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Health & Welfare Plans Newsletter

February 14, 2022

7 New Job Opportunities 7 New Job Opportunities


[Guidance Overview]

Alert (High Risk Issue) icon Health Plan Fiduciaries Should Be Prepared for Service Provider Fee Disclosures

"Failure to obtain these disclosures and determine the reasonableness of compensation to be received and any potential conflicts of interest that may exist as a result of a service provider receiving indirect compensation from sources other than the plan or the plan sponsor could be considered a breach of fiduciary duty.... Both fiduciaries and consultants/brokers should be prepared to comply with the new fee disclosure rules for all contracts entered into, extended, or renewed on or after December 27, 2021."  MORE >>

Ice Miller LLP

[Guidance Overview]

Surprise Billing Guidance Addresses Interaction of IDR Procedures and DOL Claims Regulations

"CMS's guidance notes that the federal IDR process does not replace the [ACA's] external review requirements. The external review procedures are for resolving disputes between individuals and plans/insurers over adverse benefit determinations.... [T]he federal IDR process is for resolving payment disputes between plans/insurers and providers ... Individuals are not parties to the federal IDR process.... However, it may be possible for a dispute to go through both the external review process and the federal IDR process.... Claims will not be automatically routed from one process to another."  MORE >>

Thomson Reuters Practical Law

[Guidance Overview]

Exceptional Usefulness and Quality icon California COVID-19 Supplemental Paid Sick Leave Requirements: Next Steps for Employers

"[1] Consider the best way to track 2022 SPSL-covered absences to ensure compliance and avoid overpayment. [2] Review payroll systems/software to determine if timely compliance for paystub information is feasible ... [3] Consider developing ... leave forms that track the covered reasons 2022 SPSL usage ... [4] For employers with operations in localities with COVID-19 paid sick leave requirements ... check the status of those ordinances AND review the ordinances to determine which reasons for paid leave overlap with those set forth in 2022 SPSL."  MORE >>

Davis Wright Tremaine LLP

Alert (High Risk Issue) icon First Circuit Ruling Highlights Key Intersection of ERISA and MHPAEA

"[S]ince there is no private cause of action enumerated in the Parity Act, the court expanded its ruling to address whether the plaintiffs could also state a claim for benefits due under the terms of the plan despite the benefit plan's explicit exclusion. The court found the exclusion would not bar such a claim because the Parity Act's requirements are read into the plan, and a violation of the Parity Act would therefore be considered inconsistent with the terms of the plan as a matter of law." [N.R. v. Raytheon Company, No. 20-1639 (1st Cir. Jan. 31, 2022)]  MORE >>

DeBofsky Sherman Casciari Reynolds P.C.

How Do Copayment Coupons Affect Branded Drug Prices and Quantities Purchased?

"Using data on net-of-rebate prices and quantities from a large Pharmacy Benefits Manager, ... coupons increase quantity sold by 21-23% for the commercial segment relative to Medicare Advantage in the year after introduction ... [The authors then] estimate a discrete choice model of demand for multiple sclerosis drugs ... [and find] that coupons raise negotiated prices by 8% and result in just under $1 billion in increased U.S. spending annually. Combined, the results suggest copayment coupons increase spending on couponed drugs without bioequivalent generics by up to 30 percent."  MORE >>

National Bureau of Economic Research [NBER]; purchase required for full document

High-Deductible Health Plans: Good Practices for Employers

"Employers identified ... nine good practices in HDHP design to help enrollees maximize value ... Employers acknowledged the usefulness of HDHPs, while noting they are imperfect tools, with some employers expressing concern about the financial burden of HDHPs on enrollees, especially low- and middle-wage employees.‚Äč In addition, gaps exist between what employers considered a good practice and what they implemented in their HDHP designs."  MORE >>

National Pharmaceutical Council [NPC]

Multiemployer Health and Welfare Fund Statistics: 2021 Report

"This year's report on the Milliman Multiemployer Health and Welfare Study includes data for 1,282 plans covering approximately 4.9 million members as of 2019, the most recent year for which data is available. [This report includes]: [1] A summary of the key findings from the data; [2] Fund capitalization statistics; [3] Annual per member change in income and expenses; [4] Per member statistics."  MORE >>


CRS Insight: Proposed Changes to USPS Health Benefits in the Postal Service Reform Act of 2022

