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Health & Welfare Plans Newsletter

June 14, 2022

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[Guidance Overview]

Upcoming Deadline icon PCORI Filing Due August 1

"IRS regulations provide three options for determining the average number of covered lives: actual count, snapshot and Form 5500 method.... [T]he PCORI fee must be paid by the plan sponsor; it cannot be paid in whole or part by participant contributions or from a trust holding ERISA plan assets."  MORE >>


[Guidance Overview]

COVID's Impact on Mental Health Prompts Guidance from DOL and EEOC

"Employers ... should try to address mental health issues caused or exacerbated by the pandemic, both to support employees, and also to reduce the risk of workplace claims.... [S]upervisors and managers should be trained on what they should and should not ask of employees, the importance of maintaining the confidentiality of medical information that is shared with them and the importance of not sharing why a given employee is receiving a particular accommodation."  MORE >>


[Guidance Overview]

Exceptional Usefulness and Quality icon Paid Family and Medical Leave in the United States

46 pages. "This report provides an overview of PFML in the United States, summarizes state-level family and medical leave insurance program provisions, reviews PFML policies in other advanced-economy countries, and describes recent federal legislative action to increase access to paid family leave." [R44935 updated Jun. 13, 2022]  MORE >>

Congressional Research Service [CRS]

[Guidance Overview]

Bloomington Becomes Fourth Minnesota City to Mandate Paid Sick and Safe Time

"Employers have just over a year to address their compliance obligations under Minnesota's fourth local paid sick and safe time mandate, which does not take effect until July 1, 2023. The Bloomington ordinance is a near replica of the Minneapolis Sick and Safe Time Ordinance, which has been in effect since July 1, 2017. It generally requires employers to provide certain employees in Bloomington with up to 48 hours of paid sick and safe time per year."  MORE >>


Ninth Circuit Affirms Insurer's Denial of Claim for Air Ambulance Transportation from Lima, Peru to Miami, Florida

"The court found that there was no evidence that [the patient] could not have received certain care and treatment at the hospital in Lima and that the hospitals' plan of care was similar.... [T]he court found that the independent review organization's (IRO) denial of benefits does not require de novo review because 'the IRO's non-binding affirmance of Blue Cross's denial of benefits did not negate Blue Cross's discretion.' " [Continental Med. Transp. LLC v. Health Care Serv. Corp., No. 21-35481 (9th Cir. June 7, 2022; unpub.)]  MORE >>

Roberts Disability Law

Domestic Partner Benefits Remain Popular But Present Challenges (PDF)

18 pages. "Despite the acceptance and prevalence of domestic partner benefits, complex legal, tax, administration and other compliance issues come with the territory.... This GRIST summarizes the major issues, provides a tax-dependent flowchart and a domestic partner checklist for employers, and includes two charts summarizing applicable state laws"  MORE >>


Wellness Travel Boosts a Struggling Industry

"[W]ellness travel ... [comprised] 44% of the tourism market in 2022 ... Contributing to that growth is an expanded idea of wellness tourism that includes health coaching, medical-grade spa treatments, fitness classes and special food menus. Guests might design their own itineraries to meet fitness goals, help lose weight or improve their mindfulness through meditation and coaching."  MORE >>

HUB International

Considerations for Telemedicine Companies Shifting Reimbursement Models

"The administrative nightmare that is fee-for-service, third-party reimbursement can quickly increase operating expenses, require real revenue cycle management and move companies into a far greater degree of regulatory oversight and scrutiny.... [1] Manage for your payer's expectations ... [2] Welcome to your new, rigorously regulated environment ... [3] You may be paid more, but when?"  MORE >>

Foley & Lardner LLP

Preventive Care May Be Free, But Follow-Up Diagnostic Tests Can Bring Big Bills

"Under the [ACA], many preventive services -- such as breast and colorectal cancer screening -- are covered at no cost.... But if a screening returns an abnormal result and a health care provider orders more testing to figure out what's wrong, patients may be on the hook for hundreds or even thousands of dollars for diagnostic services."  MORE >>

Kaiser Health News

As FTC Probes Pharma's Middlemen, One Company Proposes Software-Driven Fix

"Capital Rx's clearinghouse is based on the publicly available database maintained by the [CMS] known as the National Average Drug Acquisition Cost. Updated weekly, it offers a snapshot of how much a basket of pharmacies across the country are paying manufacturers and wholesalers to purchase drugs. Any pharmacy that contracts with Capital Rx agrees to charge customers the NADAC price or lower."  MORE >>

Forbes; subscription may be required

Employee Benefits Jobs

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          for Sentinel Benefits & Financial Group Plan Consultant

Sentinel Benefits & Financial Group

Remote / Wakefield MA

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          for Sentinel Benefits & Financial Group

Selected New Discussions

Effect of COBRA on Virta Diabetic Add-On Program

"Looking for thoughts on whether the Virta diabetic add-on program would be subject to COBRA. I'm inclined to say no -- that it's an independent, non-coordinated benefit (disease-specific, excepted benefit)."

BenefitsLink Message Boards

Press Releases

Federal Thrift Savings Plan Opens Mutual Fund Window Which Includes Sustainable Funds


TRA Hires Robert Dolin as New Regional Sales Consultant

The Retirement Advantage [TRA]

Webcasts and Conferences
(Health & Welfare Plans)

Guidance on State and Local Paid Family Leave Laws, Part IV: Federal, Connecticut, Washington D.C., Oregon, and New Hampshire Paid Family Leave Developments


Seyfarth Shaw LLP

The Right Balance of Benefits in a Tight Labor Market

June 14, 2022 WEBCAST

HR Daily Advisor

Last Issue's Most Popular Items

Text of HHS Guidance: How the HIPAA Rules Permit Covered Health Care Providers and Health Plans to Use Remote Communication Technologies for Audio-Only Telehealth

U.S. Department of Health and Human Services [HHS]

CMS Imposes First Price Transparency Rule Penalties

Husch Blackwell

California Officials Hit Anthem Blue Cross with $1 Million Fine


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

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