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Health & Welfare Plans Newsletter

October 21, 2022

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[Guidance Overview]

Taxation of Tuition Assistance Plans

"Since tuition assistance can be an expensive benefit for employers some ... will require employees to repay the benefit if they leave employment within a designated period of time after receiving the benefit.... What are the tax consequences to employees who receive a taxable tuition assistance amount from their employers subject to a repayment requirement, but who then leave employment and are required to repay all or a portion of the amount received?"  MORE >>

Boutwell Fay LLP

[Guidance Overview]

ACA Affordability and Employee-Only Coverage

"As a result of the expanded eligibility for federal tax credits, employer plans may see a decrease in enrollment of spouses and dependent children in their health plans.... The new rule does not change a plan sponsor's ability to impose a spousal surcharge, or a spousal exclusion based on access to other coverage. The new rule does give family members facing an exclusion or surcharge new options to avoid the impact of such plan designs."  MORE >>

HUB International

How to Make Reference-Based Pricing Work for Your Health Plan

"A successful RBP plan should have the following components: [1] Carefully drafted plan documents that strengthen the rights of the patient to dispute bills; [2] Avoidance of contracts with providers or limited use of contracts; [3] A defensible repricing mechanism; [4] A robust patient advocacy process that includes legal representation."  MORE >>


Covering Select Preventive Services Has Little Impact on Employer Health Care Spending (PDF)

"Given the current uncertainty surrounding the ACA's preventive care coverage mandate ... [EBRI] conducted an analysis of claims data on over 2.4 million enrollees to quantify spending on five commonly used services and all prescription drug classes receiving an 'A' or 'B' recommendation from the USPSTF.... [The] costs of covering select preventive services are very low. Moreover, any reintroduction of patient cost sharing will have a minimal impact on overall employer health care spending."  MORE >>

Employee Benefit Research Institute [EBRI]

State Attorneys General to Tenth Circuit: States Should Be Allowed to Regulate PBMs

"After a national trade association for PBMs ... sued the state of Oklahoma claiming the state's PBM regulations violated federal law, a district court ruled in favor of the state. PCMA appealed the case. Now, the state attorneys generals are asking the appellate court to reject PCMA's claims and uphold the district court's decision saying that Oklahoma can regulate PBMs." [Pharmaceutical Care Management Assoc. (PCMA) v. Mulready, No. 19-0977 (W.D. Okla. Apr. 4, 2022; on appeal to 10th Cir. No. 22-6047, amicus brief filed Oct. 18, 2022)]  MORE >>

MedCity News


DOL Amicus Brief to Supreme Court: City of Seattle Ordinance Is Not Preempted by ERISA (PDF)

"The Ordinance here does not require employers to establish ERISA plans, nor does it single out ERISA plans or plan sponsors for differential treatment. Instead, as with state and local prevailing-wage laws that petitioner appears to concede are valid, employers can comply fully with the Ordinance by making direct monetary payments to individual employees. The fact that the Ordinance also gives employers flexibility to establish compliance through contributions to an ERISA-covered plan does not render the Ordinance invalid. The petition for a writ of certiorari should accordingly be denied." [ERISA Industry Committee (ERIC) v. City of Seattle, No. 20-35472 (9th Cir. Mar. 17, 2021; unpub.; cert. pet. filed Jan. 14, 2022)]  MORE >>

U.S. Department of Labor [DOL]

Employee Benefits Jobs

View job as Quality Assurance Manager
            for Bates & Company

Quality Assurance Manager

Bates & Company

Remote / Winter Park FL

View job as Quality Assurance Manager for Bates & Company

Press Releases

DWC - The 401(k) Experts Announces Tianna Schulz as Firm Partner

DWC - The 401k Experts

The Standard Partners with Alight Solutions to Expand Employee Benefits Portfolio

The Standard

Webcasts and Conferences
(Health & Welfare Plans)

MHPAEA: Check Yourself Before You Wreck Yourself


NFP Corp.

Healthcare and Cybersecurity: A Risk Based Approach



employer Open Door Forum on Action to Resolve the 'Family Glitch'

October 24, 2022 WEBCAST

Centers for Medicare & Medicaid Services [CMS]

Last Issue's Most Popular Items

IRS Announces Cost-of-Living Adjustments for Health and Welfare Plans

McDermott Will & Emery

Feds Take Action to Fix the ACA 'Family Glitch'


Employers Are Making Employee Mental Health and Wellbeing a Top Health Priority

Willis Towers Watson

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

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