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Health & Welfare Plans Newsletter

May 2, 2022

4 New Job Opportunities 4 New Job Opportunities


[Official Guidance]

Text of CMS FAQs: Risk Adjustment Telehealth and Telephone Services During COVID-19 (PDF)

Updated Apr. 29, 2022. "HHS will designate the telehealth CPT service codes, including telephone-only service codes.... as valid for 2022 benefit year risk adjustment data submissions for the HHS-operated program, subject to applicable state law requirements."  MORE >>

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

[Guidance Overview]

IRS Announces 2023 Limits for HSAs, HDHPs and Excepted Benefit HRAs

"All of the dollar limits currently in effect for 2022 will change for 2023, with [one] exception ... The HSA catch-up contribution for individuals ages 55 and older will not change as it is not subject to cost-of-living adjustments. The table ]in this article] compares the applicable dollar limits for HSAs, HDHPs and excepted benefit HRAs for 2022 and 2023."  MORE >>

McDermott Will & Emery

[Guidance Overview]

Upcoming Deadline icon Transparency in Coverage Enforcement

"[ACA FAQs Part 53 provide] a safe harbor for disclosing in-network healthcare costs that cannot be expressed as a dollar amount. They also serve as a timely reminder of the pending July 1, 2022, deadline to begin enforcing the Final Rules.... Plan sponsors should remember that these machine-readable files must be posted on a public website."  MORE >>

Jackson Lewis P.C.

[Guidance Overview]

Upcoming Deadline icon Be Ready for Enforcement of Transparency Rules

"The transparency rules do set forth protections for insured arrangements when the group health plan requires the insurer to provide such information via a written agreement. If insurer fails to comply, then the insurer violates transparency disclosure requirements, not the group health plan.... [A self-funded] group health plan ... can enter into a written agreement requiring the TPA to provide the information. However, the plan is still responsible if the TPA fails to comply. Therefore, it is imperative to have an indemnification agreement with the TPA."  MORE >>

Fraser Trebilcock

The Impact of the Payment and Delivery System Reforms of the ACA

"The [ACA] instituted several mandatory national payment reforms through the Medicare program and created the Center for Medicare and Medicaid Innovation (CMMI) ... to develop, test, and promote innovative payment and delivery models.... In these first 10 years, six of the 50 models launched by CMMI yielded statistically significant savings."  MORE >>

The Commonwealth Fund

Trends in Specialty Drug Benefit Design

"8% of plans are currently using alternative funding models, while 31% are exploring [their] use ... 50% of employers are aware of new to market formulary blocks. 20% of plans can track patient treatment delays due to new to market formulary blocks ... 17% of plans feel prepared to make coverage decisions on new disease-modifying Alzheimer's drugs ... 92% of plans receive rebates under the pharmacy benefit."  MORE >>

Pharmaceutical Strategies Group, LLC

Benefits in General

Sixth Circuit Holds ERISA Section 502(a)(2) Claims May Not Be Arbitrated Absent Plan Consent

"Individual plaintiffs' ERISA Section 502(a)(2) claims for alleged individualized harm to their respective retirement accounts are derivative and 'belong,' in the first instance, to the plan. The Sixth Circuit joined several other federal courts in holding that individual plaintiffs pursuing ERISA Section 502(a)(2) claims on behalf of a defined contribution plan may not be compelled to arbitrate those claims absent evidence the plan has consented to arbitration." [Hawkins v. Cintas Corp., No. 21-3156 (6th Cir. Apr. 27, 2022)]  MORE >>

Faegre Drinker

Employee Benefits Jobs

View job as Plan Document Specialist
          for AimPoint Pension Plan Document Specialist

AimPoint Pension


View job as Plan Document Specialist
          for AimPoint Pension

View job as New Business Implementation Specialist
          for AimPoint Pension New Business Implementation Specialist

AimPoint Pension


View job as New Business Implementation Specialist
          for AimPoint Pension

View job as Finance Manager
          for Vestwell Finance Manager


Remote / New York NY

View job as Finance Manager
          for Vestwell

View job as Pension Consultant
          for Pension Associates Pension Consultant

Pension Associates

Remote / Stamford CT

View job as Pension Consultant
          for Pension Associates

Press Releases

Attorney John Sohn Returns ´╗┐to the Wagner Law Group

Wagner Law Group P.C.

Sharebuilder 401(k) Celebrates Small Business Week by Offering Free Set-Up on New 401(k) Plans Started Between May 2 - 23

Sharebuilder 401k

Last Issue's Most Popular Items

Text of IRS Rev. Proc. 2022-24: 2023 Inflation Adjusted Amounts for Health Savings Accounts (HSAs) and Excepted Benefit Reimbursement Arrangements (HRAs) (PDF)

Internal Revenue Service [IRS]

Employer Considerations When Responding to Employee Requests for a Mid-Year Enrollment Exception Outside of a Permitted Election Change Event


Employers Cautioned as Lawsuits Over COBRA Notices Add Up

Bloomberg Law

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

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