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Health & Welfare Plans Newsletter

November 16, 2021


[Official Guidance]

CMS Website: Online Form to Petition CMS for Denial of a Particular Applicant's Certification as an IDR

"Applicants interested in becoming a certified independent dispute resolution (IDR) entity who meet the minimum qualification standards will proceed to the public petition period. During this period, the public can submit a petition for denial of the application for certification. A list of eligible entities will be posted each week, and will remain open for petitions for 5 business days."  MORE >>

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

[Guidance Overview]

2022 Medicare Physician Fee Schedule Final Rule Extends Telehealth Benefits

"The [2022] Medicare Physician Fee Schedule (MPFS) finalizes the extension of coverage of certain Medicare telehealth services through calendar year 2023, permanently extends coverage of tele-behavioral health services delivered to patients in their homes and via audio-only technology, and finalizes changes that would allow for rural health centers (RHCs) and federally qualified health centers (FQHCs) to deliver mental health visits virtually."  MORE >>

Manatt, Phelps & Phillips, LLP

[Guidance Overview]

D.C. Council Adopts Paid Leave for D.C. Employees Getting COVID-19 Vaccines

"The D.C. Council has adopted legislation that 'removes one of the biggest obstacles workers say prevents them from getting the COVID-19 vaccine' by ensuring paid time off for both vaccination and recovery from any side effects.... The adopted legislation also expands some benefits of the District of Columbia Family and Medical Leave Act, while extending several protections enacted under prior emergency legislation."  MORE >>

Jackson Lewis P.C.

[Guidance Overview]

Level-Funded Plans and ACA Annual Tax Filings

"While a level-funded plan can provide some more flexibility than insured plans, and more predictability than a typical self-funded plan, it comes with additional rules to consider. Employers sponsoring level-funded plans should be mindful of their reporting requirements as well as other compliance obligations[.]"  MORE >>

HUB International

Supreme Court to Consider Medicare Secondary Payer Rules for Dialysis Coverage Under Employer Group Health Plans

"DaVita has zeroed in on the coverage provisions for dialysis in health plans and argued that they violate a particular section of the Medicare Secondary Payer Act [which] prohibits employers and their group health plans from [1] 'taking into account' that a participant is eligible for Medicare; and [2] differentiating in coverage between participants with end stage renal disease (ESRD) and those without it. The crux of these disputes and the split between the Sixth Circuit and Ninth Circuit involves the uniformity exception found in the implementing regulations for this prohibition." [Marietta Memorial Hospital Employee Health Benefit Plan v. Davita, Inc., No. 19-4039 (6th Cir. Oct. 14, 2020; cert. pet. granted Nov. 5, 2021)]  MORE >>



2022 Onsite Employee Health Clinics Summit (January 20 - 21, 2022; Scottsdale, AZ)

The leading forum on building & expanding On-Site Health Clinics – incorporating strategies that reduce costs, ensure employee satisfaction and positively impact patient behavior! Register now at

Sponsored by World Conference Forum

FMLA Claim of Employee Fired While on Leave Survives Motion to Dismiss

"The appeals court found the plaintiff adequately pleaded an interference claim by alleging his employer denied him a benefit to which he was entitled under the FMLA: reinstatement to his position upon the termination of his FMLA leave. Although the employer argued the plaintiff's own allegations show he would have been fired even if he had not taken FMLA leave and so was not entitled to reinstatement, the appeals court disagreed." [Hester v. Bell-Textron Inc., 5th Cir., No. 20-11140 (Aug. 23, 2021)]  MORE >>

Society for Human Resource Management [SHRM]; membership may be required to view article

HSA vs. FSA for Medical Costs: Which Is Better?

"While FSAs and HSAs can both help you cover the cost of care, however, the rules that govern them -- including who is eligible to contribute and when your savings must be used -- differ greatly. Before you elect an FSA or HSA during open enrollment with your employer, it is important to determine which account, or whether a combination of both accounts, might work best for you."  MORE >>



Protecting Consumers from Surprise Ambulance Bills

"[The No Surprises Act] provides landmark protections against surprise billing in a wide range of settings -- but not for ground ambulances. At least half of all ambulance rides may result in a surprise bill ... Since consumers cannot choose an ambulance service when they dial 911, patients have little ability to avoid out-of-network charges.... This post will examine coverage and billing challenges, state actions, and lessons learned from states that could be replicated as the federal advisory committee begins its work."  MORE >>

The Commonwealth Fund

Benefits in General

[Official Guidance]

More California Wildfire Relief from IRS: Deadlines Further Extended to Jan. 3 for Certain Areas

"Wildfire victims in parts of California now have until January 3, 2022, to file various individual and business tax returns and make tax payments ... Under relief provided in August, these extensions were generally due to run out on November 15.... [T]he IRS is now providing more time to any area of California designated by FEMA for either individual or public assistance. Currently, this includes Lassen, Nevada, Placer, Plumas, Tehama and Trinity counties."  MORE >>

Internal Revenue Service [IRS]

[Official Guidance]

Test of IRS Notice 2021-63: Temporary 100% Deduction Applies to Meal Portion of 2021 and 2022 Per Diem Rate or Allowance (PDF)

"This notice provides guidance regarding the temporary 100-percent deduction for expenses that are paid or incurred after December 31, 2020, and before January 1, 2023, for food or beverages provided by a restaurant for purposes of Section 274(n)(2)(D) of the Internal Revenue Code. In particular, the notice sets forth a special rule for applying the temporary 100-percent deduction to the meal portion of a per diem rate or allowance."  MORE >>

Internal Revenue Service [IRS]

[Guidance Overview]

Upcoming Deadline icon Year-End Considerations for Employer-Sponsored Retirement and Health Plans

"This client alert provides insight to employers and plan sponsors on the impact and implications associated with new health and welfare and retirement benefits legislation and guidance, including the CARES Act, SECURE Act, ARPA COBRA tax credits, CAA No Surprises Act, required qualified retirement plan amendments, updates to the EPCRS, and more."  MORE >>

Troutman Pepper

Press Releases

Portfolio Evaluations Welcomes New Senior Fiduciary Consultant to the Team

Portfolio Evaluations, Inc.

Riskalyze Integrates with Dynamic Retirement Planner Income Lab


Fidelity Investments® and Paylocity Team Up to Provide Integrated Payroll Capabilities for Fidelity Advantage 401(k) Clients

Fidelity Investments

Transamerica and FuturePlan Expand Retirement Plan Access with Innovative New Pooled Plan Solution


Webcasts and Conferences
(Health & Welfare Plans)

HSAs, FSA, HRAs, and Voluntary Insurance Programs: ERISA vs. Non-ERISA Compliance

January 19, 2022 WEBCAST


Last Issue's Most Popular Items

Deadline Relief Continues for Health Plans and Participants


CMS Announces 2022 Medicare Parts A and B Premiums and Deductibles/2022 Medicare Part D Income-Related Monthly Adjustment Amounts

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

Fifth Circuit Enjoins OSHA from Enforcing Mandatory Vaccination or Test Emergency Regulations


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

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