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Health & Welfare Plans Newsletter

January 6, 2022

3 New Job Opportunities 3 New Job Opportunities


[Guidance Overview]

EBSA Answers Key Compensation Disclosure Questions

"FAB 2021-03 answers a number of specific questions regarding ERISA Section 408(b)(2)(B) compliance, [including]: [1] Covered service providers may use prior EBSA guidance developed for pension plans.... [2] ERISA Section 408(b)(2)(B) does apply to 'excepted benefits' such as dental and vision-only plans.... [3] Covered service providers are not limited to providers who are licensed as 'Brokers' and 'Consultants.' ... [4] Contracts entered into prior to December 27, 2021 are not subject to the new statute."  MORE >>

Kilpatrick Townsend

[Guidance Overview]

DOL Issues Advice on Broker and Consultant Compensation Disclosures

"The Act's broker and consultant compensation rules are modeled on similar disclosure requirements that have applied to pension plan service providers since 2012. [FAB 2021-03] tracks and cites the pension disclosure rules while also providing transitional flexibility that individuals and entities subject to the rules act reasonably and in good faith."  MORE >>


[Guidance Overview]

2023 Proposed Notice of Benefit and Payment Parameters Would Revert Nondiscrimination and Guaranteed Availability Provisions, Return Standardized Plan Options

"The 2023 NBPP proposed rule would ... explicitly prohibit discrimination on the basis of sexual orientation and gender identity, as had been the case prior to 2020.... The proposed rule also would clarify the nondiscrimination policy for benefit design ... The rulemaking also would address prescription drug benefit tiering as a potentially discriminatory benefit design.... The proposed rule would 'reinterpret' guaranteed availability to require insurers to provide coverage to individuals even if they owe past-due premiums to the issuer (or an issuer in the same control group)."  MORE >>

Sheppard Mullin

[Guidance Overview]

New Surprise Billing Regs Mandate Provision of 'Good Faith Estimates' to Uninsured and Self-Pay Patients

"Beginning January 1, 2022, all state licensed or certified health care facilities and providers must follow extensive rules for providing a 'good faith estimate' of health care charges to uninsured and self-pay patients prior to the provision of health care services.... The estimate must be provided in the format requested by the patient (paper, electronic, or other), is considered part of the patient's medical record, and must be retained and made available to the patient on request for a period of at least six years."  MORE >>

Arent Fox

[Guidance Overview]

IRS Announces Indexing Factor to Calculate No Surprises Act's Qualifying Payment Amount for 2022

"Regulations provide that for an item or service furnished during 2022, the group health plan or insurer must calculate the [qualifying payment amount (QPA)] by increasing the median contracted rate for the same or similar item or service under the plan or coverage as of January 31, 2019, by the combined percentage increase in the consumer price index for all urban consumers (U.S. city average) (CPI-U) over 2019, 2020, and 2021. This revenue procedure advises that for 2022, the IRS has determined that the combined percentage increase to adjust the median contracted rate is 1.0648523983."  MORE >>

Thomson Reuters / EBIA

Alert (High Risk Issue) icon Eighth Circuit Warns Disability Administrators to Think Twice Before Terminating Disability Benefits

"The court found that Sun Life's decision was 'nothing more than a sudden change of heart on essentially the same record after almost a decade -- and with no notice to Roehr prior to his benefits' termination.' As a result, Sun Life had left Dr. Roehr 'without any meaningful opportunity to respond or seek other treatment.' ... [T]he court concluded that Sun Life's 'about-face' was unreasonable, and it remanded to the district court with instructions to order Dr. Roehr's reinstatement of benefits." [Roehr v. Sun Life Assurance Co. of Canada, No. 21-1559 (8th Cir. Dec. 27, 2021)]  MORE >>

Kantor & Kantor

HSA Employee Survey: Interest on the Rise

"HSAs ranked as the fifth highest-rated benefit type in the list, with 50% of respondents assigning them top-two box importance (i.e., deeming them either 'very important' or 'extremely important') and another 27% rating them as at least 'moderately important.' ... About 53% of Gen X and 55% of Millennials rated HSAs with top-two box importance, as did roughly 63% of individuals with a household income over 100k."  MORE >>

Corporate Insight

Benefits in General

[Guidance Overview]

Agencies Release 2021 Form 5500 Series with Instruction Changes Finalized by DOL

"The preamble to the DOL's action finalizing its revisions to the 2021 instructions notes that other changes in the September 2021 proposal -- i.e., those with later effective dates -- will be finalized later in one or more separate actions. As a reminder, the informational copies of Form 5500 cannot be used for filing; Forms 5500 and 5500-SF must be filed electronically."  MORE >>

Thomson Reuters / EBIA

How The ERISA Landscape May Shift This Year (PDF)

"Within the next few months, the U.S. Supreme Court will weigh in for the first time on the pleading standard for challenges to excessive fees in retirement plans.... At the circuit court level, there were important new decisions in 2021 regarding the enforceability of arbitration agreements and class action waivers under ERISA, and the U.S. Court of Appeals for the Third Circuit agreed to hear an important interlocutory appeal regarding whether defined contribution plan participants can challenge investment options in which they were not invested. And there continues to be a steady flow of health plan-related lawsuits in several areas, including with respect to [COBRA] notices and mental health parity."  MORE >>

Groom Law Group, via Law360

Employee Benefits Jobs

View job as Account Manager
for Pentegra Account Manager


Remote / West Harrison NY

View job as Account Manager
for Pentegra

View job as Client Service Specialist
for EPIC RPS Client Service Specialist


IL / IN / MA / MD / ME / NC / NH / NY / PA / TN / VA / VT

View job as Client Service Specialist

View job as Senior Retirement Plan Consultant
for July Business Services Senior Retirement Plan Consultant

July Business Services

Remote / Waco TX

Press Releases

NFP Acquires Improved Funding Techniques Inc., Expanding Retirement Footprint in Northeast Region

NFP Corp.

Global Retirement Technology Provider Smart Enters Into Agreement to Acquire Stadion Money Management


DOL Recovers More Than $9.3 Million for Minnesota Employee Stock Ownership Plan After Investigation Finds Plan Overpaid for Shares

Employee Benefits Security Administration [EBSA], U.S. Department of Labor

EBRI Announces Volunteer Leadership Changes

EBRI [Employee Benefit Research Institute]

Hub International Enhances Employee Benefits and Retirement Services with Acquisition of Raffa Financial Services, Inc. in Maryland

HUB International

Webcasts and Conferences
(Health & Welfare Plans)

Considering Health Spending: Is It Time to Regulate Health Care Prices?

January 20, 2022 WEBCAST

Health Affairs

Last Issue's Most Popular Items

New Employer Health Plan Compliance Responsibilities for 2022

MZQ Consulting, LLC

Health Plans Face New Liabilities for Inaccurate Provider Directories (PDF)


DOL Releases Field Assistance Bulletin on Disclosure Requirements for Brokerage and Consulting Service Providers Under ERISA 408(b)(2)

Groom Law Group

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

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