[Guidance Overview]

New OSHA ETS: What Paid Leave Must an Employer Provide an Employee to Obtain a COVID-19 Vaccine or Test?

"[T]he ETS requires employers to ... [provide] employees reasonable paid time, including up to four hours of paid time, to receive each primary vaccination dose. Pay differs, however, depending on whether the employee is obtaining the vaccination during work time or after work hours.... [F]our hours of pay is not automatic.... In the preamble to the ETS, OSHA [provides details of what] will be considered a reasonable period of time to be compensated ... [It] seems apparent that OSHA will expect employers to generally provide up to two sick days per shot where side effects occur and recovery time if needed (using time either through the employee's own sick bank or, if the well is dry, directly from the employer)."  MORE >>

FMLA Insights

[Guidance Overview]

COVID-19 Relief for Health Plans: How Long Does it Last?

"Since the COVID-19 pandemic began back in early 2020, there's been a myriad of group health plan COVID-19 relief measures, ranging from no-cost coverage for COVID-19 testing to extended COBRA election and payment and HIPAA special enrollment right entitlements. Some relief measures apply only during the COVID-19 'public health emergency' (PHE) -- not to be confused with the COVID-19 'national emergency' -- and some are permanent.... Here's a summary to help you keep it all straight."  MORE >>

Mercer

[Guidance Overview]

The Pandemic Continues, But ACA Reporting Relief Does Not

"[E]mployers who have fluctuated in size a great deal over the past two years (sometimes getting smaller and then growing again quickly, or vice versa) are unsure of whether the ACA reporting requirements apply to them. Generally, the reporting requirements apply starting the year after which the employer first averages 50 or more full-time (including full-time equivalent) employees on business days. As with all things tax code, however, there can be a lot more to the analysis."  MORE >>

Jackson Lewis P.C.

[Guidance Overview]

Surprise Billing Regs Create Dispute Resolution Process Designed to Decrease the Risk of Higher Prices and Premiums for Consumers

"The new interim rule emphasizes adhering closely to the qualifying payment amount; this should help prevent an inflationary effect. If providers expect to only be paid the qualifying payment amount, they are less likely to seek arbitration. Conversely, in states like New Jersey and Texas, many providers have received payments well above the qualifying amount, which has encouraged more cases to go to arbitration."  MORE >>

The Commonwealth Fund

Ready. Set. Launch: 2022 Plan Year!

"Collaboration and ongoing open communication year-round drive the planning process with your insurance carriers and vendors, and Human Resources team with employees' feedback enables you to develop a strategy that maximizes your total rewards offerings for the upcoming plan year -- kicked off at open enrollment."  MORE >>

Newfront

Third Circuit: Employer Who Corrected Mistake in Its FMLA Certification Requirements May Terminate Employee for Taking Unauthorized Leave

"The court ruled that, while the initial denial of additional FMLA leave was improper, that wrongful denial 'was not irremediable' ... If the employee had submitted a sufficient recertification form to the employer within the seven day deadline, she could have obtained an extension of her FMLA leave. Because she did not submit the proper [corrected] forms, however, she was not entitled to FMLA leave and, therefore, could not show prejudice as a result of the violation or claim retaliation for exercising her FMLA rights." [Watson v. Drexel Univ., No. 20-3001 (3d Cir. Sep. 27, 2021; unpub.)]  MORE >>

The Wagner Law Group

Fifth Circuit: Denial of Life Insurance Benefit Supported by Clear Plan Provisions Despite Years-Long Collection of Premiums

"[T]he court concluded that reliance on the erroneous statements and deductions was not reasonable because the plan clearly and unambiguously set forth the evidence-of-insurability requirement and explained that insurance company approval was required before the coverage would become effective." [Talasek v. National Oilwell Varco, L.P., No. 21-20069 (5th Cir. Oct. 19, 2021)]  MORE >>

Thomson Reuters / EBIA

Seventh Circuit Affirms Unum's Termination of Long-Term Disability Benefits Based Substantially on Paper Reviews

"[T]here is no treating physician rule in the ERISA context and Unum did not arbitrarily refuse to credit Feeney's treating doctor's opinion. Unum found her opinions to be inconsistent with her own treatment notes and the findings of other doctors. Third, Unum did not have to consider the VA and SSA awards or other notes Feeney did not submit to Unum before it made a final decision." [Feeney v. Unum Life Insurance Company of America, No. 20-1685 (7th Cir. Nov. 3, 2021; unpub.)]  MORE >>

Roberts Disability Law

[Opinion]

Without a Dedicated Enforcement Mechanism, New Federal Protections Are Unlikely to Improve Provider Directory Accuracy

"These seemingly straightforward directories play a vital role in ensuring consumer access to health care from in-network providers at lower costs covered by their insurers than were they to seek care from out-of-network providers. Yet, despite the importance of provider directories, they are frequently highly inaccurate.... Directory errors may impose substantial costs on consumers, who -- unable to rely on information in the directory -- must first establish whether providers are in their network before scheduling an appointment.... More broadly, directory errors undermine the ability of individuals to choose health care based on personal preferences, an ideal that underpins many of America's health care regulations."  MORE >>

Health Affairs Blog

[Guidance Overview]

2021 Year-End Preparation for Benefit Plans (PDF)

"[I]tems to be sure to check off your list before 2021 concludes. Retirement plans: [1] Hardship distribution amendments.... [2] Other amendments.... [3] Pension funding.... [4] Notarization.... [5] Part-time employees for 401(k) eligibility.... [6] Nonqualified plan compliance.... Health and welfare plans: [7] Cafeteria plans and FSAs.... [8] Health plan telehealth relief.... [9] Surprise billing.... [10] Mental health parity expansion.... ERISA plans generally (retirement and welfare plans): [11] COVID-19 extensions expiring."  MORE >>

Ivins, Phillips & Barker

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Maryellen Coggins Becomes President of the American Academy of Actuaries

American Academy of Actuaries

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What Is in OSHA’s New Emergency Temporary Standard for COVID-19?

November 8, 2021 WEBCAST

Jackson Lewis LLP

Managing Critical Gaps in the Employee Benefits Experience

November 10, 2021 WEBCAST

Quantum Health

End of Year Benefits 'To-Do' List

November 18, 2021 WEBCAST

Hunton Andrews Kurth

2021 ERISA Litigation: What You Need to Know

December 2, 2021 WEBCAST

Faegre Drinker

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Text of OSHA Interim Final Rule and Comment Request: COVID-19 Vaccination and Testing; Emergency Temporary Standard

Occupational Safety and Health Administration [OSHA], U.S. Department of Labor [DOL]

DOL Issues Emergency Temporary Standard to Protect Workers from Coronavirus

Occupational Safety and Health Administration [OHSA], U.S. Department of Labor [DOL]

California Expands Health Insurance Mandates, Modifies Leave Laws

Mercer