"In 2020, Colorado enacted a statewide paid family and medical leave insurance program ... While employees cannot take FAMLI benefits until 2024, premiums are due under the program starting January 1, 2023.... The FAMLI benefit is designed to run concurrently with FMLA.... While participation in the FAMLI program is mandatory for private employers, local government employers may choose to opt out of the FAMLI program."  MORE >>

"[P]lan sponsors should review their plan documents to assess current coverage and discuss potential coverage options with ERISA counsel and with vendors (including insurers, stop-loss carriers and administrators, as applicable) ... [P]lan sponsors and administrators should ... familiarize themselves with the applicability of relevant state laws, the availability of ERISA preemption, and the unique risks and opportunities that their plans may face."  MORE >>

"Some states ... had relative prices below 175 percent of Medicare prices, while other states ... had relative prices that were at or above 310 percent of Medicare prices. In 2020, across all hospital inpatient and outpatient services (including both facility and related professional charges), employers and private insurers paid 224 percent of what Medicare would have paid for the same services at the same facilities."  MORE >>

"States recently passed an array of reforms, mostly targeting prescription drug costs, provider reimbursement, consumer protection, data collection on health care spending, and insurance coverage.... While recent Supreme Court precedents limit ERISA preemption's application, the law still poses an obstacle to state cost-control reforms -- whether ambitious or modest."  MORE >>

"Beginning in June 2023, health plans [in Michigan] will have to act on non-urgent prior authorization requests in nine calendar days and on urgent requests in 72 hours. In 2024, the time frame for non-urgent requests will shrink to seven days.... At least a dozen states have passed broad reforms ... Others have passed narrower laws that target the process or certain types of medical care or drugs. However, state laws don't protect most patients because they are in so-called self-funded plans, in which the employer pays claims directly rather than buying insurance for that purpose."  MORE >>

"CBO and JCT estimate that lowering the age of Medicare eligibility to 60 would increase federal budget deficits by $155 billion over the 2026-2031 period through the effects of that policy on federal revenues and mandatory spending. Enacting the policy would have a significant effect on primary sources of health insurance coverage, and it would increase the number of people insured."  MORE >>

"The IRS [asserted] that the debtors owed more than $900 for failing to maintain health insurance coverage in violation of the ACA's individual mandate during 2018. The IRS characterized the payment as an excise tax that was entitled to priority under the Bankruptcy Code.... [T]he Third Circuit held that the individual mandate payment was a tax on or measured by income ... for bankruptcy purposes.... [T]he court relied primarily on a six-factor test under Third Circuit precedent for determining whether a payment is a tax." [In re Szczyporski, No. 21-1858 (3d Cir. May 11, 2022))  MORE >>

"[A] 65-year-old couple retiring this year can expect to spend an average of $315,000 in health care and medical expenses throughout retirement. The 2022 estimate for single retirees is $150,000 for men and $165,000 for women.... This year's estimate is up 5% from 2021 ($300,000) and has nearly doubled from its original $160,000 in 2002."  MORE >>

"Nearly six-in-10 (57%) Baby Boomer (ages 58-76 years old) respondents incorrectly think a person can elect to enroll in Medicare at age 62 and receive reduced benefits.... More than four-in-10 Baby Boomer respondents (41%) ... incorrectly ... assume there are out-of-pocket limits for Medicare Coverage.... Among Baby Boomer respondents, 40% ... incorrectly ... think Medicare will pay for them to stay in a nursing home when they can no longer take of themselves (e.g. feed/dress/bathe)."  MORE >>