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Health & Welfare Plans Newsletter

February 17, 2022

6 New Job Opportunities 6 New Job Opportunities


[Guidance Overview]

Alert (High Risk Issue) icon ACA Guidance Expands Mandatory Coverage List of Women's Preventive Services

"On December 30, 2021, the Health Resources and Services Administration (HRSA) of [HHS] adopted updated preventive services guidelines.... The one new required covered service is counseling to prevent obesity in midlife women ... defined as women aged 40 to 60 years. The counseling is available for those midlife women with normal or overweight body mass index (BMI) to help them maintain weight or limit weight gain to prevent obesity."  MORE >>

HUB International

[Guidance Overview]

CMS Publishes Letters on No Surprises Act Enforcement in States

"[T]he letters state CMS' determination regarding whether state or federal law will determine the amount that plans must pay for out-of-network items and services covered by the NSA ... The CMS letters apply the NSA's web of state and federal law and authority provision-by-provision and state-by-state."  MORE >>

Manatt, Phelps & Phillips, LLP

[Guidance Overview]

Upcoming Deadline icon California Adopts COVID Sick Leave -- Again

"[A] new version of Supplemental Paid Sick Leave (SPSL) [will] take effect on February 19, 2022, and apply retroactively back to January 1, 2022 ... Employers who provided an employee with another form of COVID-specific paid leave on or after January 1, 2022, can count those hours toward the employee's SPSL entitlement.... There are two likely scenarios where an offset will apply: [1] If an employer is voluntarily providing COVID-specific leave, separate from PSL and their regular PTO program; or [2] if the employer has provided paid leave under a city- or county-mandated COVID-specific leave law."  MORE >>

Benefit Revolution

[Guidance Overview]

Upcoming Deadline icon California Rolls Out New COVID-19 Supplemental Paid Sick Leave for 2022

"What employers should do now: [1] Reinstate COVID-19 supplemental paid sick leave and update policies. [2] Revise wage statements to display the 2022 COVID-19 supplemental paid sick leave used. [3] Prepare processes to handle employees' requests for retroactive pay ... [4] Post the DLSE's model workplace notice and disseminate copies to employees working remotely."  MORE >>

Epstein Becker Green

Provider Lawsuits Over the No Surprises Act: Latest Developments

"[P]roviders have been particularly aggressive about challenging the NSA in court. By filing six lawsuits in five different jurisdictions, providers are trying to maximize their chances that at least one lawsuit succeeds."  MORE >>

Health Affairs

New Evidence Suggests a Lack of Cost-Shifting in Prescription Drug Markets

"[B]iosimilar entry in the EU caused sharp reductions to global revenue but [the authors] observe little evidence of offsetting revenue increases in the US market relative to prior trend. These results are consistent with the theory that drug makers are already using their market power in full. At a minimum, revenue targeting arguments must contend with the reality that firms appear willing to accept revenue losses internationally, despite holding similar market power in the US commercial market as they would in the wake of Medicare price regulation."  MORE >>

The Incidental Economist

Recertification Request Does Not Interfere with FMLA Rights

"The 8th Circuit noted Whittington's 16 consecutive days of leave more than tripled the length of the consecutive leave days certified by [his doctor].... Therefore, Tyson's recertification request was reasonable as a matter of law and didn't interfere with Whittington's FMLA rights." [Whittington v. Tyson Foods, Inc., No. 20-3518 (8th Cir. Dec. 29, 2021)]  MORE >>

HR Daily Advisor


Administration Is Quietly Pursuing the Creeping Privatization of Medicare

"If you take it from CMS, [direct contracting entities (DCEs)] are simply a collection of different health care providers 'who agree to work together to keep you healthy' -- an innovative new payment model to keep health care costs down and raise the quality of care up. For its critics, the initiative is something far less benign."  MORE >>



NCPA Cites Litany of PBM Abuses at FTC Hearing

"Huge claw-backs, patient steering, under-water reimbursements, mafia-style contracts. NCPA didn't pull any punches today at an FTC hearing on whether the agency should order PBMs to hand over reams of information about their anti-competitive practices."  MORE >>

National Community Pharmacists Association [NCPA]

Employee Benefits Jobs

View job as Account Executive
for Kluwer Account Executive Kluwer


View job as Account Executive
for Kluwer

View job as Senior Counsel, IRA
for Guideline, Inc. Senior Counsel, IRA

Guideline, Inc.

Remote / CA / CO / FL / GA / IN / MA / MD / ME / MI / NC / NY / OH / OR / PA / SC / TX / VA / WA

View job as Legal Counsel
for Guideline, Inc. Legal Counsel

Guideline, Inc.

Remote / CA / CO / FL / GA / IN / MA / MD / ME / MI / NC / NY / OH / OR / PA / SC / TX / VA / WA

View job as Offboarding Manager
for Guideline, Inc. Offboarding Manager

Guideline, Inc.

Remote / CA / CO / FL / GA / MA / MD / ME / MI / NC / NY / OH / OR / PA / SC / TX / VA / WA

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 / Boston MA

View job as 401(k) Plan Administrator
for 401k Generation 401(k) Plan Administrator

401k Generation

Altamonte Springs FL

Webcasts and Conferences
(Health & Welfare Plans)

2022 Enrollment Technology Strategy Seminar

March 27, 2022 in FL


Last Issue's Most Popular Items

CMS Releases No Surprises Act State Enforcement Letters

Health Law Advisor, Epstein Becker Green

What Is a Post-Deductible Health Reimbursement Arrangement?


Employer Must Provide Retroactive Coverage and Pay Penalties for COBRA Election Notice Violations

The Wagner Law Group

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

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