessment of what the system will bear has led pharmaceutical companies to invest their research and development funds into the health conditions and drugs that they either expect or know to be profitable ... Switching to a value-based pricing system would better serve patients and improve the efficiency of health care spending in the United States ... [and] would promote, rather than hinder, pharmaceutical innovation, especially into the health needs that are currently unmet."  MORE >>

Center for American Progress

Benefits in General

[Official Guidance]

IRS Announces Tax Relief for North Carolina Victims of Remnants of Tropical Storm Fred

"Victims of Remnants of Tropical Storm Fred that began August 16, 2021 now have until December 15, 2021, to file various individual and business tax returns and make tax payments ... Individuals and households affected by Remnants of Tropical Storm Fred that reside or have a business in Avery, Buncombe, Haywood, Madison, Transylvania, Watauga and Yancey counties qualify for tax relief."  MORE >>

Internal Revenue Service [IRS]

Press Releases

Dan Mayfield Named Partner at Farient Advisors

Farient Advisors LLC

Ahead of DOL IRA Rollover Requirements, Broadridge Fi360 Offers Enhanced Solution

Broadridge Financial Solutions, Inc.

As Open Enrollment Season Begins, Health-E Commerce Reminds Employers, Benefits Managers of Key Account Changes That Employees Need to Understand

Health E-Commerce

iJoin Adds the Power of ProNvest’s Full-Service Managed Account Solution


Webcasts and Conferences
(Health & Welfare Plans)

COVID-19 Compliance for California Employers – New Vaccine Mandates (plural) and Ongoing Administrative Concerns

September 28, 2021 WEBCAST

CDF Labor Law LLC

Retirement & Welfare Benefits To Boost Your Business: A Case Study Approach to Compliance Learning

September 28, 2021 WEBCAST

New England Employee Benefits Council [NEEBC]

Last Issue's Most Popular Items

Treasury Department 2021-2022 Priority Guidance Plan (PDF)

Internal Revenue Service [IRS], U.S. Department of the Treasury

OSHA to Develop Rule Requiring All Employers with 100+ Employees to Implement Vaccine Mandate


FAQs on Employee Privacy Issues Related to the COVID-19 Vaccine

Reed Smith

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

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