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Health & Welfare Plans Newsletter

March 28, 2022

10 New Job Opportunities 10 New Job Opportunities

 

[Guidance Overview]

HHS Adjusts 2022 HIPAA, Certain ACA and MSP Monetary Penalties

"Inflation adjustments released by [HHS] apply to penalties assessed on or after March 17, 2022, for violations occurring on or after Nov. 2, 2015. These penalty increases come on the heels of the last adjustment for penalties assessed on or after Nov. 15, 2021."  MORE >>

Mercer

[Guidance Overview]

Final Key Dates for Calendar Year 2022: Qualified Health Plan Data Submission and Certification; Rate Review; and Risk Adjustment (PDF)

This document summarizes key dates for calendar year 2022 regarding activities and policies that are outlined in other documents.  MORE >>

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

Wit Is Flipped: The Ninth Circuit Reverses Decision on Standards for Coverage of Behavioral and Mental Health Treatment

"[In] 2019, the [district] court issued a 106-page decision, finding that UBH had violated ERISA by applying 'unreasonable' standards allegedly not consistent with generally accepted standards of care [GASC] ... The Ninth Circuit, however, decided that UBH had properly exercised its discretion ... and that the underlying health plans did not require consistency with the GASC, only that they not be inconsistent.... Many courts have relied upon Wit's reasoning to deny United any deference in benefit decisions, allow broad discovery, and even award benefits. The Ninth Circuit's decision will likely bring an end to that." [Wit, et al. v. United Behavioral Health, Nos. 20-17363, 21-15193, 20-17364, 21-15194 (9th Cir. Mar. 22, 2022; unpub.)]  MORE >>

Dorsey ERISA

Employers and Providers Fight Over COVID-19 Testing Costs

"After encountering pushback from insurers and claims administrators, out of network providers have sued to recover reimbursement for thousands of claims, primarily arguing that the CARES Act provides them with a private cause of action for reimbursement at the at 'cash price' they listed on their websites.... [One District Court] rejected that argument, pointing, among other things, to the absence of Congressional intent for a private remedy." [Murphy Med. Assocs., LLC. v. Cigna Health & Life Ins. Co., No. 20-1675 (D. Conn. Mar. 11, 2022)]  MORE >>

Dorsey ERISA

Fifth Circuit Upholds ACA Risk Adjustment Program

"[T]he Fifth Circuit upheld the lower court's ruling that HHS's interpretation of 42 US Code Section 18063 is entitled to Chevron deference because Congress delegated development of the methodology to HHS, which prompts courts to adopt 'a deferential standard of review' giving 'considerable weight to HHS's judgment.' " [Vista Health Plan, Inc. v. HHS, No. 20-50963(5th Cir. Mar. 17, 2022)]  MORE >>

Sheppard Mullin

Estimating Equilibrium in Health Insurance Exchanges: Price Competition and Subsidy Design Under the ACA

"Combining data from the first four years of the California ACA marketplace with a model of insurance demand, cost, and insurers' competition, [the author quantifies] the impact of alternative subsidy designs on premiums, enrollment, costs, public spending, and consumer surplus. Younger individuals are more price sensitive and cheaper to cover. Increasing subsidies to this group would make all buyers better off, increase market participation, and lower average costs and average subsidies."  MORE >>

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

Benefits in General

Reimagining Work, Pay and Benefits During Major Crises

"[L]eaders of high-performing organizations think expansively and incorporate company stock or other long-term incentive programs, career growth initiatives, retirement and wealth-building benefits, flexible work, voluntary benefits, skill building, caregiving support, and other programs into their core offering as appropriate, supported by a strong employee experience."  MORE >>

Willis Towers Watson

ERISA Rulings Call for Seal of Sensitive Records

"Courts that have sealed claim files in ERISA cases have done so thoughtfully and with good reason....  The most meticulous effort to scrub such information from claim records is beyond a herculean task and is close to impossible ...  Identity theft is rampant nowadays, and the ease with which court records can be downloaded heightens such risks."  MORE >>

DeBofsky Sherman Casciari Reynolds P.C.

Employee Benefits Jobs

View job as Assistant Director of Pension Administration
          for Primark Benefits Assistant Director of Pension Administration

Primark Benefits

Remote / San Mateo CA

View job as Assistant Director of Pension Administration
          for Primark Benefits

View job as Sales Consultant
          for Spectrum Pension Consultants, Inc. Sales Consultant

Spectrum Pension Consultants, Inc.

Remote / Tacoma WA

View job as Sales Consultant
          for Spectrum Pension Consultants, Inc.

View job as Retirement Plan Distribution Specialist
          for Karel-Gordon & Associates Retirement Plan Distribution Specialist

Karel-Gordon & Associates

Remote / Deerfield IL

View job as Retirement Plan Distribution Specialist
          for Karel-Gordon & Associates

View job as Retirement Implementation Consultant
          for CUNA Mutual Group Retirement Implementation Consultant

CUNA Mutual Group

Remote

View job as Retirement Implementation Consultant
          for CUNA Mutual Group

View job as Retirement Plan Officer
          for Midland States Bank Retirement Plan Officer

Midland States Bank

Rockford IL

View job as Retirement Plan Officer
          for Midland States Bank

View job as Plan Implementation Specialist
          for The Retirement Advantage, Inc. (TRA, Inc) Plan Implementation Specialist

The Retirement Advantage, Inc. (TRA, Inc)

Remote

View job as Plan Implementation Specialist
          for The Retirement Advantage, Inc. (TRA, Inc)

View job as MEP/PEP Relationship Manager
          for Nova 401(k) Associates MEP/PEP Relationship Manager

Nova 401(k) Associates

Remote / Houston TX / Scottsdale AZ

View job as MEP/PEP Relationship Manager
          for Nova 401(k) Associates

View job as 401k Compliance Manager
          for Betterment 401k Compliance Manager

Betterment

Remote

View job as 401k Compliance Manager
          for Betterment

View job as 401(k) Recordkeeping Manager
          for July Business Services 401(k) Recordkeeping Manager

July Business Services

Remote / Woodway TX

View job as 401(k) Recordkeeping Manager
          for July Business Services

View job as Assistant General Counsel, Employee Benefit Plans
          for National Rural Electric Cooperative Association (NRECA) Assistant General Counsel, Employee Benefit Plans

National Rural Electric Cooperative Association (NRECA)

Remote / Arlington VA

View job as Assistant General Counsel, Employee Benefit Plans
          for National Rural Electric Cooperative Association (NRECA)

Press Releases

OneDigital Reveals Updated Brand Identity with Redesigned Logo and Video

OneDigital

Webcasts and Conferences
(Health & Welfare Plans)

The History of Mental Health Policy

RECORDED

Health Affairs

ERISA Covered Health and Welfare Plan Administration: Compliance, Fiduciary Liability, DOL Enforcement Actions

June 23, 2022 WEBCAST

Strafford

Last Issue's Most Popular Items

Attorney Work Product in the ERISA Context (PDF)

The Wagner Law Group, via Benefits Law Journal

Ninth Circuit Reversal of United Behavioral Health Trial Court Order Provides Big Win for Payors

Troutman Pepper

More Than $300 Billion in Health Care Spending Goes to Middlemen. We Need Accountability.

Adam Gluck of Sanofi, via RealClearPolicy

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

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