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Health & Welfare Plans Newsletter

October 20, 2021

4 New Job Opportunities 4 New Job Opportunities


[Guidance Overview]

Mental Health Parity Act: A Compliance Wake-Up Call

"[This article will:] [1] [D]iscuss the new MHPAEA requirement, the DOL's recent settlement and why both of these items matter; [2] Highlight some issues plans -- especially self-funded plans -- and insurers are facing in attempting to comply with this new requirement; and [3] Provide action steps that plans and insurers can take to help meet this requirement."  MORE >>

Hall Benefits Law

[Guidance Overview]

CAA Surprise Billing Rules Preserve HSA Eligibility

"[I]ndividuals covered by an HDHP with no other disqualifying coverage remain HSA-eligible even if the plan pays non-preventive benefits prior to the individual satisfying the applicable minimum statutory HDHP deductible ... [and] HDHPs may pay non-preventive benefits prior to the individual satisfying the applicable minimum statutory HDHP deductible -- provided such benefits are required pursuant to the CAA (or other similar state law) surprise billing protection provisions."  MORE >>


[Guidance Overview]

Massachusetts Updates PFML Rates for 2022

"Effective January 1, 2022, the Massachusetts Paid Family & Medical Leave (PFML) contribution will reduce to .68% of payroll (from .75% in 2021) on the first $142,800 of wages (from $128,400 in 2021). The maximum weekly PFML benefit will also increase to $1,084.31 (from $850 in 2021)."  MORE >>


[Guidance Overview]

Colorado Public Health Emergency Supplemental Leave Continues

"On October 15, 2021, [HHS] announced another extension of the nationwide COVID-19 public health emergency ... Colorado's Healthy Families and Workplaces Act (HFWA) requires employers to supplement paid sick leave in certain circumstances ... 'until four weeks after the official termination or suspension of the public health emergency.' ... [If] the COVID-19 public health emergency declaration remains in effect until 'the official termination or suspension of the public health emergency' on January 16, 2022, the HFWA requirement for supplemental paid sick leave would not expire until February 13, 2022."  MORE >>

Ogletree Deakins

District Court Addresses ERISA Coverage of Voluntary Benefit

"A court found an employer 'contributed' to a supplemental AD&D policy by paying for basic AD&D insurance and that it 'established' the plan by negotiating terms with the insurer." [Blake v. Life Ins. Co. of N. Am., No. 20-319 (W.D. Ky. Sep. 27, 2021)]  MORE >>

PLANSPONSOR; free registration may be required

Fifth Circuit Affirms Dismissal of ERISA Plan Beneficiary's Estoppel Claim Over Supplemental Life Insurance Benefits

"Though [the] misrepresentations [by the employee benefits service center operated by her late husband's employer] were frustrating, Plaintiff failed to create a genuine dispute of material fact over the reasonable reliance aspect of the second element. As such, the court declined to consider whether extraordinary circumstances existed." [Talasek v. National Oilwell Varco, L.P., No. 21-20069 (5th Cir. Oct. 19, 2021)]  MORE >>

Roberts Disability Law

Prepare for a 'Tsunami' of Long-COVID Disability Claims: 20% of Long-Haulers Will Be Too Sick to Return to Work

"If long-COVID patients, called long-haulers, file as expected, it could amount to an historic influx into the US's disability system. But claims require approval, and some insurance providers are already denying long-COVID claims, leaving it up to HR departments to consider other ways to protect their workers.... Attorney Andrew Kantor says the rejections are strategic and expected: 'Insurers are incentivized to deny righteous claims because there is very little risk to doing so.' "  MORE >>

HR Brew

Integrating a Limited-Purpose Health FSA Into Your HSA Program

"Limited-Purpose Health FSAs offer four distinct advantages ... [1] Enjoy immediate access to elections.... [2] Increase tax savings.... [3] Build HSA balances.... [4] Help certain adult children."  MORE >>


The Pitfalls of Cost Sharing in Healthcare

"[B]ecause the benefits of health care treatment are often long-term, can be difficult to observe, and often come with side effects, the costs and benefits that a patient observes may not be the same as the actual cost of production and cost sharing may discourage the use of cost-effective, high-value medical or pharmaceutical interventions. [This short video] provides [an] overview summary of the potential benefits and key pitfalls of cost sharing."  MORE >>

Healthcare Economist

Cost Estimates for Certain Health Insurance Provisions in Reconciliation Legislation

"CBO and JCT estimate that enacting those provisions would increase deficits by $553.2 billion over the 2022-2031 period ... [and] result in a net decline of about 3.9 million people without health insurance.... CBO and JCT estimate that under the legislation, in 2031, 23.6 million people under the age of 65 would be uninsured -- a reduction from the current-law total of 27.7 million people."  MORE >>

Congressional Budget Office [CBO]

Senate Finance Committee Hearing: Health Insurance Coverage in America: Current and Future Role of Federal Programs

Video of Oct. 20 hearing, with links to testimony by: [1] Linda Blumberg, Ph.D., Urban Institute; [2] Sara Collins, Ph.D., The Commonwealth Fund; [3] Douglas Holtz-Eakin, Ph.D., American Action Forum; and [4] Frederick Isasi, J.D., M.P.H., Families USA.  MORE >>

Committee on Finance, U.S. Senate

Shift Toward Government-Backed Plans a Major Trend in Health Care

"Since 2017, the percentage of managed care organization members who receive care through Medicare or Medicaid jumped from 31% to 41%.... [C]ommercial self-funded insurance makes up the biggest piece of the pie at 43%, although that share decreased from 50% in 2017. Commercial private insurance makes up 16% of the mix, down slightly from 19% in 2017."  MORE >>

Employee Benefits Jobs

View job as Loan and Distribution / Contribution Upload Specialist
for Aimpoint Pension Loan and Distribution / Contribution Upload Specialist

Aimpoint Pension


View job as Loan and Distribution / Contribution Upload Specialist
for Aimpoint Pension

View job as Relationship Manager - Retirement Plans
for Spectrum Investment Advisors, Inc. Relationship Manager - Retirement Plans

Spectrum Investment Advisors, Inc.

Thiensville WI

View job as Relationship Manager - Retirement Plans
for Spectrum Investment Advisors, Inc.

View job as Pension Administrator
for Actuaries Unlimited, Inc. Pension Administrator

Actuaries Unlimited, Inc.


View job as Pension Administrator
for Actuaries Unlimited, Inc.

View job as Health Insurance Specialist (Program Policy)
for Centers for Medicare & Medicaid Services [CMS] Health Insurance Specialist (Program Policy)

Centers for Medicare & Medicaid Services [CMS]

Remote / Woodlawn MD

Press Releases

Nationwide, Capital Group and Annexus Retirement Solutions Set to Launch Next Evolution in Target Date Series


BPAS Launches Innovative Tool to Prevent Fraud


Transamerica Debuts Employer-Funded Health Reimbursement Accounts


Last Issue's Most Popular Items

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

Holland & Hart LLP

Handling Medical Loss Ratio Rebates (PDF)

Cowden Associates, Inc.

IRS Guidance Clarifies COBRA/Outbreak Period Interaction

HUB International

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

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