logo logo

Health & Welfare Plans Newsletter

September 16, 2021

3 New Job Opportunities


[Guidance Overview]

Mental Health Parity: Next Steps for Plan Sponsors

"Some third party administrators are indicating that they will provide the Comparative Analyses, but only if the employer adopts the administrator's standard plan design or processes. Others are taking the position that they will provide certain information relating to the MH/SUD benefits, but the employer will be responsible for MHPAEA compliance, including performing the Comparative Analyses.... Employers should also review their administrative services agreements for provisions that may be needed regarding MHPAEA compliance, including timing and responsibility for required participant disclosures."  MORE >>

Kilpatrick Townsend

[Guidance Overview]

Excluding Gender Reassignment Surgery Comes with Risk

"While the law is still a bit up in the air, plans that exclude gender reassignment surgery and other gender-confirming care are running an increased risk of violations of ACA Section 1557 and Title VII.... Even if the employer wants to exclude coverage for these items and services, the carrier or TPA/ASO may not be comfortable with those exclusions from its own risk perspective given the recent precedent on the application of ACA Section 1557."  MORE >>

HUB International

[Guidance Overview]

California's COVID-19 Paid Sick Leave Expires September 30, 2021

"Absent legislative action or an executive order, September 30 will be the end of mandatory paid COVID-19 leave under California law. But beware: Local ordinances will remain."  MORE >>

Davis Wright Tremaine LLP

MHPAEA Enforcement Action Heats Up

"This marks the first time the DOL has brought litigation to enforce MHPAEA.... [P]lan sponsors should inquire into what document disclosures their carriers and TPAs are making in response to employees' requests for information on MH/SUD treatment limitations or claims guidelines.... [T]he scope of information required to be produced goes well beyond the plan document and summary plan description." [Walsh v. United Behavioral Health and UnitedHealthcare Ins. Co., No. 21-4519 (E.D.N.Y. settlement agreement filed Aug. 11, 2021); Walsh v. UnitedHealth Group Inc. and Oxford Health Ins. Inc., No. 21-4519 (E.D.N.Y. settlement agreement filed Aug. 11, 2021)]  MORE >>


Exceptional Usefulness and Quality icon Imposing Group Health Plan Monthly Surcharges on the Unvaccinated

"While efforts to impose workplace vaccine mandates are not new (and only heating up), Delta's approach based on an economic incentive has caused some to ask whether it is permitted under applicable law. This post explores that question."  MORE >>


Drug Plan Fails, Signaling Thorny Path for Democrats' $3.5 Trillion Bill

"A Democratic plan to lower prescription drug prices as part of the party's $3.5 trillion social policy package failed in a House committee on Wednesday after moderates refused to support it, highlighting internal divisions that could complicate the legislation's path to enactment."  MORE >>

The New York Times; subscription may be required

Democrats' Stumble on Drug Prices Shows Power of Industry

"The dynamic is familiar to lawmakers who have worked on health issues: Health industries are large and powerful lobbies, and they do not enjoy having their revenues cut. As with measures that might reduce payments to hospitals, doctors and insurance companies, the House's attempt to take a bite out of drug companies has generated a backlash."  MORE >>

The New York Times; subscription may be required

What's an Employer to Do When It Realizes It Failed to Designate FMLA Leave?

"The court ... took a rather pragmatic approach. On one hand, the employer technically violated the FMLA when it failed to provide [the employee] proper and timely FMLA notices, but this inaction does not create a standalone FMLA claim. On the other hand, [the employee] failed to provide any evidence that she actually was harmed by the employer's failure to provide proper notice. For the court, nothing was lost, nor was any harm suffered, by reason of the failure to provide proper and timely notices." [Jergens v. Marias Medical Center, No. 20-015 (D. Mont. Jul. 30, 2021)]  MORE >>

FMLA Insights


Why the Flawed Hospital Price Transparency Requirements Miss the Mark

"[The hospital price transparency] requirements ... at least in [their] current form, will not drive significant transformation.... Here's why: [1] Current pricing and payment processes lack clarity. [2] Very few fully comply with the HPT and have no incentive to do so. [3] Transparency in some markets may actually drive prices up, not down. [4] About 20% of consumers of health care still account for 80% of the health care spend."  MORE >>

BenefitsPro; free registration required

Benefits in General

[Guidance Overview]

Agencies Propose SECURE Act and Other Revisions to Form 5500

"While focused largely on retirement plans, some of the changes also affect welfare plans, notably multiple employer welfare arrangements (MEWAs).... This package of changes to Form 5500 goes well beyond satisfying the agencies' obligations under the SECURE Act.... [T]he DOL is apparently planning another, broader set of improvements to the annual reporting requirements.... Also, the DOL has not acted on a SECURE Act provision that authorized simplified reporting for certain MEPs with fewer than 1,000 participants."  MORE >>

Thomson Reuters / EBIA

Employee Benefits Jobs

View job as Retirement Plan Benefits Consultant
for Compass Retirement Consulting Group Retirement Plan Benefits Consultant

Compass Retirement Consulting Group

Remote / Stratham NH

View job as Plan Administration Manager, Client Services
for The Retirement Advantage, Inc. Plan Administration Manager, Client Services

The Retirement Advantage, Inc.


View job as Document Specialist
for The Retirement Advantage, Inc. Document Specialist

The Retirement Advantage, Inc.


Press Releases

Quantum Health Announces Collaboration with Stanford University Empathy Expert and Author Jamil Zaki

Quantum Health

Last Issue's Most Popular Items

New Federal Transparency Rules for Employers as Health Plan Sponsors

The Alliance

Proposed Rules Address Air Ambulance Services Under the No Surprises Act, Health Insurer Compensation Disclosures, and More

Thomson Reuters Practical Law

District Court Highlights Importance of Complying with ERISA's 'Other Instruments Rule' for Document Disclosures

The Wagner Law Group

Unsubscribe  |   Change Email Address

Search Past Issues   |   Privacy Policy

Submit an Article   |   Contact Us   |   Advertise Here

Copyright 2021, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.

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

Links to web sites other than and are offered as a service to our readers. We are not involved in their production and are not responsible for their content.