logo logo

Health & Welfare Plans Newsletter

January 11, 2022

6 New Job Opportunities 6 New Job Opportunities


[Official Guidance]

HRSA Updates to ACA Preventive Health Care Guidelines

"[The Health Resources and Services Administration (HRSA) has] accepted updates to existing guidelines ... regarding breastfeeding services and supplies, well-woman preventive care visits, access to contraceptives and contraceptive counseling, screening for human immunodeficiency virus (HIV), and counseling for sexually transmitted infections (STIs). These updates include, for the first time, requiring coverage without cost-sharing for double electric breast pumps. HHS also approved a new guideline aiming to prevent and reduce obesity in midlife women (ages 40 to 60) through counseling.... HRSA also accepted updates to existing Bright Futures guidelines [which] include adding universal screening for suicide risk ... for individuals ages 12 to 21, and new guidance for behavioral, social and emotional screening. HRSA has also accepted new guidelines for assessing risks for cardiac arrest or death for individuals ages 11 to 21 and assessing risks for hepatitis B virus infection in newborn to 21 year-olds." [HRSA guidelines, both existing and updated, are available online.]  MORE >>

Health Resources and Services Administration [HRSA], U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

Administration Requires Insurance Companies and Group Health Plans to Cover the Cost of At-Home COVID-19 Tests

"The new coverage requirement means that most consumers with private health coverage can go online or to a pharmacy or store, buy a test, and either get it paid for up front by their health plan, or get reimbursed for the cost by submitting a claim to their plan. This requirement incentivizes insurers to cover these costs up front and ensures individuals do not need an order from their health care provider to access these tests for free." [See FAQs Part 51, issued January 10, 2022.]  MORE >>

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

[Guidance Overview]

Exceptional Usefulness and Quality icon CMS Q&As for Employees: How to Get Your At-Home Over-the-Counter COVID-19 Test for Free

"How do I get a free at-home over-the-counter COVID-19 test? ... How much will I be reimbursed for an at-home over-the-counter COVID-19 test if I purchase the test upfront and then submit a claim for reimbursement to my insurance company? ... Why would these companies be incentivized to cover the cost up front? ... What if I can't afford to pay for the at-home over-the-counter COVID-19 test(s) upfront? ... How many tests can I get reimbursed for? ... My employer requires that I test myself multiple times per week and send them the results as a condition of employment. Can I get these tests reimbursed by insurance?"  MORE >>

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

[Guidance Overview]

New Health Plan Disclosure Requirements Should Bring More Transparency

"The new disclosure requirements apply to persons who provide 'brokerage services' or 'consulting' to ERISA-covered group health plans [and] expect to receive $1,000 or more in direct or indirect compensation. The disclosures are intended to provide plan fiduciaries with sufficient information to assess the reasonableness of the compensation to be received (before it is received) and any potential conflicts of interest."  MORE >>

McAfee & Taft

[Guidance Overview]

Elimination of Good Faith Relief for ACA Reporting

"[D]espite the elimination of the transitional good faith relief, the IRS stated in the preamble to the proposed regulations that ... penalty relief for 'reasonable cause,' has always been, and will continue to be, available ... Of course, reasonable cause is a higher standard than good faith."  MORE >>

Verrill Dana LLP

[Guidance Overview]

HHS Reaffirms That ACA Section 1557 Includes Discrimination Based on Sexual Orientation and Gender Identity

"Among other things, it is clear from the preamble to the new rule that it prohibits discrimination in 'benefit design based on sexual orientation and gender identity.' HHS makes clear that it disapproves of policies that make gender-affirming care unavailable to transgender individuals in need of such care. HHS intends that, when finalized, the rule will require that essential benefit determinations not discriminate based on sexual orientation or gender identity."  MORE >>

The Wagner Law Group

[Guidance Overview]

Alert (High Risk Issue) icon All Connecticut Employers Are Covered by State Family and Medical Leave Act Beginning 2022

"All employers with at least one employee in Connecticut are covered by the Connecticut FMLA as of January 1, 2022.... Employees are eligible after three months of employment. Eligible employees are entitled 12 weeks of unpaid, job-protected leave in a 12-month period for various covered reasons."  MORE >>

Jackson Lewis P.C.

