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Health & Welfare Plans Newsletter

November 23, 2021

7 New Job Opportunities 7 New Job Opportunities


[Guidance Overview]

Mental Health Parity: Don't Be Left Out in the Cold!

"As the demand for mental health and substance use disorder benefits has increased, many employers and plan participants are discovering that their group health plan coverage for those benefits is sorely lacking ... [M]ental health and substance use disorder services are more likely to be provided out-of-network ... [EBSA] seems especially interested in identifying claim-handling procedures, provider credentialing, and reimbursement rates that tend to limit mental health and substance use disorder benefits more than medical and surgical benefits."  MORE >>

Jackson Lewis P.C.

[Guidance Overview]

Agencies Issue Two Rounds of No Surprise Billing Guidance

"Health plans must work now to understand the [independent dispute resolution (IDR)] requirements for certain payors and out-of-network providers, as well as the other requirements to implement the prohibitions on surprise billing, as many of these rules are expected to be effective next year.... With external review procedures affected, even for grandfathered plans, amendments to health plan claims procedures will be necessary to comply."  MORE >>

The Wagner Law Group

Network Adequacy for Behavioral Health: Existing Standards and Considerations for Designing Standards (PDF)

40 pages. "[S]tandards specific to behavioral health typically include only a small number of provider types ... relative to the overall number of behavioral health providers and services.... The panelists [1] highlighted several underlying causes of inadequate behavioral health networks that warrant further attention from plans, regulators, and policymakers.... [2] identified a number of principles for designing network adequacy standards.... [and] [3] emphasized that monitoring access and network adequacy is at least as important as improving standards."  MORE >>

Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS]

Wellness Programs as Alternative to Employer Vaccine Mandates (PDF)

"Employers seeking to increase employee vaccinations [may] explore using their health care wellness programs to incentivize vaccinations, but this approach has limitations and introduces other considerations."  MORE >>

Winstead PC

Exceptional Usefulness and Quality icon Evidence on Surprise Billing: Protecting Consumers with the No Surprises Act (PDF)

10 pages. "This issue brief reviews evidence on surprise billing and its burden on patients, explores policy approaches to address surprise billing including state actions, and describes new federal rules implementing the No Surprises Act."  MORE >>

Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS]

HHS Secretary Says Surprise Billing Rules Force Doctors Who Overcharge to Accept Fair Prices

"The doctor groups say giving the insurers the upper hand will let them drive payment rates down and potentially force doctors out of networks or even out of business, reducing access to health care. [HHS] has heard those concerns, [HHS Secretary Xavier Becerra] said, but the bottom line is protecting patients. Medical providers who have taken advantage of a complicated system to charge exorbitant rates will have to bear their share of the cost, or close if they can't, he said."  MORE >>

Kaiser Health News

Telehealth Visits by Phone May Soon End Unless Legislators Act

"To date, about half of all U.S. states have passed measures keeping audio-only telehealth in place. In the remaining states, absent legislation, old restrictions governing telehealth have kicked back in or will; some will sunset when the federal public health emergency ends sometime after the end of the year, while others have set their own timelines. Meanwhile, insurance coverage policies are also in flux."  MORE >>

National Public Radio [NPR]

Class Action Lawsuit Challenges Washington State's Long Term Care Mandate

"A class action lawsuit has been filed against Washington State's Long-Term Services and Supports Trust Act that requires each worker in Washington to contribute $0.58 per $100 (0.58%) of wages to a trust set aside to pay long-term care benefits for its residents. The lawsuit challenges the Act and requests a declaratory judgment that the Act is unenforceable as it violates ERISA and federal and state laws governing employee benefit plans." [Pacific Bells, LLC v. Inslee, No. 21-1515 (W.D. Wa. complaint filed Nov. 9, 2021)]  MORE >>

Seyfarth Shaw LLP

Employee Benefits Jobs

View job as Plan Administrator / Assistant
for National Employers Retirement Trust Plan Administrator / Assistant

National Employers Retirement Trust

Remote / Bethesda MD / DC / PA / VA / WV

View job as Defined Contribution Plan Administrator
for PPS Pension Services Defined Contribution Plan Administrator

PPS Pension Services

Remote / Williamsville NY

View job as Defined Contribution Plan Administrator
for PPS Pension Services

View job as Retirement Plan Consultant
for Cetera Retirement Plan Specialists Retirement Plan Consultant

Cetera Retirement Plan Specialists


View job as Retirement Plan Consultant
for Cetera Retirement Plan Specialists

View job as Compliance Administrator II
for Associated Pension Consultants Compliance Administrator II

Associated Pension Consultants


View job as DC Administrator with a Life!
for Nova 401(k) Associates DC Administrator with a Life!

Nova 401(k) Associates

Remote / Houston TX / Dallas TX / Scottsdale AZ

View job as Service Specialist - 401(k) / S125, Key Partner Service
for Paychex, Inc. Service Specialist - 401(k) / S125, Key Partner Service

Paychex, Inc.

Rochester NY / Phoenix AZ

View job as Retirement Plan Consultant
for Qualified Plan Administrators, Inc. Retirement Plan Consultant

Qualified Plan Administrators, Inc.

Remote / Greensboro NC

Press Releases

National Competition Selects Three 401(k) Champions®

401(k) Champion® Award

Webcasts and Conferences
(Health & Welfare Plans)

Ethical Considerations for ERISA Attorneys

December 14, 2021 WEBCAST

American Bar Association Joint Committee on Employee Benefits [JCEB]

Ask the Experts

December 16, 2021 WEBCAST

Boutwell Fay LLP

Last Issue's Most Popular Items

Text of IRS Proposed Regs: Information Reporting of Health Insurance Coverage and Other Issues Under Sections 5000A, 6055, and 6056 (PDF)

Internal Revenue Service [IRS]

HHS Regs Include Expansive New Prescription Drug and Health Care Reporting Requirements for Employer Plans

HR Policy Association

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

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

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

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