"Reimbursement of Internal Revenue Code Section 213(d) health expenses creates a group health plan, which would trigger the full array of group health plan laws (ERISA, COBRA, HIPAA, ACA, HSA eligibility, Section 105(h), etc.). Therefore, employers should avoid providing reimbursement for any Section 213(d) medical expenses outside of the group health plan unless it is part a HRA or wellness program that is integrated with the health plan."  MORE >>

16 pages. "This report describes current law and applicable regulations and guidance, specifically with regard to how the PTC and CSR requirements apply in tax year 2022." [R44425, updated Sep. 7, 2022]  MORE >>

"If an employer's wellness services fit within the definition of an excepted benefit, then the wellness service shouldn't be subject to reporting. But if the wellness service is billed as a claim under the major medical plan, it may still be included in reporting as the TPA or insurer may not be able to separate those claims out from the reporting submission."  MORE >>

"The final surprise billing rule provides that certified IDR entities should select the offer that best represents the value of the item or service under dispute, after considering both the QPA and certain other factors (rather than assuming that the QPA alone is the correct value). In addition, the departments issued ACA FAQs Part 55, which answer questions on the NSA and the Transparency in Coverage rules[.]"  MORE >>

"Judge O'Connor held that a key part of the preventive services mandate -- namely, the requirement that most commercial plans cover services with an 'A' or 'B' recommendation from the U.S. Preventive Services Task Force (USPSTF) without cost sharing -- violates the Appointments Clause and is thus unconstitutional. He also ruled that the requirement that insurers and plans cover an HIV prevention medication known as preexposure prophylaxis (PrEP) violated one plaintiff's rights under the Religious Freedom Restoration Act (RFRA)." [Braidwood Management, Inc. v. Becerra, No. 20-0283 (N.D. Tex. Sep. 7, 2022)]  MORE >>

"A key part of the ruling by Judge Reed O'Connor of the U.S. District Court for the Northern District of Texas says one way that preventive services are selected for the no-cost coverage is unconstitutional. Another portion of his ruling says a requirement that an HIV prevention drug therapy be covered without any cost to patients violates the religious freedom of an employer who is a plaintiff in the case. It is not yet clear what all this means for insured patients. A lot depends on what happens next." [Braidwood Management, Inc. v. Becerra, No. 20-0283 (N.D. Tex. Sep. 7, 2022)]  MORE >>

"Because the terminated employee's manager accepted previous messages regarding absences via Facebook Messenger, the Company's position that using Facebook Messenger was not its 'usual and customary' notice practice for reporting FMLA absences, was called into question. The [Fourth Circuit] found that previous utilization of Facebook Messenger to communicate absences raised a question of material fact for a jury to determine if a Facebook Messenger Chat satisfied the FMLA's notice requirements." [Roberts v. Gestamp West Virginia, LLC, No. 20-2202 (4th Cir. Aug. 15, 2022)]  MORE >>

"[If] the charge is a late pickup fee, ... the fee can be reimbursed under your DCAP, so long as it is for taking care of the child and satisfies the other criteria for reimbursement under your plan and the Code. But if the charge is for late payment of a bill from the day-care center, it probably would not qualify for reimbursement from a DCAP."  MORE >>

"Brand your pre-open enrollment campaign ... Supercharge your communication plan ... Meet with your benefits vendors and tech partners ... Host a series of webinars."  MORE >>

"OCR has specifically stated in FAQ guidance that covered entities are not permitted to simply abandon PHI or dispose of it in dumpsters or other containers that are accessible by the public or other unauthorized persons. Failure to implement reasonable safeguards to protect PHI in connection with waste disposal (such as removing or obliterating any individually identifiable information) can result in impermissible disclosures of PHI and costly liability under HIPAA."  MORE >>

"While unlimited PTO has its benefits for employers, it can lead to significant cultural problems by creating an atmosphere of uncertainty and tension in the workplace where employees don't know where they stand with management and relative to their colleagues. The alternative ... is a set of clearly defined policies ... [which] could include convertible PTO (which allows employees to direct unused vacation time toward other priorities), increased compensation, a pre-specified number of days off, or some combination of all the above."  MORE >>

"Policies similar to Ramp Down/Ramp Up benefit companies by giving employees the space and support that they need to prepare for parenthood -- and to parent -- while maintaining high levels of productivity and commitment to the company."  MORE >>

"Victims of Arizona severe storms occurring between July 17 and July 18, 2022, now have until November 15, 2022, to file various individual and business tax returns and make tax payments ... Individuals and households affected by severe storms that reside or have a business in the Salt River Pima-Maricopa Indian Community qualify for tax relief."  MORE >>

"[1] Genuine, specific recognition of good work ... [2] Greater job autonomy ... [3] Customized employee benefits ... [4] Profit-sharing plans and other incentive pay ... [5] Nonqualified deferred compensation and other key employee benefits ... [6] ESOP."  MORE >>