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Health & Welfare Plans Newsletter
November 2, 2021
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5 New Job Opportunities
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[Official Guidance]
Text of CMS Memorandum to Issuers Offering Health Insurance Coverage in the Small Group Market: Temporary Policy on 2021 Premium Credits (PDF)
Nov. 1, 2021. "CMS is permitting small group market health insurance issuers, subject to the applicable state regulator's permission, the flexibility in non-merged market states to temporarily offer premium credits for 2021 coverage. CMS believes that small employers will
benefit from this additional flexibility to maintain continuous comprehensive coverage for their employees while recovering from the financial instability caused by the COVID-19 [public health emergency]." MORE >>
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]
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[Guidance Overview]
IRS Information Letter Addresses Employee Prescription Drug Rebates and HDHPs
"HDHP/HSA participants can use drug coupons and discounts, provided that the value of the coupon or discount does not count towards the HDHP minimum deductible. While insured HDHPs must cover certain benefits under applicable state laws, those benefits may not be covered without
cost-sharing that is otherwise applicable to non-preventive services before the deductible is met." MORE >>
Seyfarth
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[Guidance Overview]
New Health Plan Requirements for Employers in 2022: Consolidated Appropriations Act Checklist
"Removal of gag clauses ... Broker and consultant compensation disclosure ... Medical and drug cost reporting ... Mental health parity and addiction equity act (MHPAEA) comparative analysis ... Surprise billing ... Surprise air ambulance bills ...
Reporting requirements regarding air ambulance services ... Modify identification cards ... No discrimination against certain providers ... Advanced explanation of benefits (EOB) ... Continuity of care ... Price comparison tool ... Provider directory and coverage information requests." MORE >>
The Alliance
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[Guidance Overview]
Tri-Agencies Issue FAQs Regarding COVID-19 Vaccine and Group Health Plan Premium Discounts
"Employers should calculate the incentive limit to ensure that the vaccine incentive, taken together with all other non-tobacco incentives, does not exceed the 30% incentive limit, particularly if the employer had previously considered the COVID-19 vaccine as a participatory
wellness program.... [E]mployers should ensure that the ACA affordability standards are still being met assuming that participants do not earn the COVID-19 vaccine incentive." MORE >>
Calfee, Halter & Griswold LLP
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[Guidance Overview]
Agencies Clarify How Employers Can Charge COVID-19 Vaccine Premium Incentives
"Employers and group health plan sponsors considering implementing vaccine premium incentives should ensure that they comply with all of the criteria for activity-only health-contingent programs in the HIPAA wellness regulations and account for vaccine premiums in their ACA
affordability calculations." MORE >>
McDermott Will & Emery
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[Guidance Overview]
Self-Funded Employers May Need to Pay Washington State Mental Health Program Fee
"Washington State recently passed legislation requiring health insurance carriers and health plans to pay a quarterly assessment to assist medical providers with managing patients' mental health needs. Health insurance carriers will pay on behalf of fully insured plans, but
self-funded plans may need to pay the fee themselves.... Employers subject to ERISA may argue that they are exempt from the fee due to ERISA preemption of state laws, but Washington state law specifically says that the fee applies to any plan that covers employees living in the state of Washington, including self-funded plans sponsored by employers located in other states. " MORE >>
EPIC
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How Employers Can Help Ensure a Smooth Open Enrollment
"Holding meetings via webinar or video conference will allow for remote or dispersed workers to participate and stay involved.... Be sure that all communication is clear and concise with important dates and changes highlighted. Don't rely on only one channel.... Mailings
should be sent to those on COBRA as well as anyone that may not have access to company communication." MORE >>
Corporate Synergies
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Democrats Drop Medicare Dental and Vision Coverage from Social Spending Bill But Voters Say It's Their Top Priority
"Across political parties, voters' top priority for the bill is adding dental and vision benefits to Medicare, which was cut from the White House's latest framework after intense pushback from dental groups and amid concerns about the price tag.... Among the 18 provisions listed in the poll, voters' second-highest priority is funding for home health care for seniors and people with disabilities, followed by Medicare drug price negotiation." MORE >>
Morning Consult
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[Opinion]
Rulemaking for Health Care Affordability: Implementing the No Surprises Act
"As rulemaking finalizes, HHS can use three unique No Surprises Act provisions to build durable affordability standards through the mandated arbitration process ... HHS should also carefully monitor the IDR turnaround time and characteristics of arbitration requests to make
sure payers and providers do not manipulate or inadvertently overwhelm the system ... The long-term risk to these 'compromise' solutions embedded in the No Surprises Act is that average people could pay more out of pocket in the form of premiums." MORE >>
Ryan Koski-Vacirca and Arjun Venkatesh, in Health Affairs Blog
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Benefits in General |
GAO Report on Social Security and Medicare: Improving the Timeliness of Trust Fund Reports
"In 2019, GAO reported that the trustees issued their annual reports to Congress after the statutory deadline in 17 of the 25 years from 1995-2019 ... Treasury missed its April 1 deadlines for the 2020 and 2021 reports.... This report [1] describes Treasury's
progress in addressing GAO's 2019 recommendations, and [2] offers potential actions ... that could help ensure timely completion of the Trustees reports." [GAO-21-105413, published Sep. 30, 2021, released Nov. 1, 2021] MORE >>
U.S. Government Accountability Office [GAO]
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Employee Benefits Jobs |
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Retirement Client Services Manager
Newport
Remote / Folsom CA / Chicago IL / Saint Petersburg FL / Lake Mary FL / La Crosse WI / Charlotte NC / Mobile AL / Overland Park KS / Dallas TX / West Des Moines IA / Los Angeles CA / Pittsburgh PA
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Press Releases |
OneAmerica Launches New Retirement Plan Offering More Flexibility and Streamlined Administration
OneAmerica
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Goldman Sachs Asset Management and Ascensus Offer a Retirement Plan Solution for Small and Mid-Sized Businesses
Ascensus
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Webcasts and Conferences (Health & Welfare Plans) |
Health Policy Regulation for Employers
RECORDED
The Alliance
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Vaccination Incentives and Employer-Sponsored Benefit Plans
RECORDED
Gallagher
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Benefit Plans in the COVID-19 Era: 2021 Year-End Action Items and 2022 Considerations
November 9, 2021 WEBCAST
Western Pension & Benefits Council - Denver Chapter
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Last Issue's Most Popular Items |
How Employers Can 'Carve-Out' Group Health Plan Savings
Employee Benefits Report
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Ninth Circuit Affirms Attorneys' Fee Award to ERISA Welfare Plan in Dispute Brought by Health Care Providers
Roberts Disability Law
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Teladoc Ramping Up Focus on Virtual Primary Care with Plans to Take on Financial Risk
FierceHealthcare
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BenefitsLink Retirement Plans Newsletter, ISSN no. 1536-9587.
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