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Health & Welfare Plans Newsletter

June 21, 2022

2 New Job Opportunities 2 New Job Opportunities


[Guidance Overview]

Upcoming Deadline icon ACA Reminders: Patient-Centered Outcome Research Institute Fee and MLR Rebates

"[The PCORI] fee will remain effective for plan or policy years ending before October 1, 2029. The fee is scheduled to sunset after that.... If some of the premium is paid by employees and dependents (including former employees and dependents on COBRA), then such participants are likely owed some portion of the [MLR] rebate.... If the rebate is small, you may also be able to use it for health plan improvement activities."  MORE >>

HUB International

[Guidance Overview]

Is EEOC Wellness Guidance Coming Out of the Deep Freeze?

"It is possible that, if Biden's nominee to the EEOC secures confirmation, the proposed regulations containing the de minimis rule may be revived in their original or a modified form. [This article provides] a brief summary of existing wellness incentive rules and some thoughts on what a de minimis incentive rule might look like, if enforced."  MORE >>

E is for ERISA

[Guidance Overview]

OCR Issues Guidance on HIPAA-Compliant Use of Audio-Only Telehealth

"[1] OCR emphasizes the important role telehealth plays in expanding access to healthcare and the need to ensure compliance with HIPAA for these arrangements post-PHE. [2] The guidance clarifies when audio-only telehealth services and vendor agreements require compliance with the HIPAA Security Rule. [3] Covered entities should take the opportunity now, prior to the end of the PHE, to analyze changes needed in telehealth arrangements."  MORE >>

Nixon Peabody LLP

Text of Supreme Court Opinion: Group Health Plan's Limits on Coverage for Outpatient Dialysis Does Not Violate the Medicare Secondary Payer Statute (PDF)

12 pages. "The question in this case is whether a group health plan that provides limited benefits for outpatient dialysis -- but does so uniformly for all plan participants -- violates the Medicare Secondary Payer statute. We agree with petitioner Marietta and the United States as amicus curiae that the answer is no. We therefore reverse the judgment of the U. S. Court of Appeals for the Sixth Circuit and remand the case for further proceedings consistent with this opinion." [Marietta Memorial Hospital Employee Health Benefit Plan v. Da Vita Inc., No, 20-1641 (S. Ct. Jun. 21, 2022)]  MORE >>

Supreme Court of the United States

Prevent a Benefits Renewal Bombshell by Performing a Mid-Year Review

"Even if the benefits plan performance is monitored closely throughout the year, steadily rising healthcare and pharmacy costs and a host of other factors make it difficult to predict just how much the benefits renewal rate will increase for the next plan year. Without proper preparation, the employer could be in for a scary surprise."  MORE >>

Corporate Synergies

High Job Flexibility and Paid Sick Leave Increase Health Care Access and Use Among U.S. Workers

"This study explored the impact of job flexibility, including both its informal aspects and access to paid sick leave, on health care access and use.... Results showed that a one-unit increase in job flexibility was associated with a 2.15-percentage-point increase in the likelihood of having an office-based health care visit in the past year and a 2.42-percentage-point increase in the likelihood of having a usual source of care. Access to paid sick leave was associated with a 3.83-percentage-point increase in the likelihood of having an office-based health care visit."  MORE >>

Health Affairs

Medicare Could Save $3.6 Billion on Generic Drugs by Matching Direct-to-Consumer Pricing

"If Medicare purchased generic drugs at the maximum quantities available from MCCPDC, the program could have saved $3.6 billion on 77 of the 89 generic drugs. This represented a 37% cost savings.... The drug with the highest cost savings was esomeprazole at $293 million in savings.... [These findings] are consistent with findings that Medicare overspent on 43% of generic prescriptions in 2018 relative to Costco member prices[.]"  MORE >>

HealthLeaders Media

Men Often Press the Snooze Button on Their Health Care

"The study of 1,000 U.S. men reveals fewer than half, 47%, had an annual checkup or wellness visit either virtually or in person in the past 12 months. Additionally, just 37% had a routine dental exam and only 29% had a routine eye exam in the past year. At the same time, 1 in 4 men admitted they've never talked to anybody about their mental health and well-being despite 72% of respondents stating they experienced some type of mental or behavior health concern in the past 12 months alone."  MORE >>



HSAs No Longer Promote Consumer Cost-Consciousness

"[The authors] argue that HSAs no longer appreciably achieve this cost-consciousness aim because cost sharing has increased so much in non-HSA-qualified plans. Indeed, people who have HDHPs with HSAs are becoming less likely than others with private insurance to report financial barriers to care. In sum, promised gains in efficiency from HSAs have not borne out, so it is difficult to justify maintaining this regressive tax break."  MORE >>

Health Affairs

Employee Benefits Jobs

View job as Compliance Analyst - 401(k) Administration
          for Ubiquity Retirement + Savings Compliance Analyst - 401(k) Administration

Ubiquity Retirement + Savings

Remote / San Francisco CA

View job as Compliance Analyst - 401(k) Administration
          for Ubiquity Retirement + Savings

View job as Plan Consultant
          for BPAS Plan Consultant


Remote / Syracuse NY

View job as Plan Consultant
          for BPAS

Press Releases

SageView Advisory Group Agrees to Acquire $321 Million Los Angeles-Based Wealth Management Firm

SageView Advisory Group

Webcasts and Conferences
(Health & Welfare Plans)

Ethics: A Practical Approach

July 19, 2022 WEBCAST

Western Pension & Benefits Council

Last Issue's Most Popular Items

Limiting Exposure for Health and Welfare Plan Fiduciaries

HUB International

Fifth Circuit Enforces Pre-Existing Condition Exclusion in Long-Term Disability Policy Despite Employer's Misrepresentations

Roberts Disability Law

Form 5500 Reminders for Plan Sponsors

Hawley Troxell

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

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