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Health & Welfare Plans Newsletter

September 12, 2022

4 New Job Opportunities 4 New Job Opportunities


[Guidance Overview]

California Legislature Extends COVID Supplemental Paid Sick Leave

"Assembly Bill 152 (AB 152), is expected to extend the state's current COVID-19 Supplemental Paid Sick Leave expiration date from September 30 to December 31, 2022."  MORE >>

Davis Wright Tremaine LLP

Fifth Circuit Case Carries Significant Implications for Health Plan Regulation

"If arrangements like Data Marketing are legitimate single employer ERISA-covered health plans, other similar arrangements could proliferate. The Data Marketing plan operates much like an insurance company offering individual market coverage to persons with no employment relationship to each other or to Data Marketing (beyond downloading an app). These plans are exempt from many consumer protections under the [ACA] ... They would also be exempt from state insurance laws, including financial solvency regulation." [Data Marketing Partnership, LP v. DOL, No. 20-11179 (5th Cir. Aug. 17, 2022)]  MORE >>

Groom Law Group

Sixth Circuit Rules in Favor of Former Attorney on Long-Term Disability Claim; Affirms Dismissal of Counterclaim for Overpaid Benefits

"[T]he court found it irrelevant that Messing no longer possesses the skills to return to the practice of law since the question is whether he suffers from a disability that prevents him from working as a lawyer.... On the whole, the court found that Messing proved his entitlement to continued benefits.... The court agreed with the district court that Provident failed to proffer any evidence that it would have terminated Messing's benefits earlier." [Messing v. Provident Life and Accident Ins. Co., No. 21-2780 (6th Cir. Sep. 9, 2022)]  MORE >>

Roberts Disability Law

Second Circuit Grants Benefit Fund's Audit Request Well Beyond CBA Coverage

"In a decision that bodes poorly for unionized employers, the U.S. Court of Appeals for the Second Circuit recently held that a union benefit fund was contractually entitled to conduct an audit whose scope far exceeded the bargaining unit for whom fund contributions were required. Since the employer did not produce evidence that the fund trustees' conduct of the audit breached their ERISA fiduciary duties, the court held that the fund was entitled to conduct the requested audit." [New York State Nurses Association Benefits Fund v. Nyack Hospital, No. 20-0378 (2nd Cir. Aug. 19, 2022)]  MORE >>

Jackson Lewis P.C.

District Court: ACA's HIV/Prep Coverage Mandate Violates Religious Freedom Restoration Act

"In a dispute involving the [ACA's] preventive health services rules, a Texas district court held that the coverage mandate for preexposure prophylaxis (PrEP) drugs to prevent HIV infections violated an employer's rights under the Religious Freedom Restoration Act of 1993 (RFRA). The district court also addressed the appointment process for the entities that determine which items and services must be covered under the ACA's preventive health services rules, as implemented." [Braidwood Management, Inc. v. Becerra, No. 20-0283 (N.D. Tex. Sep. 7, 2022)]  MORE >>

Thomson Reuters Practical Law

Hospital and Insurer Price Transparency Rules Now in Effect But Compliance Is Still Far Away

"The short answer to the question of whether these transparency rules are working is -- not quite yet. Hospitals have been slow to comply with transparency rules.... Even when hospitals have complied with the rules, experts have found the data to be 'consistently inconsistent' in terms of how data elements are defined and displayed, making it very difficult for third parties to make connections across hospitals and payers."  MORE >>

Health Affairs

Crush Open Enrollment Season with a Plan to Maximize Employee Satisfaction and Boost Financial Literacy

"What matters to employees in the open enrollment period? ... What do you want to achieve in the 2023 benefits enrollment season? ... Is there a benefits communications gap? ... Put it all together to plan for open enrollment ... [1] Use targeted training and resources to engage your workforce.... [2] Promote financial literacy to help all employees understand their options.... [3] Concentrate on cost savings."  MORE >>


Nebraska Blue Cross Telehealth Reimbursement Cut Has Officials Worried About Potential for More

"Jeremy Nordquist, president of the Nebraska Hospital Association, said Blue Cross and Blue Shield of Nebraska's decision to cut reimbursement for telehealth visits by 50% as of July 1 is a huge concern that could drastically reduce the use of virtual care in the state if other insurers follow suit.... [It's] not clear if any other health insurers plan to follow suit."  MORE >>

Lincoln Journal Star

Benefits in General

[Guidance Overview]

Exceptional Usefulness and Quality icon DOL (Somewhat) Unshackles Auditors from Stringent Independence Requirements

"The relief, while limited, is a step toward closing the gap between the American Institute of Certified Public Accountants (AICPA) auditor independence standards and those standards imposed by the Department. Additionally, IB 2022-01 should reduce the number of auditors that are inadvertently disqualified from initial engagements, thereby allowing plan sponsors more latitude in their auditor selection process."  MORE >>

Groom Law Group

Employee Benefits Jobs

View job as Retirement Plan Consultant
          for The MandMarblestone Group, llc Retirement Plan Consultant

The MandMarblestone Group, llc

Remote / Philadelphia PA

View job as Retirement Plan Consultant
          for The MandMarblestone Group, llc

View job as Retirement Plan Adminstrator
          for NC Staffing Retirement Plan Adminstrator

NC Staffing


View job as Retirement Plan Adminstrator
          for NC Staffing

View job as Manager, Compliance
          for FuturePlan, by Ascensus Manager, Compliance

FuturePlan, by Ascensus

Remote / Atlanta GA

View job as Manager, Compliance
          for FuturePlan, by Ascensus

View job as Actuarial Analyst
          for Definiti LLC Actuarial Analyst

Definiti LLC


View job as Actuarial Analyst
          for Definiti LLC

Press Releases

Woman-Advised PEP Brings Small Town Charm to All of America

Castle Rock Investment Company

DOL Recovers $131.8M for Wells Fargo 401(k) Participants After Investigation Finds Plan Overpaid for Company Stock

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

Vestwell Launches Two Products for 401(k) Third Party Administrators


Webcasts and Conferences
(Health & Welfare Plans)

Mental Health Parity: The Basics for Plan Sponsors

September 22, 2022 WEBCAST

Boutwell Fay LLP

No Surprises Act Guidance for Health Plans: Final Rules, IDR Process, Qualifying Payment Amounts, Disclosures

November 2, 2022 WEBCAST


Last Issue's Most Popular Items

Addressing Employee Health Plan Exception Requests: Requests for Employer to Reimburse Outside the Plan


District Court Holds That Key ACA Preventive Services Requirements Are Unconstitutional

Health Affairs

Updated CMS Instructions Limit Rx Reporting for Wellness Services


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

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