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Health & Welfare Plans Newsletter

June 8, 2022

4 New Job Opportunities 4 New Job Opportunities


Second Circuit: Insurer 'Overturning' Previous Claim Denial Doesn't Reset Response-Time Clock

"Federal regulations only required McQuillin to wait 45 days for Hartford Life to issue a 'benefit determination' after he challenged its initial denial, and he had filed his lawsuit on day 46, Senior Circuit Judge John Walker Jr wrote for the 2nd Circuit. Hartford Life's attorneys ... argued that it met the 45-day deadline by 'overturning' its previous denial, and telling McQuillin it would reconsider his claim, 12 days after he filed his internal appeal; and that McQuillin was therefore barred from filing suit until the company finished its review." [McQuillin v. Hartford Life and Accident Ins. Co., No. 21-1514 (2d Cir. Jun. 7, 2022)]  MORE >>

Reuters; free registration may be required

District Court: Employer's Health Plan Gender Reassignment Exclusion Violated Title VII

"A district court has concluded that an exclusion for gender reassignment surgery under a government employer's health plan violated Title VII's prohibition against sex discrimination. The court also concluded that the participant's gender dysphoria was not a disability covered by Title I of the Americans with Disabilities Act (ADA)[.]" [(Lange v. Houston Cty., Ga., No. 19-0392 (M.D. Ga. June 2, 2022))]  MORE >>

Thomson Reuters Practical Law

Surging Drug Prices Targeted in FTC Study of Pharmacy Giants

"The U.S. Federal Trade Commission [FTC] is looking into how big pharmacy benefit managers like CVS Caremark affect pricing and patients' access to prescription drugs at a time when costs of some medicines, even older ones like insulin, have skyrocketed ... As part of the probe, the FTC is sending demands for information to CVS Health Corp's Caremark, Humana Inc, Cigna Corp's Express Scripts and UnitedHealth Group's OptumRx, among others."  MORE >>

Reuters; free registration may be required

Patients Seeking Mental Health Care Find Health Plans Standing in the Way

"As mental health concerns have risen over the past decade -- and reached new heights during the pandemic -- there's a push for primary care doctors to provide mental health care.... But the way many insurance plans cover mental health doesn't necessarily support integrating it with physical care.... In some cases, the main insurance plan may deny a claim, saying it's related to mental health, while the behavioral health company also denies it, saying it's physical."  MORE >>


California Proposal Would Mandate Bereavement Leave

"The proposed law would require employers in California to give eligible employees up to five days of bereavement leave after the death of a spouse, child, parent, sibling, grandparent, grandchild, domestic partner or parent-in-law. Other family relationships are not included. The bill covers all public employers and private companies that employ five or more individuals in California."  MORE >>

Society for Human Resource Management [SHRM]; membership may be required to view article

Health and Welfare Plans 2022 Update

"HHS Transparency Rule likely to require amendment to TPA confidentiality agreement provision ... Fee disclosure requirement for group health plan service providers ... Insurers and group health plans required to provide free COVID tests."  MORE >>

Frost Brown Todd LLC


Council for Affordable Health Coverage Comment Letter to IRS on Proposed Regs: Affordability of Employer Coverage for Family Members of Employees (PDF)

"The mechanisms of the proposed rule ... will have consequences for job-based coverage, that will erode insurance options for employees and their families while increasing costs for employers. Fixing one problem in ACA markets should not detrimentally impact markets where a majority of Americans receive their coverage."  MORE >>

Council for Affordable Health Coverage [CAHC]

Employee Benefits Jobs

View job as Retirement Plan Consultant
          for The Retirement Plan Company (TRPC)/an ABG firm Retirement Plan Consultant

The Retirement Plan Company (TRPC)/an ABG firm


View job as Retirement Plan Consultant
          for The Retirement Plan Company (TRPC)/an ABG firm

View job as Lead Client Executive
          for Transamerica Lead Client Executive


Remote / TN

View job as Lead Client Executive
          for Transamerica

View job as H&W Sales Consultant
          for Alerus H&W Sales Consultant


Remote / CO / MA / NH / NJ / PA

View job as H&W Sales Consultant
          for Alerus

View job as Cash Balance Retirement Account Administrator
          for Alerus Cash Balance Retirement Account Administrator


Remote / MI / MN / ND / NH

View job as Cash Balance Retirement Account Administrator
          for Alerus

Press Releases

Sana Expands Affordable Health Plans for Small Businesses to Indiana


SageView Advisory Group Acquires $825 Million Retirement and Wealth Management Firm kPlans

SageView Advisory Group

Webcasts and Conferences
(Health & Welfare Plans)

New Mexico’s Healthy Workplaces Act: Complying With the New Earned Sick Leave Requirement

June 9, 2022 WEBCAST

Jackson Lewis LLP

Abortion Services and Employee Benefits: Plan Design Options and Legal Compliance Post Dobbs v. Jackson Women’s Health Org

July 12, 2022 WEBCAST

American Bar Association Joint Committee on Employee Benefits [JCEB]

Last Issue's Most Popular Items

Health FSAs: Things Employers May Not Know


ACA PCORI Fee Increases to $2.79 for 2021 Calendar Year Plans


Employers: Warn Your Managers to Stop Saying Stupid Stuff in Response to an Employee's Request for FMLA Leave!

FMLA Insights

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

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