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Health & Welfare Plans Newsletter

April 5, 2022

9 New Job Opportunities 9 New Job Opportunities

 

[Official Guidance]

Text of IRS Proposed Regs: Affordability of Employer Coverage for Family Members of Employees

35 pages. "This document contains proposed regulations under section 36B of the Internal Revenue Code ... that would amend the existing regulations regarding eligibility for the premium tax credit (PTC) to provide that affordability of employer-sponsored minimum essential coverage (employer coverage) for family members of an employee is determined based on the employee's share of the cost of covering the employee and those family members, not the cost of covering only the employee. The proposed regulations also would add a minimum value rule for family members of employees based on the benefits provided to the family members ... This document also provides a notice of a public hearing on these proposed regulations."  MORE >>

Internal Revenue Service [IRS]

[Official Guidance]

Text of CMS Cost-Sharing Reduction Reconciliation Issuer to MIDAS Inbound Specification (PDF)

Version 4.0, April 2022. 17 pages. "The purpose of this document is to provide the details on cost-sharing reduction (CSR) reconciliation files that issuers submit to the Multidimensional Insurance Data Analytics System (MIDAS). This specification document (version 4.0) is applicable to CSR reconciliation for the 2021 benefit year as well as restatements for benefit year 2020."  MORE >>

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

[Official Guidance]

Text of CMS Cost-Sharing Reduction Reconciliation Issuer to MIDAS Attestation Inbound Specification (PDF)

Version 4.0, April 2022. 8 pages. "The purpose of this document is to provide the details on cost-sharing reduction (CSR) attestation files that issuers submit to the Multidimensional Insurance Data Analytics System (MIDAS). The Attestation Forms will be in Excel format and users must select the correct Attestation Forms A or B, as applicable. Attestation Forms A or B must be sent in a zipped format for each Health Insurance Oversight System (HIOS) ID and benefit year."  MORE >>

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

[Guidance Overview]

Fact Sheet: IRS Proposal to Fix 'Family Glitch' and Lower Health Care Costs

"Current regulations define employer-based health insurance as 'affordable' if the coverage solely for the employee, and not for family members, is affordable, making family members ineligible for a premium tax credit even though they need it to afford high-quality coverage through the Marketplace.... The Treasury Department and the [IRS] are proposing to eliminate the 'family glitch.' Should today's proposed rule be finalized, family members of workers who are offered affordable self-only coverage but unaffordable family coverage may qualify for premium tax credits to buy ACA coverage. Should the proposed change be made, it's estimated that 200,000 uninsured people would gain coverage, and nearly 1 million Americans would see their coverage become more affordable."  MORE >>

Executive Office of the President

[Guidance Overview]

Local COVID-19 Paid Sick Leave Laws Could Show Emerging Compliance Trends for Employers

"Since the onset of the pandemic, many states and localities have passed COVID-19 supplemental paid sick leave laws requiring employers to provide leave to employees for COVID-19-related reasons. California and Colorado have gone beyond many other states by adding to the required amount of sick time.... [S]ick leave developments in those states could foreshadow developments in other states."  MORE >>

PilieroMazza PLLC, via JDSupra

Ninth Circuit Reverses Landmark Wit Case Addressing Behavioral Health Coverage

"Appeals to the full Ninth Circuit and possibly to the Supreme Court are expected, as plaintiffs are likely to argue the appellate court improperly disregarded the district court's factual findings about the plan administrator's conflicts of interest and unreasonable plan interpretations, contrary to the weight of expert testimony on generally accepted standards of care and other evidence.... It seems clear that Congress will be required, and likely motivated, to address underlying issues with parity and equity for behavioral health coverage." [Wit, et al. v. United Behavioral Health, Nos. 20-17363, 21-15193, 20-17364, 21-15194 (9th Cir. Mar. 22, 2022; unpub.)]  MORE >>

Polsinelli PC

Ninth Circuit Defers to Plan Design and Administrative Discretion on Bounds of Mental Health Coverage

"The Ninth Circuit's decision illustrates how claims for coverage, especially for mental health services, are inherently fact-specific because they require analysis of the patient's medical needs, medical necessity, and sufficiency of alternative treatments. Rather than address the merits of any particular claim, the Ninth Circuit simply concluded that in light of the discretion conferred to UBH to interpret the plans, it was not appropriate to send over 50,000 claims back to UBH for review en masse." [Wit, et al. v. United Behavioral Health, Nos. 20-17363, 21-15193, 20-17364, 21-15194 (9th Cir. Mar. 22, 2022; unpub.)]  MORE >>

