"The Final Rules expand on the interim final rules and incorporate the court's striking of certain provisions.... However, the myriad rules surrounding the process increase complexity and compliance costs for both medical providers and plans/issuers. Additionally, the Final Rules almost pre-suppose that certified IDR entities are well-trained in medical procedures, medical billing and insurance."  MORE >>

"[1] Tackle ID card requirements ... [2] Be prepared for prescription drug reporting ... [3] Enter into written agreements regarding submission of RxDC reports ... [4] Take logistical steps to prepare to submit RxDC files where necessary ... [5] Prepare to provide personalized cost-sharing information."  MORE >>

"Under both the amended [California Family Rights Act (CFRA) and California's Healthy Workplaces Healthy Families Act (HWHFA)], employees will be able to identify a designated person for whom they want to use leave when they request unpaid (CFRA) or paid (HWHFA) leave.... [U]nder both amended laws, employers will be able to limit an employee to one designated person per 12-month period. How these [two laws] define designated person, however, differs slightly."  MORE >>

"The level premium is tripartite. One component is set in reserve to cover expected claims based on factors including employee demographics.... A second portion of the level premium goes toward stop-loss insurance.... The level premium's third piece is an administrative fee ... Level-funded plans provide transparency to employers ... [It's] usually easy to switch back to a fully insured plan later if conditions warrant."  MORE >>

31 pages. "[AHIP offers] detailed comments on how HHS should maintain regulatory flexibility to focus on quick and streamlined access to interpretation, with written translations provided upon request.... [AHIP's] comments include additional recommendations to modify notice timing and frequency, as well as other suggestions to further improve the notice requirements ... AHIP recommends HHS convene a stakeholder process to gather additional input about the use and application of clinical algorithms."  MORE >>

"The proposed regulations increase both the enrollment and renewal of enrollment user fees for enrolled actuaries from $250.00 to $680.00. The proposed regulations affect individuals who apply to become an enrolled actuary or seek to renew their enrollment."  MORE >>

"On September 29, 2022, the U.S. House of Representatives passed the [Employee and Retiree Access to Justice Act (part of HR 7780)] ... [which] seeks to amend ERISA's civil enforcement provision (ERISA Section 502) to make any arbitration provisions in ERISA plans invalid and unenforceable ... [unless] the participant or beneficiary consented in accordance with particular rules ... Additionally, the Act would eliminate discretionary authority for claim administrators and allow only de novo review of a benefit claim in court."  MORE >>