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Health & Welfare Plans Newsletter

February 25, 2022

14 New Job Opportunities 14 New Job Opportunities

 

[Official Guidance]

Text of IRS FAQs for the Premium Tax Credit

Updated Feb. 24, 2022:

  • The Basics FAQs: Q1, Q3, Q4
  • Eligibility FAQs: Q5, Q7, Q8, Q9, Q11
  • Reporting, Claiming and Reconciling FAQs: Q24, Q26, Q27
  • Suspension of Repayment of Excess Advance Payments of the Premium Tax Credit (Excess APTC) for Tax Year 2020 FAQs: Q33, Q36

Added Feb. 24, 2022: Unemployment Compensation 2020 and 2021 FAQs: Q38 through Q45.  MORE >>

Internal Revenue Service [IRS]

[Official Guidance]

Text of CMS Memorandum: 2019 Benefit Year HHS Risk Adjustment Data Validation Results (PDF)

13 pages. "The 2019 benefit year HHS-RADV error rates will be averaged with the 2020 benefit year HHS-RADV error rates and applied to the 2020 plan liability risk scores and risk adjustment transfers.... As a result, combined 2019 and 2020 benefit year HHS-RADV adjustments to 2020 benefit year risk adjustment transfers will not be released until summer 2022, after 2020 benefit year HHS-RADV error rates are published. This memo contains an overview of the 2019 benefit year HHS-RADV error rate methodology, an overview of the 2019 benefit year HHS-RADV reports, and information to assist issuers in understanding their results."  MORE >>

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

[Guidance Overview]

If a Non-ALE Acquires an ALE Mid-Year, Does the Non-ALE Immediately Become an ALE?

"An employer entertaining a merger must explore these ACA matters prior to entering into any agreement. While ... there is a creditable argument that no employer can become an ALE midyear, the IRS does not have any sort of guidance explicitly addressing that scenario."  MORE >>

Accord

[Guidance Overview]

When is an EAP a Group Health Plan Subject to COBRA?

"EAPs are typically ... subject to COBRA because they provide access to trained counselors offering therapy, which is a medical benefit. Very limited EAPs that provide only referrals by individuals who are not trained counselors are not group health plans, but that approach is uncommon."  MORE >>

Newfront

Texas District Court Vacates Portions of No Surprises Act Rule

"The court held that the Rule's presumption that the QPA is the correct amount and the requirement for the arbitrator to give more weight to the QPA over other permissible factors conflicted with the 'unambiguous terms of the Act.' The court vacated that portion of the Rule.... The court also determined that the Departments improperly bypassed the notice and comment period under the Administrative Procedure Act when implementing the Rule.... This ruling is generally applicable, meaning that the portion of the Rule regarding QPA presumption and weighting is vacated throughout the country." [Texas Medical Assoc. v. HHS, No. 21-0425 (E.D. Tex. Feb. 23, 2022)]  MORE >>

Husch Blackwell

District Court Sets Aside Key Parts of No Surprises Act Rule

"The overall IDR process is not disturbed and will still be available to resolve payment disputes between payers and out-of-network providers. But [this] ruling sets aside parts of the IDR rule -- the parts that gave guidance to IDR entities -- that were meant to help keep health care costs down. With those guardrails no longer in place, providers could be more likely to use the federal IDR process to obtain higher out-of-network payments when doing so is not warranted." [Texas Medical Assoc. v. HHS, No. 21-0425 (E.D. Tex. Feb. 23, 2022)]  MORE >>

Health Affairs

Justice Department Seeks to Block UnitedHealth Acquisition of Change Healthcare

"The U.S. Justice Department has moved to block a UnitedHealth Group subsidiary's attempted $13 billion acquisition of a medical technology company.... In its lawsuit, the Justice Department alleged that UnitedHealth's move to purchase Change Healthcare would give UnitedHealth sensitive information that it could use against rival companies in the insurance industry." [U.S. v. UnitedHealth Group Inc., No. 22-0481 (D.D.C. complaint filed Feb. 24, 2022)]  MORE >>

Legal Reader

Annual HITECH Report to Congress on Breaches of Unsecured Protected Health Information for Calendar Year 2020 (PDF)

31 pages. "[In 2020,] OCR received 656 notifications of breaches affecting 500 or more individuals, representing an increase of 61% from the number of reports received in calendar year 2019. These reported breaches affected a total of approximately 37,641,403 individuals."  MORE >>

Office of Civil Rights [OCR], U.S. Department of Health and Human Services [HHS]

Annual Report to Congress on HIPAA Privacy, Security, and Breach Notification Rule Compliance for Calendar Year 2020 (PDF)

