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Health & Welfare Plans Newsletter

January 21, 2022

2 New Job Opportunities 2 New Job Opportunities


[Guidance Overview]

Exceptional Usefulness and Quality icon Correcting Missed Cafeteria Plan Contributions

"Employers generally have three straightforward options to address missed Section 125 cafeteria plan contributions. However, if the missed contributions extend back to a prior plan year or the affected employee has terminated employment, the correction approach is somewhat more complex."  MORE >>


[Guidance Overview]

Paid Sick Leave Requirements in Allegheny County, Pennsylvania

"In September 2021, the Allegheny County Council passed an ordinance compelling employers with 26 or more employees to provide their workers with paid sick leave. Although the rule took effect on December 15, 2021, fines and penalties for failing to adapt to the new rule will not be levied against employers until [December 15, 2022]."  MORE >>

Schneider Downs

[Guidance Overview]

Illinois Employers Face New Health Coverage Reporting Requirement

"This reporting requirement is imposed on employers -- not insurers, TPAs, or group health plans.... The law applies to all employers, regardless of size, if they employ individuals in Illinois. The law does not require employers' plans to provide all of the EHBs offered under the Get Covered Illinois program, just to show the information in a format that facilitates an easy comparison."  MORE >>

Michael Best

Does Your Retiree Health Care Program Have an Appropriate OPEB Document?

"OPEB increasingly represents one of the major underfunded liabilities of government. In order for public agency management and decision-makers to more efficiently deal with the legal, financial, and political aspects of OPEB, it only makes sense to clarify and distill the agency's obligations in a comprehensive and up-to-date plan document."  MORE >>

Best Best & Krieger LLP

Surprise Medical Bills Are Ending, but Controversy Continues

"The main controversy over surprise billing legislation was never over the surprise bills themselves. Rather, the controversy was over determining how much insurers should pay for out-of-network care once patients are held harmless.... [It] is likely that the ban on surprise billing will in fact tilt the scale of market power away from physicians and hospitals and toward the payers of health care."  MORE >>

JAMA Health Forum

CBO Report: Comparison of Prices Paid by Commercial Health Insurers and Medicare for Hospitals' and Physicians' Services

"In recent years, commercial health insurers' per-person spending on hospitals' and physicians' services has grown more quickly than analogous spending by the Medicare fee-for-service (FFS) program.... [C]ommercial insurers pay much higher prices for hospitals' and physicians' services than Medicare FFS does. In addition, the prices that commercial insurers pay hospitals are much higher than hospitals' costs."  MORE >>

Congressional Budget Office [CBO]

PTSD, Depression and Addiction Soar Amid Skyrocketing Cases of Omicron

"An alarming 1 in 4 American workers screened positive for post-traumatic stress disorder (PTSD) -- up 54% in the past three months and up 136% when compared to pre-pandemic. Depression is surging -- up 87% since fall (63% higher than before COVID-19).... When looking specifically at men ages 40-59, general anxiety is up 94%."  MORE >>

National Alliance of Healthcare Purchaser Coalitions

Text of CMS Memo: Reissuing 2018 Benefit Year HHS Risk Adjustment Data Validation (RADV) Results (PDF)

18 pages; Jan. 20, 2022. "[CMS] is reissuing 2018 benefit year ... Risk Adjustment Data Validation results in response to a successful appeal ... which challenged the calculation of the 2018 benefit year error rates under the HHS-RADV error estimation methodology."  MORE >>

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

Updated Summary Report of 2018 Benefit Year Risk Adjustment Data Validation Adjustments to Risk Adjustment Transfers (PDF)

81 pages; Jan. 20, 2022. "CMS is releasing an updated version of the Summary Report of 2018 Benefit Year Risk Adjustment Data Validation Adjustments to Risk Adjustment Transfers that was originally released on August 18, 2020. The purpose of releasing this updated report is to describe the impact of the reissued 2018 benefit year HHS-RADV results on 2019 benefit year risk adjustment transfers."  MORE >>

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

Benefits in General

New Audit Responsibilities for Plan Sponsors Take Effect

"Under SAS 136, plan sponsors must acknowledge their responsibility for the plan's administration in the audit engagement letter ... [and] provide written representations at the end of the audit regarding their responsibilities.... Tips for working with benefits plan auditors[:] ... [1] Take a hard look at your auditors.... [2] Invest time and effort to prepare.... [3] Discuss the audit plan.... [4] Be available and involved during your audit.... [5] Seek actionable feedback from the audit report.... [6] Keep your auditors informed all year."  MORE >>

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

Employee Benefits Jobs

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


View job as Sales Account Executive
for Capital Services, Inc. Sales Account Executive

Capital Services, Inc.

Towson MD / DC / VA

Press Releases

USI Consulting Group Launches New Retirement Readiness Calculator Program for Retirement Plan Participants


Corporate Insight Announces Annual User Experience Awards in Insurance and Annuities

Corporate Insight

Stephen P. Wilkes Appointed as Chief Legal Officer of The Wagner Law Group

Wagner Law Group P.C.

Last Issue's Most Popular Items

2023 Out-of-Pocket Maximums and Projected Employer Mandate Penalties

HUB International

Employee Benefits Due Diligence Should Be at Top of M&A Checklist

Fisher Phillips LLP, via Crain's Cleveland Business; free registration required

Group Health Plans Must Provide Free Over-the-Counter COVID-19 Tests: Takeaways and Action Items for Employers

Snell & Wilmer

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

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