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Health & Welfare Plans Newsletter

January 28, 2022

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[Official Guidance]

Text of CMS Extension of Comment Deadline for Draft 2023 Letter to Issuers (PDF)

"CMS is extending the public comment deadline for parties to comment on the Draft 2023 Letter to Issuers. The new deadline is Tuesday, February 1, 2022[.]"  MORE >>

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

[Guidance Overview]

Agencies Report MHPAEA Compliance Lacking, But Don't Name and Shame Plans and Issuers... Yet

"[T]he DOL's MHPAEA Self-Compliance Tool and multiple FAQs have provided guidance on certain questions to ask and general orientation, but stopped short of identifying exactly how and what must be done to satisfy regulators. This concern is exacerbated by the fact that states may have additional and variable expectations, particularly during market conduct exams. Nonetheless, the Report's summaries of common missteps ... provides more grist for iterating an effective comparative analysis model."  MORE >>

Sheppard Mullin

[Guidance Overview]

Alert (High Risk Issue) icon Washington State Long-Term Care Premium Tax Formally on Ice

"Lawmakers have passed legislation delaying the implementation of Washington state's novel long term care premium tax until July 2023 ... Employers who have already withheld the tax will need to refund it to their employees within 120 days. Those about to run their payroll should take steps to avoid (further) withholding of the tax."  MORE >>

Lane Powell

[Guidance Overview]

In 2022 MHPAEA Report, DOL Highlights Robust Enforcement of CAA-21 and Widespread Noncompliance

"[T]he report does include guideposts for complying with MHPAEA ... including: [1] Insight into how the Departments chose who to request [comparative analyses (CAs)] from ... [2] A list of the most common NQTLs for which DOL requested CAs. [3] The most common deficiencies in submitted CAs. [4] Common corrections and plan amendments in response to the Departments' enforcement.... [T]he DOL has also focused its efforts on service providers that administer claims for large numbers of plans (so that any resulting changes are passed through to those plans)."  MORE >>

Thomson Reuters Practical Law

Eighth Circuit: Insurer Cannot Terminate LTD Benefits Unless It Has New Evidence

"[T]he Court explained that a plan administrator's reliance on the same evidence to both find a disability and later discredit that disability does not amount to a reliance on significant new evidence. The insurer's about face requires evidence that a 'reasonable mind might accept as adequate to support' its change in decision. " [Roehr v. Sun Life Assurance Co. of Canada, No. 21-1559 (8th Cir. Dec. 27, 2021)]  MORE >>

The Wagner Law Group

How Hospital Pricing Data Can Help Cut Costs and Improve Employee Benefits

"How are prices distributed across the hospital locations your employees use? Are most of your employees going to the most expensive facility? Why? If it's because of location, you might need to switch to a carrier that has better prices at that specific hospital or consider creating an incentive for employees to use a different facility. You could partner with the target facility for certain types of standard care and do things like building an in-office clinic or bringing a mammography truck to your office regularly."  MORE >>

HR Daily Advisor


AHIP Comment Letter to HHS on 2023 Notice of Benefit and Payment Parameters (PDF)

34 pages. "Given the broad and substantial set of proposals and significant challenges to fully assess the impact under the short comment time frame, we recommend providing additional comment opportunities before finalization.... [AHIP is] particularly concerned that finalizing many of these policies for the 2023 plan year would result in a significant change from current requirements and plan offerings, placing a significant strain on issuers and providers[.]"  MORE >>


Benefits in General

Data Privacy and Security: Key Concerns for Employee Benefit Plans

"[1] Do you collect more information than required or retain information longer than necessary, possibly increasing your risk of a breach? [2] Do you know how your data flows internally? Are there safeguards to make sure only those who need to see data can access it? [3] With whom do you share data externally? Should you hold vendors to a particular privacy or security standard? [4] Should you be using encryption or other security measures with respect to your data? [5] What are your procedures in the event of a security breach?"  MORE >>

Groom Law Group

Employee Benefits Jobs

View job as Retirement Contributions Specialist
for Alerus Retirement Contributions Specialist


Arden Hills MN

Selected New Discussions

Participant Must Pay Shipping Costs for At-Home COVID-19 Tests?

"Can a plan charge a participant for shipping/handling as part of its direct-to-consumer COVID-19 shipping option and stay within the safe harbor so that it can limit reimbursement to $12 for at-home tests purchased out-of-network? One of the large (perhaps the largest) PBMs is saying that's the case. To me, that's not within the spirit if not the letter of the current FAQs."

BenefitsLink Message Boards

Press Releases

Franklin Templeton Selects Ascensus to Host Personal Retirement Path Managed Account Services Offering


Custodia Financial Announces Free Access to Form 5500 Data via

Custodia Financial

Webcasts and Conferences
(Health & Welfare Plans)

2022 Legislative Update

February 3, 2022 WEBCAST


Everything's Bigger in Telehealth: A Look at Past and Present Trends in Telehealth and What's in Store for Tomorrow

February 22, 2022 in TX

Worldwide Employee Benefits Network [WEB] - Dallas Chapter

Everything's Bigger in Telehealth: A Look at Past and Present Trends in Telehealth and What's in Store for Tomorrow

February 22, 2022 WEBCAST

Worldwide Employee Benefits Network [WEB] - Dallas Chapter

Last Issue's Most Popular Items

Health Plan Fiduciaries Must Solicit Information from Brokers and Consultants

Ballard Spahr LLP

Text of CMS Guidance: Federal Independent Dispute Resolution (IDR) Process for Disputing Parties (PDF)

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

Understanding the Great Resignation and Work for Older Adults


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

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