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Health & Welfare Plans Newsletter

October 11, 2022

4 New Job Opportunities 4 New Job Opportunities


[Official Guidance]

Text of IRS Final Regs: Affordability of Employer Coverage for Family Members of Employees

86 pages. "This document contains final regulations under section 36B of the Internal Revenue Code that amend the regulations regarding eligibility for the premium tax credit (PTC) to provide that affordability of employer-sponsored minimum essential coverage (employer coverage) for family members of an employee is determined based on the employee's share of the cost of covering the employee and those family members, not the cost of covering only the employee. The final regulations also add a minimum value rule for family members of employees based on the benefits provided to the family members."  MORE >>

Internal Revenue Service [IRS]

[Official Guidance]

Text of IRS Notice 2022-41: Additional Permitted Election Changes for Health Coverage Under Section 125 Cafeteria Plans (PDF)

13 pages. "This notice expands the application of the permitted change-in-status rules for health coverage under a section 125 cafeteria plan. In particular, this notice addresses the situation in which, during a period of coverage (typically a plan year), a cafeteria plan participant may wish to revoke the employee's election under the cafeteria plan for other-than-self-only (family) coverage under a group health plan (other than a flexible spending arrangement (FSA)) in order to allow one or more family members to enroll in a Qualified Health Plan (QHP) through a Health Insurance Exchange in the individual market. Under this notice, the employee will be able to elect out of family coverage and into self-only coverage (or family coverage including one or more already-covered related individuals) under that health plan prospectively during a period of coverage, provided specific conditions are satisfied....

"This notice is being issued in conjunction with regulations under section 36B, which provide that the affordability of an offer of group health plan coverage for a related individual is based on the employee's cost to cover the employee and the employee's related individuals"  MORE >>

Internal Revenue Service [IRS]

[Guidance Overview]

Understanding FMLA Leave for Mental Health Conditions

"The [DOL] recently issued a fact sheet relating to an employee's ability to use FMLA leave for their own or a family member's mental health condition. This article provides an overview of the FMLA, the DOL's guidance, FMLA assistance for employees struggling with mental health issues, and ways employers can support their employees."  MORE >>


[Guidance Overview]

Alert (High Risk Issue) icon California Creates Bereavement Leave Requirement

"As of January 1, 2023, AB 1949 makes it unlawful for an employer to refuse to grant an eligible employee the opportunity to take up to five days of bereavement leave upon the death of a family member.... [T]his new requirement applies to employers with five or more employees."  MORE >>


[Guidance Overview]

Massachusetts PFML Update: Contribution Rates and Benefit Amounts for 2023

"For 2023, the overall PFML contribution rate has decreased from 0.68% to 0.63% of eligible wages for employers with 25 or more covered individuals. The PFML contribution rate for smaller employers -- fewer than 25 covered individuals -- decreased from 0.344% to 0.318%."  MORE >>

Seyfarth Shaw LLP

Reasons to Consider Self-Funding Your Company's Healthcare Benefits

"With a self-funded plan: [1] You pay for actual claims. In a fully-insured plan, your costs are fixed regardless of your employees' claim history, and any end-of-plan-year excess remains with the insurer instead of your company. [2] You have access to data to make informed decisions.... [3] You save on state premium taxes and avoid state-mandated benefits. [4] You can customize your benefit plan design to meet employee needs via quality providers and programs while controlling, and even reducing, costs for both you AND your employees."  MORE >>


U.S. Employers Eyeing Alternative Approaches to Retiree Healthcare Benefits

"[S]ome employers plan to replace their traditional group retiree medical benefits for pre-Medicare retirees with individual insurance through private marketplaces.... [H]alf of employers (50%) are concerned about increases in their costs to provide medical benefits for retirees. These costs for retirees who aren't eligible for Medicare are projected to increase 4.8% next year, up from 3.6% this year. Costs for Medicare-eligible retirees are projected to rise 2.7% next year, up from 2.1% this year."  MORE >>

Willis Towers Watson

Pulling Back the Curtain: Lowering Prescription Drug Prices

"Rep. Earl L. 'Buddy' Carter (R-GA) ... announced the 'Pulling Back the Curtains on PBMs' report, an initiative to educate Members of Congress and the public on the role pharmacy benefit managers (PBMs), the pharmaceutical industry's middlemen, play in driving up costs for medications, delaying necessary treatments for patients, and robbing hope from their loved ones. This initiative focuses on the people at the heart of the problem, who are battling PBMs for access to basic treatments and prescriptions."  MORE >>

