26 pages. "This document is a request for information (RFI) to inform DOL, HHS, and the Treasury and OPM's rulemaking for advanced explanation of benefits (AEOB) and good faith estimate (GFE) requirements of the No Surprises Act, which was enacted as part of the Consolidated Appropriations Act, 2021 (CAA). This RFI seeks information and recommendations on transferring data from providers and facilities to plans, issuers, and carriers; other policy approaches; and the economic impacts of implementing these requirements."  MORE >>

"Employers should review the required employee contribution for 2023 coverage if they plan to meet the ACA's affordability limit under the applicable safe harbor. For the many plans using the FPL affordability safe harbor, the considerations differ for calendar- and noncalendar-year plans."  MORE >>

"By amending the California Family Rights Act (CFRA), the bill would expand the definition of who an employee could take leave to care for. The bill defines 'designated person' as 'any individual related by blood or whose association with the employee is the equivalent of a family relationship.' Employers can limit employees to one designated person per 12-month period."  MORE >>

"The PFMLI program will be funded by employer and employee contributions in the form of payroll deductions beginning January 1, 2023 and will provide employees with up to 12 weeks of paid time off for leave that qualifies as family, medical, or safe leave, absent undue hardship, beginning on September 3, 2023. [This article provides] a summary of the more notable rules governing the PFMLI program and how an employer may submit an equivalent plan application."  MORE >>

"Judge O'Connor did not immediately issue an order blocking enforcement of the coverage requirements. He also did not specify whether such an order would be nationwide, for his district only, for all the named plaintiffs, or only for Braidwood. These issues are held for further argument before Judge O'Connor." [Braidwood Management, Inc. v. Becerra, No. 20-0283 (N.D. Tex. Sep. 7, 2022)]  MORE >>

"If the preventive services coverage mandate is partly struck down, the result could be a confusing patchwork of health plan benefit designs offered in various industries and in different parts of the country. Patients who have serious medical conditions or are at high risk for such conditions may have a hard time finding a plan that fully covers preventive and screening services."  MORE >>

"Open enrollment season is here once again! The rush of meeting deadlines to offer benefits, educate employees on benefit changes, and make sure all required notices are provided and filings are timely made could cause some stress and anxiety.... Here are potential action items for the fourth calendar quarter (through Dec. 31, 2022)."  MORE >>

"While there is no direct impact on employer-sponsored health plans, caps on Medicare Part D out-of-pocket limits and other cost reductions could affect prescription drug coverage creditable status. Employers must provide notice of a health plan's creditable coverage status at different times, and at least annually before October 15."  MORE >>

"Congress may consider legislation that further addresses the coordination of Medicare and employer- based coverage with respect to benefits for ESRD patients. Federal legislation could, among other things, address a level of dialysis coverage that must be provided by a group health plan, or amend the MSP statute to address further the circumstances under which employers may limit such benefits." [LSB10819 Sep. 14, 2022] [Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc., No. 20-1641 (S. Ct. Jun. 21, 2022)]  MORE >>

"While price transparency compliance ranged from 13% to 49% of hospitals studied, the findings revealed that facilities with fewer beds were less likely to be compliant with the rule. Additionally, hospitals located in the South and the West were also associated with less transparency."  MORE >>

"If we are serious about changing the unsustainable trajectory of US health care spending, it is time to stop just managing illness and start finally addressing the root causes of chronic disease and their associated costs."  MORE >>