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Health & Welfare Plans Newsletter

October 13, 2021

2 New Job Opportunities 2 New Job Opportunities

 

[Guidance Overview]

Exceptional Usefulness and Quality icon IRS Guidance Sheds Light on COBRA Premium Payment Deadlines in the Time of COVID-19

"The transition relief is targeted at certain individuals who elected COBRA outside of the regular 60-day deadline and whose initial premium deadline has already passed ... based on the premise that prior to the issuance of this guidance, they may have thought the 1-year tolling period began on their election date.... The Notice highlights that individuals who delay electing COBRA coverage may not have more than 1 year of total disregarded time for the COBRA election and initial COBRA premium payment."  MORE >>

Groom Law Group

[Guidance Overview]

We Have No Idea When the Outbreak Period Will End, But We Have a Better Idea When COBRA Payments Are Due

"Notice 2021-58 reiterates that the extensions of the timeframes do not apply to the periods for providing the required ARPA Notice, or for electing subsidized COBRA. A plan may require an individual to elect COBRA retroactive to the date of loss of coverage within 60 days of receiving the ARPA Notice or lose eligibility for retroactive COBRA."  MORE >>

Seyfarth Shaw LLP

[Guidance Overview]

CMS Greenlights Coverage of LGBTQ+ Care as an Essential Health Benefit in Colorado

"Changes to [Colorado's] EHB-benchmark plan will allow access to a wider range of services for transgender individuals in addition to benefits already covered.... The state is also adding EHBs in the benchmark plan to include mental wellness exams and expanded coverage for 14 prescription drug classes. These changes will take effect beginning on January 1, 2023."  MORE >>

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

District Court Finds LTD Benefits Properly Terminated After Plaintiff Failed to Undergo Recommended Surgery for Disability

"[T]he court noted that 'together with Hall's failure to engage another doctor and her refusal (or inability) to schedule surgery, [the doctor's] disavowal casts doubt on the veracity of Hall's claims of total disability.' The court also held that Hall failed to offer any evidence to counter 'the reasonable assumption' that the doctor contacted Aetna because he was no longer comfortable certifying Hall's disability for medical reasons.' " [Hall v. Aetna Life Ins. Co., No. 20-1863 (N.D. Cal. Jun. 23, 2021)]  MORE >>

Hinshaw & Culbertson LLP

Health Industry Wields Power in California's High-Stakes Battle to Lower Health Care Costs

"When [California Governor Newsom] ultimately drafted legislation for the office, he took an idea health care executives had pitched and made it his own: Instead of capping prices or cutting revenues, he would allow industry spending to grow -- but with limits.... If Newsom's plan to rein in health care spending succeeds, ... it could ... cement the power of an industry that continues to wield immense influence -- negotiating behind the scenes to protect its massive revenues and secure exemptions and side deals in exchange for its support."  MORE >>

Kaiser Health News

[Opinion]

Today's Primary Care Problems Can Be Solved by Advanced Primary Care

"The fragmented, impersonal, and sometimes inaccessible primary care options wrought by the pandemic have highlighted our need for a new primary care solution -- one that focuses on the whole person and one that places an emphasis on preventative care. Employers are ditching traditional care methods for Advanced Primary Care due to its unique benefits."  MORE >>

The Alliance

[Opinion]

Partnership for Employer-Sponsored Coverage Letter to Congress in Support of the Primary and Virtual Care Affordability Act (HR 5541) (PDF)

"Telehealth has served as an essential lifeline to care for millions of Americans during the pandemic, especially those seeking behavioral and mental health services. Extending this policy and covering in-person primary care visits will provide a continuity of care beyond 2021."  MORE >>

Partnership for Employer-Sponsored Coverage [P4ESC]

Benefits in General

[Official Guidance]

ERISA Advisory Council to Meet via Teleconference on November 19

"The purpose of the morning session of the open meeting is ... to finalize observations and recommendations on the issues [the members of the council] studied in 2021. During the afternoon session, the members ... will present their observations and recommendations to the [DOL] and receive an update from leadership of [EBSA]. The issues studied ... in 2021 [were]: [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]

Additional Standing Issues Under ERISA (PDF)

"Currently ... there is agreement among the courts that ERISA's standing requirements are to be strictly construed and 'absent a valid assignment of a claim, non-enumerated parties lack standing under ERISA, even if they have a direct stake in the outcome of the litigation.' That is why, for example, that a health care provider with no assignment has no standing. However, there remain areas in which the courts are divided and nuances of which practitioners should be aware."  MORE >>

The Wagner Law Group, via Benefits Law Journal

Motion for Class Certification Denied: Plaintiff Who Released ERISA Claims Deemed Unfit to Lead Class

"Can a former employee serve as a class representative for ERISA claims when she has signed a general release agreement and has waived her right to participate in class actions? According to a recent decision by the District Court for the Western District of Oklahoma, the answer may very well be 'no.' " [Myers v. Administrative Committee, Seventy Seven Energy, Inc. Retirement & Savings Plan, No. 17-200 (W.D. Okla. Sep. 29, 2021)]  MORE >>

Jackson Lewis P.C.

Exceptional Usefulness and Quality icon Employee Benefits, Executive Compensation, and Employment Law Practice: Ten Years in Review

"This article reviews some of the most significant ... legal, regulatory, and practice developments of the past ten years [in the fields of employee benefits, executive compensation and employment law], including key insights and predictions for the future[.]"  MORE >>

Thomson Reuters Practical Law

Employee Benefits Jobs

View job as DC Plan Administrator
for United Benefit Pensions Inc. DC Plan Administrator

United Benefit Pensions Inc.

Melville NY

View job as DC Plan Administrator
for United Benefit Pensions Inc.

View job as HRS Internal Service Support Specialist
for Paychex, Inc. HRS Internal Service Support Specialist

Paychex, Inc.

Rochester NY / Phoenix AZ / Saint Petersburg FL / Indianapolis IN / Baton Rouge LA / Auburn ME / High Point NC / Albuquerque NM / Franklin OH / Allentown PA / Nashville TN

Press Releases

Fiduciary Decisions Announces Redesigned User Experience for DOL PTE 2020-02 Solution

Fiduciary Decisions

Deadline Extended to Compete For the 401(k) Champion® Award

401(k) Champion

Employee Fiduciary Launches New 401k Fee Savings Calculator

Employee Fiduciary, LLC

Executive Compensation and Employee Benefits Lawyer Daniel McClain Joins Reed Smith

Reed Smith

Last Issue's Most Popular Items

IRS Clarifies Application of COVID-19 Outbreak Period Extensions for Electing COBRA Continuation Coverage and Paying COBRA Premiums

Verrill Dana LLP

COVID-19 Relief Addresses COBRA Election and Premium Payment Deadlines

Thomson Reuters Practical Law

COVID Vaccines: When Is an Employee's Vaccination Status HIPAA-Protected?

McAfee & Taft

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

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