logo logo

Health & Welfare Plans Newsletter

August 16, 2022

5 New Job Opportunities 5 New Job Opportunities


[Guidance Overview]

IRS Issues Affordability Percentage Adjustment for 2023

"Coverage is considered affordable if the employee's required contribution for self-only coverage on the employer's lowest-cost, minimum value plan does not exceed 9.12% of the employee's household income in 2023 ... An ALE may rely on one or more safe harbors in determining if coverage is affordable: W-2, rate of pay, and federal poverty level."  MORE >>

Woodruff Sawyer

[Guidance Overview]

Massachusetts Sets 2023 Individual-Mandate Coverage Dollar Limits

"For 2022 plan years, Bulletin 06-21 sets the maximum MCC deductibles at $2,750 for individual coverage and $5,500 for family coverage. A plan can have a separate prescription drug deductible if individual/ family amounts do not exceed $340/$680 in 2022. The overall maximum deductible still applies."  MORE >>


[Guidance Overview]

Colorado Workers, Employers to Begin Paying 0.45% of Wages for Voter-Approved Paid Leave Program

"Employees who are eligible for paid leave are those who've earned at least $2,500 in wages over a one-year period. Both employers and employees will contribute to the program. Employees will designate 0.45% of their wages and employers will provide a matching amount. This rate is set through 2025 in accordance with Proposition 118. After 2025, the rate will be set each year, however, the combined rate is statutorily capped at 1.2%."  MORE >>

Aegis Risk Medical Stop-Loss Premium Survey (PDF)

"Excluding claimants at renewal, known as lasering, is not permitted for 61% of respondents -- with 43% of those having a renewal rate cap.... Plan mirroring is more common, now at 49%.... 98% of surveyed plans cover pharmacy, an ongoing increase from around 90% several years back. Increased high-dollar pharmacy exposure is driving the change, and stop-loss without pharmacy coverage is now ill- conceived."  MORE >>

Benefits Quarterly, published by the International Society of Certified Employee Benefit Specialists [ISCEBS]

Mental Health Support Increasing for Commercial Plan Enrollees (PDF)

"Commercial health plans average 1,851 in-network behavioral health care providers per 100,000 enrollees, representing a 48% increase over the past 3 years.... All respondents (100%) provide in-network coverage for telebehavioral health services ... More than 3 in 4 health plans (78%) have increased payments to in-network behavioral health providers ... 83% of plans report they assist enrollees with finding available behavioral health appointments."  MORE >>

America's Health Insurance Plans [AHIP]

Inflation Reduction Act's Health Care Provisions Could Affect Employers

"With the expansion of enhanced PTC subsidies until 2025, it becomes more likely that the higher subsidies will eventually be made permanent ... One consequence could be to make ACA marketplace plans a more appealing health care option for employers, who could opt to ... meet the ACA's coverage requirements by funding individual coverage health reimbursement arrangements (ICHRAs), which allow employees to purchase their own coverage on ACA exchanges."  MORE >>

Society for Human Resource Management [SHRM]; membership may be required to view article

When the Federal No Surprises Act's Dispute Resolution Process Does Not Apply: No 'Surprise Billing'

"Although the federal IDR process has established an alternative method for resolving some [out-of-network (OON)] payment disputes, many are still subject to litigation in federal courts. Determining which OON payment disputes fall under the federal IDR process is a source of some confusion. Even for OON patients, there are circumstances in which disputes remain subject to litigation because no 'surprise bill' occurs."  MORE >>

K&L Gates

Employee Benefits Jobs

View job as Plan Administration Manager
          for FranFund Plan Administration Manager


Fort Worth TX

View job as Plan Administration Manager
          for FranFund

View job as DB/DC Administrator
          for Primark Benefits DB/DC Administrator

Primark Benefits

Remote / San Mateo CA

View job as DB/DC Administrator
          for Primark Benefits

View job as TPA Conversion Specialist
          for Third Party Administrators, Inc. TPA Conversion Specialist

Third Party Administrators, Inc.


View job as TPA Conversion Specialist
          for Third Party Administrators, Inc.

View job as Plan Document Specialist
          for Vestwell Plan Document Specialist


Remote / New York NY

View job as Plan Document Specialist
          for Vestwell

View job as Executive Director
          for North Atlantic States Carpenters Benefit Funds Executive Director

North Atlantic States Carpenters Benefit Funds

Wilmington MA

Press Releases

Inc. Magazine Names Vestwell One of America's Fastest-Growing Private Companies


Prime Pensions Completes Carve-Out of Aldrich Retirement Solutions

Prime Pensions

Webcasts and Conferences
(Health & Welfare Plans)

Coming Soon: Oregon Paid Family Medical Leave

October 4, 2022 WEBCAST

Ogletree Deakins

Bias in Actuarial Work: A Primer

October 26, 2022 WEBCAST

Conference of Consulting Actuaries

Statutory Paid Leaves: What You Need To Know For 2023

November 16, 2022 WEBCAST

Disability Management Employer Coalition [DMEC]

Last Issue's Most Popular Items

Inflation Reduction Act Contains 'Unprecedented' Health Care Provisions

Collective Bargaining Implications of the U.S. Supreme Court Decision in Dobbs

Dickinson Wright

Impact of First Impression Equitable Relief ERISA Ruling

Bloomberg Law

Unsubscribe  |   Change Email Address

Search Past Issues   |   Privacy Policy

Submit an Article   |   Contact Us   |   Advertise Here

Copyright 2021, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.

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

Links to web sites other than and are offered as a service to our readers. We are not involved in their production and are not responsible for their content.