[Guidance Overview]

New York DOL Adopts Rules Regarding Sick Leave

"[E]mployees outside of New York must be included in determining an employer's size, which will affect the amount of leave an employee is eligible to accrue.... [W]hile employers may require employees to provide documentation -- such as a note from a healthcare provider -- to support their eligibility for leave, they cannot require documentation that would cause employees to incur any costs."  MORE >>

Davis Wright Tremaine LLP

[Guidance Overview]

Updated Rates for California EDD Benefits and San Francisco Paid Family Leave Ordinance

"Employers with employees located in California are generally required to withhold and send state disability contributions to the [Employment Development Department (EDD)]."  MORE >>

Jackson Lewis P.C.

Access to Preventive Services Without Cost-Sharing: Evidence from the ACA

"This Issue Brief summarizes the ACA's preventive services provisions for private health coverage, Medicare, and Medicaid; provides updated estimates of the number of people benefiting from these provisions nationally; and examines evidence on trends in utilization of preventive services and outcomes since the ACA's preventive services coverage requirements went into effect."  MORE >>

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

Sky-High COVID-19 Mortality Not Affecting All Life Insurers the Same

"Life insurance executives shuddered last week with news of a reported 40% increase in death rates due to the COVID-19 pandemic.... But those mortality rates might not be what they seem for most life insurers.... One of the things life insurers are doing in the age of COVID is sharpening the underwriting process to better identify risk."  MORE >>

Benefits in General

Can Service Providers Be Trusted? (PDF)

"Many problems with service providers arise because Primary Fiduciaries do not understand their roles and accountabilities. Lack of formal training, which the DOL reports is a rampant deficiency among plan sponsors, undermines otherwise well-intentioned Primary Fiduciaries' ability to make proper choices of service providers. Consequently, they expose themselves and their employers to needless risk, as ERISA ignorance is not a legal defense."  MORE >>

Roland Criss

Employee Benefits Jobs

View job as Retirement Plan Administrator
for ForUsAll Retirement Plan Administrator



View job as Retirement Plan Administrator
for ForUsAll

View job as Product Support Specialist - Conversions
for part of Wolters Kluwer Legal & Regulatory Product Support Specialist - Conversions part of Wolters Kluwer Legal & Regulatory


View job as Product Support Specialist - Conversions
for part of Wolters Kluwer Legal & Regulatory

View job as Transaction Coordinator
for The Retirement Advantage, Inc. (TRA, Inc.) Transaction Coordinator

The Retirement Advantage, Inc. (TRA, Inc.)


View job as 401k Plan Administrator
for Northeast Planning Services, Inc. 401k Plan Administrator

Northeast Planning Services, Inc.

Remote / Waltham MA

View job as Administrative Assistant
for E.H. Thomson & Co., Inc. Administrative Assistant

E.H. Thomson & Co., Inc.

Sea Girt NJ

View job as TPA Operations Team
for Retirement Plan Administrators, LLC TPA Operations Team

Retirement Plan Administrators, LLC

Atlanta GA

Press Releases

Katie Martin Named New President and Chief Executive Officer of HCCI

Health Care Cost Institute [HCCI]

Everside Health Announces Launch of COVID-19 Surveillance Testing Solution for Large Employers

Everside Health

Webcasts and Conferences
(Health & Welfare Plans)

Benefits Compliance in 2022: Preparing for a New Year

January 20, 2022 WEBCAST

Acrisure LLC

The New Broker and Consultant Disclosure Requirements

January 21, 2022 WEBCAST

New England Employee Benefits Council [NEEBC]

Optimizing Your Pharmacy Benefit: Maximizing Value for the Plan and Participants

February 10, 2022 WEBCAST

Worldwide Employee Benefits Network [WEB] - Northeast Ohio Chapter

Last Issue's Most Popular Items

Text of Agency FAQs, Part 51: FFCRA and CARES Act Implementation, COVID-19 Diagnostic Testing and Coverage of Preventive Services (PDF)

U.S. Department of Health and Human Services [HHS]; U.S. Department of Labor [DOL]; and U.S. Treasury Department

Looking Ahead to 2022: Compliance Topics for Employer-Sponsored Health and Welfare Plans


Text of DOL Inspector General Report to Congress, Including Findings and Recommendations for EBSA (PDF)

Office of Inspector General [OIG] for the U.S. Department of Labor [DOL]

Unsubscribe  |   Change Email Address

Search Past Issues   |   Privacy Policy

Submit an Article   |   Contact Us   |   Advertise Here

Copyright 2021, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.

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

Links to web sites other than and are offered as a service to our readers. We are not involved in their production and are not responsible for their content.