21 pages; August 2022. Topics include: [1] Batching and bundling, [2] Eligibility for the Federal IDR process, and [3] Failure to submit information in response to a certified IDR entity"s request.  MORE >>

"Key requirements for plans and issuers are providing personalized cost-sharing information and ensuring other information on costs is publicly available.... Many employers think that personalized cost-sharing information ... has the potential for near-term impact on employee healthcare purchasing behaviors once implemented. But overall sentiment leans toward a small (53%) or moderate (24%) effect ... Price transparency will likely benefit employees more than employers."  MORE >>

"The 2022 Proposed Rule re-expands the interpretation of 'on the basis of sex' to prohibit discrimination on the basis of sexual orientation and gender identity. The 2022 Proposed Rule additionally expands the interpretation to prohibit discrimination against someone for seeking reproductive care and discrimination on the basis of pregnancy or related conditions, including 'pregnancy termination.' "  MORE >>

"While gender identity and sexual orientation protections are a primary focus of the proposed regulations, along with protections for disabled individuals and individuals with limited English proficiency (LEP), a number of other issues are addressed, including several for which HHS has requested comments."  MORE >>

"This case serves as a stark reminder of the uphill battle ERISA claimants face when confronted with the abuse of discretion standard of review. Ms. Stewart proved to a federal appellate court’s satisfaction that her claim administrator had misread the policy, but that wasn’t enough. It is no surprise that state legislatures across the country have increasingly reacted to cases like this by prohibiting insurers from including discretionary authority provisions in their policies." [Stewart v. Hartford Life & Accident Ins. Co., No. 21-11919 (11th Cir. Aug. 10, 2022)]  MORE >>

"[1] What is the reputation of the carrier? ... [2] Does the policy contain discretionary language? ... [3] Are the benefits taxable? ... [4] What is the definition of disability? ... [5] What is the elimination period? ... [6] What are the limitations and exclusions?"  MORE >>

"[T]he varied distribution protocols outlined in different life insurance and 401(k) plan provider documents are often contrary to what one might expect would be the distribution protocol.... [T]he distribution of large sums of money could potentially be against the deceased employee's wishes. The best way to avoid this issue is to make sure that an individual employee's life insurance and 401(k) beneficiary form(s) exist, is current, and matches any estate planning documents."  MORE >>