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Health & Welfare Plans Newsletter

July 27, 2022

4 New Job Opportunities 4 New Job Opportunities


New York Extends Paid Leave for COVID Vaccinations Through December 31, 2023

"Employers should remain aware that this paid COVID vaccination leave cannot be charged against any other leave to which the employee is entitled, including paid sick leave or leave provided under a collective bargaining agreement."  MORE >>

Davis Wright Tremaine LLP

Alert (High Risk Issue) icon First Circuit Construes Life Insurance Policy Ambiguities Against Insurer, Affirms Over $1.1 Million Award to Widow

"Construing the ambiguous terms in the policy against Reliance, there was no requirement that Ministeri work any specific number of hours during his irregularly scheduled workweeks. Thus, Ministeri was working 'Part-time' within the policy's meaning until he formally took leave on August 8, 2014. The court further found that the policy's provisions for a one-year continuation and 60-day conversion means that Ministeri's basic life insurance coverage was in effect when he died on October 2, 2015." [Ministeri v. Reliance Standard Life Ins. Co., No. 21-1651 (1st Cir. July 25, 2022)]  MORE >>

Roberts Disability Law

Ninth Circuit Holds ERISA Health Plan's Self-Help Recoupment Provision Is Enforceable

"The Ninth Circuit held that under the clear terms of the [plan's SPD], Plaintiff Norman Mull is liable for the reimbursement of his daughter's benefits, and the Plan is authorized to recoup those benefits through its self-help provision because ERISA does not limit the use of such self-help remedies, and neither contractual doctrines nor res judicata prevent the Plan from enforcing its recoupment provision." [Mull v. Motion Picture Industry Health Plan, No. 20-56315 (9th Cir. Jul. 25, 2022)]  MORE >>

Roberts Disability Law

Benefits, Wellbeing and Employee Trends to Watch

"Employers must help current employees and new recruits meet their diverse wellness needs by providing a comprehensive benefits package, and resources to help them navigate it.... Employers and insurers may face DOL audits to confirm that they are providing equal coverage for both mental health/substance use disorder benefits and medical/surgical benefits.... Employees expect a highly integrated benefits experience, resulting in a more cohesive care experience overall and requiring less effort to find, understand, and access the care they need."  MORE >>


Potemkin Protections: Assessing Provider Directory Accuracy and Timely Access for Four Specialties in California

"Surveys were able to verify provider directory entries for the four specialties for 59% to 76% of listings or 78% to 88% of providers reached.... [C]onsumers were able to schedule urgent care appointments for 28% to 54% of listings or 44% to 72% of accurately listed providers. For general care appointments, the percentages ranged from 35% to 64% of listed providers or 51% to 87% of accurately listed providers."  MORE >>

Abigail Burman and Simon F. Haeder, via Journal of Health Politics, Policy and Law

Even Well-Intended Laws Can't Protect Us from Inaccurate Provider Directories

"Despite a spate of state and federal regulations that require more accurate health plan directories, they can still contain numerous errors and are often maddeningly outdated.... The law gives insurers some leverage to induce providers to respond, and a whole industry has sprung up around collecting provider updates through a centralized portal and selling the information to health plans. The inaccuracy problem remains, however. Health plans and providers often have outdated data systems that don't communicate with each other."  MORE >>

Kaiser Health News

CMS Releases Maternity Care Action Plan

"The action plan takes a holistic and coordinated approach across CMS to improve health outcomes and reduce inequities for people during pregnancy, childbirth, and the postpartum period.... CMS Administrator Chiquita Brooks-LaSure also encouraged industry stakeholders -- including health care facilities, insurance companies, state officials, and providers -- to consider key commitments the private sector can make to improve maternal health outcomes."  MORE >>

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

Benefits in General

[Official Guidance]

Text of EBSA Meeting Notice for ERISA Advisory Council

"[T]he 212th open meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans (also known as the ERISA Advisory Council) will be held via a teleconference on Thursday, September 8 and Friday, September 9, 2022.... The Advisory Council is studying the following topics: [1] Cybersecurity Issues Affecting Health Benefit Plans, and [2] Cybersecurity Insurance and Employee Benefit Plans.... The agenda and instructions for public access to the teleconference meeting will be available on the ERISA Advisory Council's web page ... approximately one week prior to the meeting."  MORE >>

Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

Employee Benefits Jobs

View job as DC Plan Administrator
          for Heritage Pension Advisors, Inc. DC Plan Administrator

Heritage Pension Advisors, Inc.

Commack NY

View job as DC Plan Administrator
          for Heritage Pension Advisors, Inc.

View job as Retirement Plan Relationship Consultant
          for Capital Group Retirement Plan Relationship Consultant

Capital Group

Carmel IN / Irvine CA / San Antonio TX

View job as Retirement Plan Relationship Consultant
          for Capital Group

View job as Retirement Plan Services Specialist - PlanPremier
          for Capital Group Retirement Plan Services Specialist - PlanPremier

Capital Group

Carmel IN / Irvine CA / San Antonio TX

View job as Retirement Plan Services Specialist - PlanPremier
          for Capital Group

View job as Employee Benefits and Executive Compensation Attorney (Counsel or Attorney)
          for Thompson Hine LLP Employee Benefits and Executive Compensation Attorney (Counsel or Attorney)

Thompson Hine LLP

Cleveland OH / Atlanta GA / Chicago IL / Cincinnati OH / Columbus OH / Miamisburg OH / Washington DC

View job as Employee Benefits and Executive Compensation Attorney (Counsel or Attorney)
          for Thompson Hine LLP

Press Releases

WTW Appoints Kevin House to Lead Via Benefits


New Prospect Drip Content Kit Available for 401k Advisors

Centivo Names Jim Foreman Chairman of the Board of Directors


TRA Hires Drew Graser as New Business Development Consultant

The Retirement Advantage [TRA]

Webcasts and Conferences
(Health & Welfare Plans)

Affordable Care Act Responsibilities for Cannabis Employers

July 27, 2022 WEBCAST

Warner Norcross & Judd LLP

Health Plan Transparency: Group Health Costs and Mental Health Compliance

September 13, 2022 WEBCAST

American Bar Association Joint Committee on Employee Benefits [JCEB]

Last Issue's Most Popular Items

Addressing Employee Health Plan Exception Requests: Ineligible Dependents


Michigan Court Voids State's Minimum Wage and Paid Medical Leave Acts, Creating Compliance Limbo

Jackson Lewis P.C.

Health Plan Can Stop Coverage to Recoup Money Without Going to Court

Reuters; free registration may be required

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

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