[Guidance Overview]

Handling Medical Loss Ratio Rebates (PDF)

"In the absence of definitive direction in the plan document: [1] no portion of the rebate is a plan asset when the premium was paid entirely by the employer; [2] the full amount of the rebate is a plan asset when the premium was paid entirely by employees; [3] the full amount of the rebate is a plan asset when the premium was paid entirely from trust assets; or [4] portion of the rebate attributable to employee contributions is a plan asset when the premium was paid by both the employer and employees."  MORE >>

Cowden Associates, Inc.

[Sponsor]

Jump Start your Prospecting with Leads from Judy Diamond

Open Enrollment will soon be upon us, and there’s no better way to get in front of plan decision makers than a subscription to Judy Diamond. User-friendly and accurate, Judy Diamond is the industry standard for ERISA-qualified lead generation.

[Guidance Overview]

IRS Guidance Clarifies COBRA/Outbreak Period Interaction

"[To] the extent there are COBRA qualified beneficiaries who have elected COBRA, but not made the initial payment even though it has been more than a year and 105 days since they were initially eligible for COBRA (or a year and 45 days since they elected), a reminder may be in order. They may believe they have additional time and instead need to send in their payment by November 1."  MORE >>

HUB International

[Guidance Overview]

Missouri Victims Economic Safety and Security Act (VESSA) Requires Notification to Employees by October 27, 2021

"Employers must advise current employees of this new law no later than October 27, 2021. The Missouri Department of Labor has developed a poster that should be prominently displayed to meet the notification requirement, or a copy of a newly-developed policy should be provided to employees.... [E]mployees hired after October 27, 2021, should be provided with a copy of the ... notice."  MORE >>

FordHarrison

[Guidance Overview]

D.C. Modifies the Paid Family Leave and Local FMLA Laws

"The new laws entitle employees to three times as much paid medical leave and a new category of paid prenatal leave. The modifications also expand the group of employees eligible for D.C. FMLA."  MORE >>

McGuireWoods

[Guidance Overview]

New California Law Requires Insurers to Cover COVID-19 Testing and Vaccinations Without Cost Sharing

"The law applies to plans that cover medical, surgical and hospital benefits regulated by the either the California Department of Managed Health Care or Department of Insurance, which includes most fully insured health plans and HMOs (excluding specialized health care plans) situated in the State."  MORE >>

Burnham Benefits

Reminder: No Extensions on ACA Reporting Deadlines for 2021

"Last year at this time, the IRS ... [announced] it was extending the January 31 deadline to provide individuals with a copy of Form 1095-B and/or 1095-C by 30 days. This year, no extension has been announced, nor is one expected. That means the 2021 deadline for providing individuals with Forms 1095-B or 1095-C is January 31, 2022."  MORE >>

OneDigital

GAO Report on Rare Diseases: Although Limited, Available Evidence Suggests Medical and Other Costs May Approach $1 Billion

"Partly due to the difficulty of diagnosing rare diseases, the costs related to them are hard to track.... One study estimated total 2019 U.S. costs for rare diseases at $966 billion -- including direct medical costs (e.g., drugs, doctor visits) and other nonmedical and indirect costs (e.g., loss of income)." [GAO-22-104235, Oct. 18, 2021]  MORE >>

U.S. Government Accountability Office [GAO]

Study Provides Blueprint for Businesses to Avoid a Post-Pandemic Workplace Failure

"73% of employees say their manager helping them maintain a life and work balance is moderately to extremely important.... Across well-being dimensions, entry-level employees are much less satisfied (ranging from 34% to 41%) than senior employees (ranging from 62% to 64%)."  MORE >>

Vitality

[Opinion]

Expanding Consumer Health Insurance Options by Easing the Boundaries Between Individual and Small-Group Markets

"Whereas initially under the ACA, unsubsidized premiums in the individual market were much lower than in the small-group market, now premium levels are much more similar. But because market conditions can vary substantially by location, consumer options could be enhanced by providing select opportunities to cross this market border in either direction.... Policies that ease these market boundaries without substantially harming market conditions may be valuable."  MORE >>

The Commonwealth Fund

Evaluating Prospective Plan Auditors

"CPA firms with specialized retirement plan audit practices choose to demonstrate their commitment to quality employee benefit plan audits by displaying their auditors' badges on marketing materials, social media, and email signature lines. What do the badges mean and how does a plan sponsor differentiate between prospective audit teams that are equally credentialed?"  MORE >>

Belfint Lyons Shuman

Service Agreements for Benefit Plans: The Devil Is in the Details

"[1] Request and review a copy of the provider's standard contract as part of the request for proposal (RFP) process.... [2] Consider business objectives and business events at the outset.... [3] Indemnification.... [4] Privacy & cybersecurity.... [5] Disguised transfers of risk under the contract."  MORE >>

Holland & Hart LLP

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Employee (Under Age 26) on Parents' Plan May Want to Add Medical Coverage Earlier Than Open Enrollment

"An employee came to me, indicating her parents are going through open enrollment effective for changes 11/1/2021. Our employee (under age 26) is under her parents' plan currently. Her parents are considering dropping her because she can get medical though us. Our open enrollment starts in November, effective 1/1/2022. Can we allow her to add medical due to losing coverage under her parents' plan effective 11/1/2021? She will not be be 26 until next September. I believe the answer is Yes due to being a QLE. I know COVID had muddied the waters a bit during 2020 and for health FSA extended relief again for 2021 regarding QLEs. We did adopt these enhancements due to COVID for both 2020 and 2021. Your input/comments would be appreciated."

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Repeat Honors for Cohen & Buckmann Co-Founders, Sandra Cohen and Carol Buckmann

Cohen & Buckmann P.C.

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The 'Now Normal': The Convergence of Data, Technology, and Employee Health

October 27, 2021 WEBCAST

Artemis Health

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Are Your Employee Benefits Plans Ready for the New Year, or Is It the Same Auld Lang Syne?

Ogletree Deakins

IRS Updates Procedures for FAQs: Improvements to Citations and Historical Versions, and Good-Faith Reliance

Internal Revenue Service [IRS]

IRS Clarifies Key Time Extensions of COBRA Election and Payment Deadlines

Miller Johnson