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Health & Welfare Plans Newsletter

August 2, 2022

4 New Job Opportunities 4 New Job Opportunities


[Official Guidance]

Text of CMS Federally-Facilitated Exchange (FFE) and Federally-Facilitated Small Business Health Options Program (FF-SHOP) Enrollment Manual (PDF)

195 pages. "All enrollments made on or after July 28, 2022, should be processed in accordance with the operational requirements set forth in this document.... This manual provides operational policy and guidance on key topics related to eligibility and enrollment within the FFE and FF-SHOPs, as well as within the SBE-FPs, which use the Federal platform to perform their eligibility and enrollment functions."  MORE >>

Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

ACA Shocker: 2023 Affordability Percentage Will Be the Lowest Ever

"The 2023 open enrollment season is quickly approaching and more so than any year to date employers are going to need to use extreme caution to ensure its health plan is affordable.... In 2023 the affordability threshold will be 9.12 percent which is the lowest the number has ever been since the ACA's inception. The number is down significantly from the 2022 amount of 9.61 percent."  MORE >>


[Guidance Overview]

Administration Delivers New Proposed Rules on ACA's Section 1557 Nondiscrimination Provision

"The proposed rules apply a broader 'covered entity' definition than the definition included in the currently effective 2020 final rules.... [M]any group health plans will be indirectly affected as the rules include any entity that provides or administers health-related services including health benefits (including telehealth benefits) offered by health insurance carriers in relation to fully insured group health plans as well as the carrier's TPA services provided to self-insured plans."  MORE >>


[Guidance Overview]

CMS Chart for Determining the Applicability of the Federal Independent Dispute Resolution (IDR) Process (PDF)

"[This chart] provides a high-level summary to assist in determining whether the Federal IDR process or a state law or All-Payer Model Agreement applies for determining the out-of-network rate. "  MORE >>

Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

Michigan Court of Claims Stays Ruling on Michigan's Paid Medical Leave Law

"[F}or now, ... the current Paid Medical Act remain[s] in effect; however, effective February 19, 2023, the Earned Sick Time Act will replace the Paid Medical Leave Act ... unless the Court's decision is overturned altogether on appeal. It is also possible that parts of the ruling will become moot if new legislation is passed."  MORE >>

Miller Johnson

[Guidance Overview]

Maryland's Flexible Leave Act Includes Mandatory Paid Bereavement Leave

"Maryland law now requires employers with 15 or more employees to permit the use of existing accrued paid leave for bereavement purposes.... Few other states require employers to provide bereavement leave."  MORE >>

Miles & Stockbridge

[Guidance Overview]

Change to Massachusetts Paid Family and Medical Leave Act Vetoed, Current Law Remains in Place

"Under the original amendment in the Massachusetts state budget, employers and employees could supplement the PFMLA benefit payments with 'any accrued sick or vacation pay or other paid leave provided under an employer policy.' ... Vetoing the provision, the governor stated concerns about the cost and implementation of the amendment and asked for a study on the costs.... [T]he Massachusetts legislature voted to override the governor's amendment veto and returned it to the governor for signature.... At this time, the governor has not acted."  MORE >>

Jackson Lewis P.C.

Remote Employees May Cause Headaches for State Mandate Reporting

"If your company ... [is] now allowing employees to work remotely, chances are there might be a few that are now residing in locations that require state mandate reporting. It's important to continue to monitor your organization's demographic data and update any records that are incorrect in a timely manner."  MORE >>

Tango Health

COBRA Notice Errors Can Be Costly

"With the continuing uptick in litigation surrounding deficient COBRA notices, now is a good time to review your notices as a precaution. While the [DOL's] Model Notices are a good place to begin, using the model notice alone does not insulate a plan from litigation."  MORE >>


District Court Vacates Rebuttable Presumption Under No Surprises Act Rules for Air Ambulance Service Providers

"The qualifying payment amount (QPA) presumption at issue in this case is similar to the one regarding emergency services (and certain other services) that the district court vacated last February in litigation brought by general health providers. The same judge who issued the February 2022 ruling also decided the current case involving air ambulance services." [LifeNet v. HHS, No. 22-162 (E.D. Tex. Jul. 26, 2022)]  MORE >>

Thomson Reuters Practical Law

Benefits in General

[Official Guidance]

Text of IRS Disaster Relief Notice 2022-06, for Victims of Kentucky Severe Storms, Flooding, Landslides and Mudslides

"Victims of severe storms, flooding, landslides and mudslides beginning July 26, 2022, now have until November 15, 2022, to file various individual and business tax returns ... Individuals and households ... that reside or have a business in Breathitt, Clay, Floyd, Johnson, Knott, Leslie, Letcher, Magoffin, Martin, Owsley, Perry, Pike, and Wolfe counties qualify for tax relief."  MORE >>

Internal Revenue Service [IRS]

Cybersecurity and ERISA Plan Management

"[H]uman resources executives must look for ways to engage more deeply with their technology peers and embrace that overlooked resource. Doing so will help enlighten EBP plan managers about the difference between a cybersecurity risk management process and the technology that protects internet-connected systems such as hardware, software, and data from cyber threats."  MORE >>

Roland Criss

How Much Does Health Spending Eat Away at Retirement Income?

"Even with Medicare coverage and ignoring long term care, retirees face sizable out-of-pocket costs for premiums, copays, and uncovered services.... After subtracting these costs, the typical retiree has only 75 percent of Social Security and 88 percent of total income left."  MORE >>

Center for Retirement Research at Boston College

Employee Benefits Jobs

View job as Regional VP of Sales
          for The Retirement Plan Company Regional VP of Sales

The Retirement Plan Company

Remote / AZ / CA / CO / MN / MO / OR / WA

View job as Regional VP of Sales
          for The Retirement Plan Company

View job as Retirement Plan Administrator
          for KB Pension Services Retirement Plan Administrator

KB Pension Services

Remote / Bradenton FL

View job as Retirement Plan Administrator
          for KB Pension Services

View job as Internal Sales Consultant
          for Definiti LLC Internal Sales Consultant

Definiti LLC


View job as Internal Sales Consultant
          for Definiti LLC

View job as Attorney - Qualified Retirement Plans
          for Trucker Huss, A Professional Corporation Attorney - Qualified Retirement Plans

Trucker Huss, A Professional Corporation

Remote / San Francisco CA / Los Angeles CA

View job as Attorney - Qualified Retirement Plans
          for Trucker Huss, A Professional Corporation

Press Releases

Empower Bolsters Its Brand With Legacy Name Alignment


Vitality Research Provides Blueprint for Employers and Health Plans to Engage People in Their Health and Improve Their Well-Being


TRA Hires Carter Gardy as Regional Sales Consultant

TRA [The Retirement Advantage]

Webcasts and Conferences
(Health & Welfare Plans)

Section 125 Cafeteria Plans

August 16, 2022 WEBCAST


Understanding Colorado’s New Paid Family and Medical Leave Insurance (FAMLI) Program

August 24, 2022 WEBCAST


Last Issue's Most Popular Items

Text of IRS Rev. Proc. 2022-34: 2023 Required Contribution Percentage for Determining Affordable Employer-Provided Coverage (PDF)

Internal Revenue Service [IRS]

The Dobbs Effect: Litigation Over Equal Access to Travel Benefits


Deadline in Five Months: Prescription Data Reporting Requirement for Health Plans


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

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