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Health & Welfare Plans Newsletter

April 27, 2022


[Guidance Overview]

How the ACA Family Glitch Fix Would Impact Employers and the Exchange

"[S]ome employees may switch from their family plans to a self-only plan so their dependents/spouses can access a premium subsidy. This could cause employer insurance costs to go down ... [E]mployers currently only report the lowest cost employer-sponsored self-only plan to the IRS. The question is whether fixing the 'family glitch' will pave the way for a new requirement in the future -- reporting on the lowest cost family plan."  MORE >>

Tango Health

[Guidance Overview]

Transparency in Coverage Final Rules

"While [FAQs Part 53] will make it easier for payers to comply with the TiC Final Rules and lead to more complete reporting, they will also make the data much more difficult for consumers and other stakeholders to use for decision-making and analysis. Flexibility in reporting will require interpretation and additional contextualization of data to make accurate comparisons of negotiated rates across payers and providers. In some cases, such comparisons may not be possible at all."  MORE >>


[Guidance Overview]

Maine Enacts Law to Study Savings in Prescription Drug Costs Based on Canadian Reference Pricing

"Maine's Democratic governor, Janet Mills, signed legislation directing the Maine Health Data Organization (MHDO) to report annually on the potential savings if certain drugs were subjected to a referenced rate, which is the lowest of the prices available among Canada's four largest provinces and the wholesale acquisition cost, beginning January 1, 2023."  MORE >>

Sidley Austin LLP

[Guidance Overview]

Maryland's 'Time to Care Act of 2022' Provides Paid Family and Medical Leave

"Employees, employers, and self-employed individuals may begin contributing to the Fund as of October 1, 2023. Employers with 15 or more employees will be required to contribute to the Fund. Beginning on January 1, 2025, employees taking leave under the Act will be paid a partial wage replacement based on a range of $50 to $1,000 per week.... The Act also provides that employers will have to ensure that employees have job protection ... Employers may be eligible for an exemption under the Act but will need to submit a request to the Maryland [Department of Labor]."  MORE >>

Miles & Stockbridge

Federal Court Dismisses ERISA Challenge to Washington Cares Act, Holding Premiums Are State Taxes

"Judge Zilly dismissed the plaintiffs' federal case, holding that the premium charged against an employee's wages was a tax and not an insurance premium.... The dismissal shifts the litigation from the federal court to the state court and adds a new state law challenge of WA Cares: Is the WA Cares premium a state income tax assessed on employee wages and, therefore, unconstitutional under Washington state law?" [Pacific Bells, LLC v. Inslee, No. 21-1515 (W.d. Wash. Apr. 25, 2022)]  MORE >>

Davis Wright Tremaine LLP


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District Court Upholds New York City Hotel Severance Law

"The court easily rejected plaintiff's argument that a program is necessary to navigate eligibility decisions about an employee's eligibility for benefits under the Severance Law, noting that the criteria ... could be resolved through 'a basic review of the employer's payroll system.' ... The court described the Severance Law as envisioning a 'one-time' project to address the lingering effects of a historically unique event (a global pandemic) by mandating certain severance payments for 'a short span of time.' " [RHC Operating, LLC v. City of New York, No. 21-9322 (S.D.N.Y. Mar. 30, 2022)]  MORE >>

Jackson Lewis P.C.

Employer-Provided Health Coverage: State-to-State 2022 (PDF)

58 pages. "This report catalogues what health plans contribute in terms of: [1] Access to health care coverage; [2] Number of jobs the industry generates, both directly and indirectly; and [3] Number of active physicians and community hospitals financed."  MORE >>

America's Health Insurance Plans [AHIP]

Benefits in General

[Official Guidance]

Text of IRS Notice 2022-21: Request for Public Recommendations on Items to Be Included in the 2022-2023 Priority Guidance Plan (PDF)

"The Department of the Treasury and the [IRS] invite the public to submit recommendations for items to be included on the 2022-2023 Priority Guidance Plan.... Taxpayers should ... briefly describe the recommended guidance and explain the need for the guidance.... [T]axpayers may include an analysis of how the issue should be resolved."  MORE >>

Internal Revenue Service [IRS] and U.S. Department of the Treasury

Press Releases

Enterprise Iron Receives California DGS Agreement

Enterprise Iron

Webcasts and Conferences
(Health & Welfare Plans)

The Future of Mental Health Coverage and Access


Kaiser Family Foundation

A Discussion of Recent Research on Health Care Prices: Prescription Drugs, Hospitals’ Services, and Physicians’ Services

April 27, 2022 WEBCAST

Congressional Budget Office

Fringe Benefits for Employers

May 17, 2022 WEBCAST


Last Issue's Most Popular Items

IRS Issue Snapshot: Qualified Parking Fringe Benefit

Internal Revenue Service [IRS]

'The No Surprises Act' a/k/a 'The Act That Continues to Surprise Providers'


Technical Guidance Issued on Transparency in Coverage Regs

Ballard Spahr LLP

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

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