27 pages. "OCR received 27,182 new complaints alleging violations of the HIPAA Rules and the HITECH Act [in 2020], representing a decrease of 4% from the number of complaints received in calendar year 2019. OCR resolved 26,530 complaints. Of those, OCR resolved 19,826 (75%) before initiating an investigation."  MORE >>

Office of Civil Rights [OCR], U.S. Department of Health and Human Services [HHS]

Proposal Aims to Upgrade HIPAA to Account for New Healthcare Technologies

"The Health Data Use and Privacy Commission Act [S 3620] seeks to close the gap between existing protections and risk to personal health information (PHI) created by new healthcare technology that extends beyond the scope of HIPAA.... [T]he Act would form a health and privacy commission to conduct research and give official recommendations to Congress on how to reform health privacy laws."  MORE >>

Morgan Lewis

[Opinion]

The Importance of Evidence-Based Leave Policy

"The FMLA was a monumental first step.... [H]owever, the FMLA only guarantees some workers the right to unpaid leave.... [S]urveys show that about 56% of the workforce is eligible for FMLA leave ... These surveys also show important gaps in workers' knowledge about the law, with more workers thinking that they are covered by the law than are covered in practice."  MORE >>

U.S. Department of Labor Blog

Employee Benefits Jobs

View job as Defined Benefit Plan Consultant
for QPA, Inc. Defined Benefit Plan Consultant

QPA, Inc.

Remote / Greensboro NC

View job as Client Experience Specialist
for Aimpoint Pension Client Experience Specialist

Aimpoint Pension

Remote

View job as Plan Administrator
for Aimpoint Pension Plan Administrator

Aimpoint Pension

Remote

View job as Employee Pension Benefits Paralegal or Consultant
for Best Best & Krieger LLP Employee Pension Benefits Paralegal or Consultant

Best Best & Krieger LLP

Remote

View job as VP Sales Consultant (Retirement Industry)
for FuturePlan, by Ascensus VP Sales Consultant (Retirement Industry)

FuturePlan, by Ascensus

Remote / Salt Lake City UT

View job as Testing Specialist I
for FuturePlan, by Ascensus Testing Specialist I

FuturePlan, by Ascensus

Remote

View job as Associate Relationship Manager - Retirement
for GuideStone Financial Resources Associate Relationship Manager - Retirement

GuideStone Financial Resources

Memphis TN

View job as System Automation Support Specialist - Payroll
for BlueStar Retirement Services Inc. System Automation Support Specialist - Payroll

BlueStar Retirement Services Inc.

Remote / Ponte Vedra Beach FL

View job as Defined Contribution Benefits Analyst
for Occidental Petroleum Defined Contribution Benefits Analyst

Occidental Petroleum

Tulsa OK

View job as Senior Benefits Representative
for Occidental Petroleum Senior Benefits Representative

Occidental Petroleum

Tulsa OK

View job as Relationship Manager for Non-Qualified Retirement Plans
for Newport Relationship Manager for Non-Qualified Retirement Plans

Newport

Remote / AZ / CA / CO / FL / GA / IA / IL / KS / MA / MD / MI / MN / MO / NC / NJ / NY / OH / SC / TX / VA / WI

View job as Senior Relationship Manager for Non-Qualified Retirement Plans
for Newport Senior Relationship Manager for Non-Qualified Retirement Plans

Newport

Remote / AZ / CA / CO / FL / GA / IA / IL / KS / MA / MD / MI / MN / MO / NC / NJ / NY / OH / SC / TX / VA / WI

View job as Client Service Manager for Non-Qualified Plans
for Newport Client Service Manager for Non-Qualified Plans

Newport

Remote / AZ / CA / CO / FL / GA / IA / IL / KS / MA / MD / MI / MN / MO / NC / NJ / NY / OH / SC / TX / VA / WI

View job as Plan Administrator/ Consulting
for Associated Pension Consultants Plan Administrator/ Consulting

Associated Pension Consultants

Chico CA / Sacramento CA

Webcasts and Conferences
(Health & Welfare Plans)

Haven't We Seen This Before? The Latest on California’s Supplemental Paid Sick Leave

March 4, 2022 WEBCAST

Fisher Phillips

Last Issue's Most Popular Items

Tolling of Important Health and Welfare and Retirement Plan Deadlines Extended Again Due to COVID-19

Groom Law Group

Health Plan's Informational Phone Calls May Have Violated Telephone Consumer Protection Act

Thomson Reuters / EBIA

COVID-19 Testing Provider Sues Plans and TPAs for Violating Group Health Plan Coverage Mandate

Thomson Reuters / EBIA

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

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