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Health & Welfare Plans Newsletter

June 10, 2022


[Guidance Overview]

Upcoming Deadline icon Health Plans and Issuers Must Post Machine-Readable Files Beginning July 1, 2022

"[T]he following information must be disclosed: [1] In-network provider negotiated rates for covered items and services (the 'In-network Rate File'); [2] Historical payments to and billed charges from out-of-network providers (the 'Allowed Amount File'); and [3] In-network negotiated rates and historical net prices for covered prescription drugs (the 'Prescription Drug File') -- this particular MRF requirement is delayed until further notice. The files must be publicly available and accessible free of charge without any restrictions."  MORE >>


[Guidance Overview]

Group Health Plans Will Need Clinical Evidence for EHB Design and Coverage Limitations

"[B]eginning on January 1, 2023, or on the next policy renewal, whichever is earlier, individual and group health plans that cover essential health benefits (EHBs) will have to use clinical evidence to support both EHB design and any related coverage limitations.... The final rule doesn't explicitly define evidence-based standards or clinical guidelines, but it does specify what is not acceptable."  MORE >>

MZQ Consulting, LLC

[Guidance Overview]

San Francisco's Newest Public Health Emergency Leave Ordinance

"Based on provisional results from the June 7, 2022, election, it appears San Francisco, California voters have approved Proposition G, which will create a permanent public health emergency leave (PHEL) ordinance that will become operative on October 1, 2022. PHEL will be in addition to paid leave employers offer or provide employees (e.g., San Francisco paid sick leave) at the beginning of a 'public health emergency'[.]"  MORE >>


Employers Seek Cost-Saving Healthcare Solutions That Don't Compromise on Value

"A competitive talent market and a turbulent economic situation have employers looking for ways to contain healthcare costs.... At the same time, many employers are wary about relying on strategies that disrupt the experience of health plan participants.... This drive to minimize disruption has led organizations to seek solutions that deliver a 'return on value,' a metric that goes beyond the traditional return on investment more commonly employed in benefits parlance[.]"  MORE >>

HR Dive

The Role of Prices in Excess U.S. Health Spending

"Prices for health care services are a critical driver of health spending growth in the US. US health care prices vary widely among hospitals and between public and private insurers. Across a range of services, US prices are higher than those in comparable countries."  MORE >>

Health Affairs

Companies Urged to Review Abortion Coverage with Roe in Balance

"Regardless of their position on whether to cover abortion, companies are being advised by their legal counsel to review their policies and, at the least, make sure they are clear about what they cover. Legal advisers also say companies need to be prepared to communicate their positions to employees and answer questions about them."  MORE >>

Bloomberg Law

Benefits in General

[Official Guidance]

Text of IRS Announcement 2022-13: Revision to Optional Standard Mileage Rates (PDF)

"The revised standard mileage rates are: [1] Business 62.5 cents per mile; [2] Medical and moving 22 cents per mile.... The revised standard mileage rates set forth in this announcement apply to deductible transportation expenses paid or incurred for business, medical, or moving expense purposes on or after July 1, 2022, and to mileage allowances that are paid both [1] to an employee on or after July 1, 2022, and [2] for transportation expenses paid or incurred by the employee on or after July 1, 2022."  MORE >>

Internal Revenue Service [IRS]

Webcasts and Conferences
(Health & Welfare Plans)

Guidance on Paid Family Leave Laws, Part I: Massachusetts, Connecticut, Washington and Washington, D.C. Paid Family Leave Developments


Seyfarth Shaw LLP

Guidance on Paid Family Leave Laws, Part II: California, Colorado, New Jersey, New York and Oregon Paid Family Leave Developments


Seyfarth Shaw LLP

Mental Health Parith: A Lucid Approach



Pest Management: Minimizing Plan Losses through Fee Disclosure



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Fraser Trebilcock

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

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