"The Postal Service Reform Act of 2022 [HR 3076] ... includes reforms intended to reduce USPS's future retiree health liability by requiring eligible postal retirees to enroll in Medicare Part B and by providing retiree drug coverage through Medicare Part D." [IN11856 Feb. 11, 2022  MORE >>

Congressional Research Service [CRS]

CRS Insight: Funding of Postal Retiree Health Benefits in the Postal Service Reform Act of 2022

"The Postal Accountability and Enhancement Act of 2006 [PL 109-435] required USPS to make annual payments into the Postal Service Retiree Health Benefit Fund (RHBF) for 10 years (from FY2007 to FY2016). This Insight provides information on the status of these payments and describes changes to the RHBF that the USPS Fairness Act (Section 102 of Postal Service Reform Act of 2022, HR 3076) would make." [IN11855 Feb. 11, 2022]  MORE >>

Congressional Research Service [CRS]

Benefits in General

Audit of DOL Cybersecurity Finds Deficiencies

"More than eight months after the [DOL] issued a list of best cybersecurity practices for ERISA practitioners, the department's Inspector General has released a report that found Labor's own IT security seriously lacking.... IG Carolyn Hantz said the department had not conducted annual security control assessments for 30 systems during FY21.... Hantz also said the [DOL] has not instituted an effective supply chain risk management program and has failed to keep an accurate record of computer hardware. The department also did not log or review DOL user accounts."  MORE >>

BenefitsPro; free registration required

Designing Benefits for Uber Drivers and Other Platform Workers

"[W]orkers are willing to trade off additional income for benefits; after accounting for the tax advantage of benefits, workers are roughly indifferent on average between the two. While there are some trends in valuation, such as higher valuation for pension than for health contributions, the most notable feature of the data is the wide variation across workers in their preferences across benefits types and relative to income."  MORE >>

National Bureau of Economic Research [NBER]; purchase required for full document

Investing and Retiring in an Unknown Future: How Companies Can Support Employees Today and Tomorrow (PDF)

"Upheaval in the economy and marketplaces presents companies with a mandate -- and a meaningful opportunity -- to discover the value of creating programs that contribute to their employees' financial wellness and, by extension, their mental well-being. With a focus on reimagining employee benefits, employers can make a meaningful difference in the lives of their employees ... now and in the future."  MORE >>

Benefits Quarterly, published by the International Society of Certified Employee Benefit Specialists [ISCEBS]

Employee Benefits Jobs

View job as Retirement Client Services Manager
for Newport Retirement Client Services Manager


Remote / Folsom CA / Chicago IL / Saint Petersburg FL / Lake Mary FL / La Crosse WI / Charlotte NC / Mobile AL / Overland Park KS / Dallas TX / West Des Moines IA / Los Angeles CA / Pittsburgh PA

View job as Benefits Advisor (English and/or Spanish)
for Employee Benefits Security Administration [EBSA] Benefits Advisor (English and/or Spanish)

Employee Benefits Security Administration [EBSA]

Remote / Dallas TX

View job as Benefits Advisor (English and/or Spanish) (Recent Graduates Program)
for Employee Benefits Security Administration [EBSA] Benefits Advisor (English and/or Spanish) (Recent Graduates Program)

Employee Benefits Security Administration [EBSA]

Remote / Dallas TX

View job as DB/DC Consultant
for Nova 401(k) Associates DB/DC Consultant

Nova 401(k) Associates

Remote / Houston TX / Dallas TX / Scottsdale AZ

View job as Defined Benefits Retirement Plan Consultant
for Economic Group Pension Services (EGPS) Defined Benefits Retirement Plan Consultant

Economic Group Pension Services (EGPS)


View job as Defined Contribution Retirement Plan Consultant
for Economic Group Pension Services (EGPS) Defined Contribution Retirement Plan Consultant

Economic Group Pension Services (EGPS)

Remote / Burnsville MN

View job as Preparation and Consulting Support Project Leader
for WTW Preparation and Consulting Support Project Leader



Press Releases

Lower 401(k) Plan Fee Trend Continues

401k Averages Book

Last Issue's Most Popular Items

Navigating the Federal Independent Dispute Resolution Process Within the No Surprises Act: Traps for Unwary Providers

K&L Gates

DOL Issues Additional Guidance on Free Over-the-Counter COVID Tests

McAfee & Taft

DOL Reports 2021 Mental Health Parity Enforcement Activity

Thomson Reuters / EBIA

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

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