Rep. Earl L. 'Buddy' Carter [R-GA]

Benefits in General

[Official Guidance]

Text of DOL Proposed Regs: Employee or Independent Contractor Classification Under the Fair Labor Standards Act

184 pages. "[T]he Department believes it is appropriate to rescind the 2021 IC Rule and set forth an analysis for determining employee or independent contractor status under the Act that is more consistent with existing judicial precedent and the Department's longstanding guidance prior to the 2021 IC Rule.... Accordingly, the Department is now proposing, in addition to rescinding the 2021 IC Rule, to again add part 795.... [T]he Department is not proposing the use of 'core factors' but instead proposes to return to a totality-of-the-circumstances analysis of the economic reality test in which the factors do not have a predetermined weight and are considered in view of the economic reality of the whole activity. The Department is further proposing to return the consideration of investment to a standalone factor, provide additional analysis of the control factor (including detailed discussions of how scheduling, supervision, price-setting, and the ability to work for others should be considered), and return to the longstanding interpretation of the integral factor, which considers whether the work is integral to the employer's business."  MORE >>

Wage and Hour Division [WHD], U.S. Department of Labor [DOL]

[Guidance Overview]

Exceptional Usefulness and Quality icon DOL Announces Proposed Rule on Classifying Employees, Independent Contractors; Seeks to Return to Longstanding Interpretation

"[T]he proposed rule would do the following: [1] Align the department's approach with courts' FLSA interpretation and the economic reality test. [2] Restore the multifactor, totality-of-the-circumstances analysis to determine whether a worker is an employee or an independent contractor under the FLSA. [3] Ensure that all factors are analyzed without assigning a predetermined weight to a particular factor or set of factors. [4] Revert to the longstanding interpretation of the economic reality factors. These factors include the investment, control and opportunity for profit or loss factors. The integral factor, which considers whether the work is integral to the employer's business, is also included. [5] Assist with the proper classification of employees and independent contractors under the FLSA. [6] Rescind the 2021 Independent Contractor Rule."  MORE >>

Wage and Hour Division [WHD], U.S. Department of Labor [DOL]

How Modern Architects Design Global Benefits Programs

"[1] Consider the broad range of personal situations ... [2] Convenience + digitalization: Good intentions, poor execution ... [3] Post-COVID continuity ... [4] Support people leaders to handle effective deployment and consistent communication."  MORE >>


Benefit Plan Considerations for Employers in a Market Downturn

"Benefits continuation during layoffs, furloughs and other leaves of absences ... Employer contribution holidays for defined contribution retirement plans ... Loans and hardship distributions ... Investment and plan fiduciary considerations."  MORE >>

Goodwin Procter

Employee Benefits Jobs

View job as Retirement Plan Department Manager
            for Keating, Inc.

Retirement Plan Department Manager

Keating, Inc.


View job as Retirement Plan Department Manager for Keating, Inc.

View job as Retirement Plan Administrator
            for Keating, Inc.

Retirement Plan Administrator

Keating, Inc.

Manhattan KS

View job as Retirement Plan Administrator for Keating, Inc.

View job as Retirement Specialist
            for DC Retirement Board

Retirement Specialist

DC Retirement Board

Washington DC

View job as Retirement Specialist for DC Retirement Board

View job as Director, Retirement Document Services
            for OneAmerica

Director, Retirement Document Services


Remote / Indianapolis IN

View job as Director, Retirement Document Services for OneAmerica

Press Releases

Catalyst for Payment Reform Report Explores Marketplace for Employers/Purchasers Seeking High-value Care

Catalyst for Payment Reform [CPR]

Webcasts and Conferences
(Health & Welfare Plans)

Employers as Health Care Change Agents: The Time Is Now

November 2, 2022 WEBCAST

BHCG [Business Health Care Group]

The Maryland Time to Care Act of 2022

November 9, 2022 WEBCAST


Last Issue's Most Popular Items

West Virginia v. EPA: Is This the End to DOL Regs as We Know Them? (PDF)

Jenner & Block, via Employee Relations Law Journal

Tax-Free Employer Reimbursement of Student Loan Repayments (PDF)

Ivins, Phillips & Barker

ACA Section 1557: Proposed Rulemaking Affecting Health Plan Coverage of Sexual Orientation and Gender Identity Treatments


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

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