Proskauer

Court Orders Aetna to Boost Coverage for Mental Health Treatment in ERISA Case

"The judge rejected the claim of the plan beneficiaries that Aetna's denial of coverage for mental health and substance abuse treatment violated federal mental health parity laws.... The judge stated that the parity law claim was duplicative of the ERISA denial of benefits claim ... [and] granted partial summary judgment to Aetna on the claims under the parity law. The judge then remanded the remaining claims back to Aetna to determine the properly allowable amount of coverage[.]" [R. v. Bank of America Group Benefits Program Aetna Life Ins. Co., No. 20-0441 (W.D.N.C. Feb. 9, 2022)]  MORE >>

Hall Benefits Law

What Federal Employees Should Know About the New Paid Parental Bereavement Leave Benefit

"Thanks to the 2022 National Defense Authorization Act, federal workers can take up to two weeks off following the death of a child.... The new leave category will be available to all Title 5 federal employees serving in permanent or term appointments of more than one year with at least one year of service. Employees with intermittent work schedules are not eligible, and seasonal employees cannot use leave during their off-season."  MORE >>

Government Executive

Employee Benefits Jobs

View job as Sales Support Specialist
          for Transamerica Sales Support Specialist

Transamerica

Remote / FL / GA / MA / MD / NY / PA

View job as Sales Support Specialist
          for Transamerica

View job as Retirement Services Plan Manager, Senior
          for OneAmerica Retirement Services Plan Manager, Senior

OneAmerica

Remote

View job as Retirement Services Plan Manager, Senior
          for OneAmerica

View job as Defined Benefit Plan Consultant
          for Planned Retirement Consultants & Administrators, LLC Defined Benefit Plan Consultant

Planned Retirement Consultants & Administrators, LLC

Remote / Ridgewood NJ

View job as Defined Benefit Plan Consultant
          for Planned Retirement Consultants & Administrators, LLC

View job as 401k & Defined Contribution Plan Consultant
          for Planned Retirement Consultant & Administrators, LLC 401k & Defined Contribution Plan Consultant

Planned Retirement Consultant & Administrators, LLC

Remote / Ridgewood NJ

View job as 401k & Defined Contribution Plan Consultant
          for Planned Retirement Consultant & Administrators, LLC

View job as Retirement Account Administrator
          for Alerus Retirement Account Administrator

Alerus

Remote

View job as Retirement Account Administrator
          for Alerus

View job as ESOP Retirement Account Administrator, Senior
          for Alerus ESOP Retirement Account Administrator, Senior

Alerus

Remote

View job as ESOP Retirement Account Administrator, Senior
          for Alerus

View job as Retirement Plan Administrator
          for Rogers Wealth Group Retirement Plan Administrator

Rogers Wealth Group

Fort Worth TX

View job as Retirement Plan Administrator
          for Rogers Wealth Group

View job as Senior Compliance Analyst - Retirement Plans
          for Newport Senior Compliance Analyst - Retirement Plans

Newport

Remote

View job as Senior Compliance Analyst - Retirement Plans
          for Newport

View job as Compliance Specialist (Entry Level)
          for Newport Compliance Specialist (Entry Level)

Newport

Remote

View job as Compliance Specialist (Entry Level)
          for Newport

Press Releases

Wealth Releases New Study Noting Lack of Preparedness Around Estate Planning

Wealth, Inc.

Hub International Enhances Commercial and Personal Insurance Capabilities with Acquisition of Chun-Ha Insurance Services, Inc. in California

HUB International

Bolton Investment Certified for 8th Consecutive Year by the Centre for Fiduciary Excellence

Bolton

PSCA Honors Nancy Gerrie and Robert C. Merton with Lifetime Achievement Awards

PSCA [Plan Sponsor Council of America]

Webcasts and Conferences
(Health & Welfare Plans)

Lunch and Learn: 'The ACA at 12'

April 14, 2022 WEBCAST

Health Affairs

Employee Benefits Briefing

May 4, 2022 WEBCAST

Nixon Peabody LLP

Last Issue's Most Popular Items

It's So Easy to ... Put Your Employees' HSAs at Risk

Holland & Hart LLP

Text of EBSA Meeting Notice for ERISA Advisory Council

Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

Oregon Rule Expands Reasons Employees Can Take Emergency Paid Leave

Littler

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

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