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Health & Welfare Plans Newsletter

November 22, 2021

8 New Job Opportunities 8 New Job Opportunities

 

[Guidance Overview]

HIPAA Penalties Increase Again

"The penalty amounts are adjusted annually for changes in the cost of living. These updated amounts for 2021 apply for penalties assessed on or after November 15, 2021 for violations that occurred on or after November 2, 2015.... [T]he penalty amounts vary based on the penalized entity's level of care."  MORE >>

HUB International

[Guidance Overview]

Alert (High Risk Issue) icon HHS Regs Include Expansive New Prescription Drug and Health Care Reporting Requirements for Employer Plans

"The extra requirements in [the Interim Final Rule] that are not in the statute include reporting the following by each state in which an employer plan has participants: [1] Detailed prescription drug data and health care service cost data; [2] The number of plan participants with a paid prescription drug claim; [3] The total dosage units of prescription drugs dispensed and number of paid drug claims; [4] Plan premium amounts; [5] Prescription drug rebates, fees, and other remuneration broken down by the amounts received by the plan and the amounts passed through to participants for each therapeutic class of drugs; and [6] The impact of prescription drug rebates, fees, and other remuneration on premiums and out-of-pocket costs."  MORE >>

HR Policy Association

[Guidance Overview]

Administration Announces Steps to Protect Consumers and Improve Ground Ambulance Billing Practices

"[HHS] unveiled details about the establishment of ... the Ground Ambulance and Patient Billing (GAPB) Advisory Committee ... [which] will be charged with providing recommendations to the Secretaries of [HHS], Labor, and Treasury on ways to protect consumers from exorbitant charges and balance billing when using ground ambulance services.... Individuals interested in serving on the GAPB Advisory Committee may either self-nominate or be nominated by an organization. Applications must be submitted within 20 days of the publication date of the Federal Register notice [scheduled for Nov. 23, 2021]."  MORE >>

U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

Do FMLA Leave Requests Scare You?

"Most HR professionals, regardless of whether they're solo practitioners, consider the Family and Medical Leave Act (FMLA) one of the toughest workplace laws to administer. But it's not an insurmountable task if you pay attention to detail and documentation."  MORE >>

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

House Passes Build Back Better Act with Paid-Leave and ACA 'Firewall' Provisions

"[The Build Back Better Act (HR 5376)] proposal would apply to all employers regardless of size and require employers to provide leave to all workers regardless of length of service, job type or worker classification.... [T]here are significant differences [from the FMLA] in employee notice requirements and the definition of who qualifies as a family member."  MORE >>

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

Congressional Doctors Lead Bipartisan Revolt Over Policy on Surprise Medical Bills

"Congress passed the No Surprises Act last December ... after long, hard-fought negotiations with providers and insurers finally yielded an agreement that lawmakers from both parties thought was fair ... But now many doctors, their medical associations and members of Congress are crying foul, arguing the [independent dispute resolution (IDR) rule] released by the Biden administration ... favors insurers and doesn't follow the spirit of the legislation."  MORE >>

Kaiser Health News

The Insurance Warrior Takes on a $61 Billion Company

Podcast, with transcript. "Although the surgery was his only option, his insurance denied the claim. That's when his wife ... contacted Laurie Todd, who calls herself the 'Insurance Warrior.' ... Fourteen years later, the speeches they gave in a conference room full of executives are a master class in winning insurance appeals ... [T]aking on your health insurance provider often means going up against your employer. That's because most large companies 'self-insure.' And in this case, that employer was one of the biggest businesses in the world."  MORE >>

Kaiser Health News

Unvaccinated Workers Pay More for Health Insurance at Some Companies

"[As] COVID cases climb once again, more companies are putting aside carrots and turning to sticks in an effort to protect their workers. From Utah grocery chain Harmons to Wall Street banking giant JPMorgan Chase, companies are telling their unvaccinated workers to get the shots or pay more for health insurance."  MORE >>

National Public Radio [NPR]

An Analysis of the HHS-Operated Risk Adjustment Technical Paper on Possible Model Changes (PDF)

"At the national level, ... receivers are likely to receive less risk transfers while payers are likely to pay less risk transfers.... Results were different in the individual market compared to small group market.... [R]isk score components for medical condition categories (HCC), prescription drug condition categories (RXC), and enrollment duration factors (EDF) decreased." [See also HHS-Operated Risk Adjustment Technical Paper on Possible Model Changes, Oct. 26, 2021]  MORE >>

Wakely Consulting Group

Employee Benefits Jobs

View job as Defined Benefits Combo Cash Balance Consultant
for Loren D. Stark Company (LDSCO) Defined Benefits Combo Cash Balance Consultant

Loren D. Stark Company (LDSCO)

Remote / Houston TX

View job as Defined Benefits Combo Cash Balance Consultant
for Loren D. Stark Company (LDSCO)

View job as Defined Contributions Consultant
for Loren D. Stark Company (LDSCO) Defined Contributions Consultant

Loren D. Stark Company (LDSCO)

Remote / Houston TX

View job as Defined Contributions Consultant
for Loren D. Stark Company (LDSCO)

View job as DC Plan Administrator
for Heritage Pension Advisors, Inc. DC Plan Administrator

Heritage Pension Advisors, Inc.

Commack NY

View job as DC Plan Administrator
for Heritage Pension Advisors, Inc.

View job as Financial Processor (Distributions Specialist)
for Retirement Solutions Specialists Financial Processor (Distributions Specialist)

Retirement Solutions Specialists

Remote / Jacksonville FL

View job as Financial Processor (Distributions Specialist)
for Retirement Solutions Specialists

View job as Defined Contribution Plan Administrator
for American Retirement Plan Services, LLC Defined Contribution Plan Administrator

American Retirement Plan Services, LLC

Remote / Hunt Valley MD

View job as MEP / PEP Relationship Manager
for Nova 401(k) Associates MEP / PEP Relationship Manager

Nova 401(k) Associates

Remote / Houston TX / Dallas TX / Scottsdale AZ

View job as Benefits Advisor (Recent Graduate)
for Employee Benefits Security Administration [EBSA] Benefits Advisor (Recent Graduate)

Employee Benefits Security Administration [EBSA]

Remote / Kansas City MO

View job as Documents Specialist
for Newport Documents Specialist

Newport

Mobile AL

Webcasts and Conferences
(Health & Welfare Plans)

Finding the Benefit Sweet Spot

November 23, 2021 WEBCAST

ArmadaCare

Last Issue's Most Popular Items

Employer-Provided COVID-19 Testing: An Employee Benefits Q&A

Ogletree Deakins

HHS Announces Adjustments to Civil Monetary Penalties for HIPAA, MSP, and SBC Violations, Effective November 15, 2021

Thomson Reuters / EBIA

Court Dismisses Former Employee's COBRA Claims Against TPA

Thomson Reuters / EBIA

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

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