"Regulators indicate that participant complaints to federal agencies have proliferated over the years ... This trend compelled regulators to warn plans that ALL FDA-approved, cleared or granted contraceptive products that are determined by an individual's medical provider to be medically appropriate for the individual must be covered without cost sharing, whether or not specifically identified in the current FDA Birth Control Guide."  MORE >>

"The Department guidance strongly encourages plans to pay for OTC Tests upfront ... [T]he guidance allows plans to: [1] Provide OTC Tests directly through the plan's retail or mail-order pharmacy network, with no out-of-pocket costs to the participant; and [2] Limit the amount the plan will pay for tests obtained outside of the plan's network to $12 per test (or the cost of the test, if less)."  MORE >>

"This was a fairly straightforward application of the Supreme Court's Rutledge ruling, which held that ERISA does not preempt state laws that merely increase costs or alter incentives for ERISA plans. While these cases involved PBM laws, this line of reasoning could apply to other state laws governing entities or processes that have some relationship to ERISA plans, such as laws regulating TPAs and other service providers." [Pharmaceutical Care Management Assoc. (PCMA) v. Wehbi, No. 18-2926 (8th Cir. Nov. 17, 2021)]  MORE >>

"At times, Allstate ... made representations to employees, both orally and in writing, that their retirement life insurance benefits were 'paid up' or 'for life.' ... Because the SPDs unambiguously gave Allstate the right to change, amend, or terminate the plan at any time, and expressly clarified that employees had no vested rights under the plan, the appellate court agreed with the district court that plaintiffs failed to establish that benefits were actually 'due' under 'the terms of the plan' for purposes of ERISA Section 502(a)(1)(B)." [Klaas v. Allstate Ins. Co., No. 20-14014 (11th Cir. Dec. 28, 2021)]  MORE >>

"Health insurance enrollment among small-firm employees remained relatively stable from 2013 to 2019, hovering between 8.9 and 9.6 million enrollees. The rate at which small firms offer health insurance coverage decreased by just 2.6 percentage points from 2013 to 2020.... [P]remiums for single coverage grew by an average of 3.2 percent per year in the small-group market and by 3.7 percent in both the medium- and large-group markets."  MORE >>

"The Court asserted that OSHA has failed to show evidence of 'grave danger' in many industries, and absolves employers of the requirement to ensure that unvaccinated employees engage in weekly testing.... With the ETS set to expire in May, it is unclear whether it will ever become law and again be enforced. The government will need to determine whether to continue to press its merits case at the Sixth Circuit before a possible return engagement with the Supreme Court." [National Federation of Independent Businesses v. OSHA; Ohio v. OSHA, Nos. 21A244 and 21A247 (S. Ct. Jan. 13, 2022)]  MORE >>

"[If] you are in a state that requires employers to mandate vaccination or testing, then you will still need to comply with state law.... [If] you are in a state (such as Florida or Texas) that restricts employers' ability to impose vaccination mandates, it's safe to start complying with your state law now.... For everybody else ... [If] you told your employees about the ETS requirements and do not want to impose them now that you don't have to, then you should put together a brief communication to employees saying that, in light of yesterday's Supreme Court decision, you no longer plan to require vaccination or testing for unvaccinated employees."  MORE >>

"The Supreme Court majority noted that OSHA could issue a narrower standard based upon heightened risk in certain types of workplaces, and OSHA could choose to do just that.... The Supreme Court decision leaves states free to regulate employers with regard to COVID-19.... The ETS also loses its preemptive effect in states without federally approved state OSHA plans." [National Federation of Independent Businesses v. OSHA; Ohio v. OSHA, Nos. 21A244 and 21A247 (S. Ct. Jan. 13, 2022)]  MORE >>

"For now, employers are not required by federal law to move forward with the written policy and other deadlines effective Jan. 10 and Feb. 9, 2022 for the ETS. Federal implementation of the CMS interim rule remains active/ongoing in all 50 states plus territories, with Jan. 27 and Feb. 28, 2022 deadlines for Phase 1 and Phase 2 implementation." [National Federation of Independent Businesses v. OSHA; Ohio v. OSHA, Nos. 21A244 and 21A247 (S. Ct. Jan. 13, 2022); Biden v. Missouri; Becerra v. Louisiana, Nos. 21A240 and 21A241 (S. Ct. Jan. 13, 2022)]  MORE >>

"[A] table reflects the DOL's 2022 annual inflation adjustments to the civil money penalties for violations of certain requirements under ERISA, effective January 15, 2022."  MORE >>

"According to a three-judge Pennsylvania Superior Court panel, providing written descriptions to employees regarding various benefits, incentives and rewards may form a binding, unilateral contract creating rights and obligations separate from an employee's at-will relationship with the employer." [Evans v. Capital Blue Cross, No. 410 MDA 2021 (Penn. Jan. 5, 2022)]  MORE >>

"The United States Senate Committee on Health, Education, Labor and Pensions (HELP) on [January 13] advanced the nomination of Lisa Gomez to serve as assistant secretary for [EBSA], setting the stage for a full Senate vote. The nomination advanced by a partisan committee vote of 12 to nine."  MORE >>