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Health & Welfare Plans Newsletter

October 27, 2022

6 New Job Opportunities 6 New Job Opportunities

 

[Official Guidance]

Text of IRS Publication 5258: Composition and Reference Guide for ACA Information Returns Submission, Processing Year 2023 (PDF)

160 pages. "This document covers details on composing and submitting Forms 1094/1095-B and Forms 1094/1095-C by transmitters to IRS. The scope of the document addresses the A2A-application based via SOAP messages exchanged between client and exposed Web Service endpoints and the Web UI-browser-based requiring human initiation."  MORE >>

Internal Revenue Service [IRS]

[Guidance Overview]

HHS Cybersecurity Newsletter: HIPAA Security Rule Security Incident Procedures

"Security incidents will almost inevitably occur during the lifetime of a regulated entity. Having a plan established and documented is essential to being able to detect security incidents quickly in order to respond to and recover from security incidents effectively.... [1] Forming a security incident response team ... [2] Identifying security incidents ... [3] Responding to security incidents ... [4] Mitigating harmful effects of a security incident ... [5] Documenting the security incident ... [6] Understanding your breach reporting obligations."  MORE >>

U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

Upcoming Deadline icon December 27 Deadline for Pharmacy Reporting

"Recently issued CMS FAQs indicate that plan sponsors can delegate CAA reporting to their vendors, and reporting does not need to be consolidated with one entity.... [S]elf-funded plans will still retain liability for reporting, but in the case of fully insured plans, liability can be delegated to issuers in writing."  MORE >>

Winston & Strawn LLP

[Guidance Overview]

New and Updated Women's Preventive Health Services Guidelines Apply in 2023

"The updated guidelines expand on women's preventive care services required under five categories: [1] Breastfeeding Services and Supplies, [2] Contraception, [3] Counseling for Sexually Transmitted Infections, [4] Screening for Human Immunodeficiency Virus Infection (HIV), and [5] Well-Women Preventive Visits.... [A] new preventive service for obesity prevention in midlife women has been added."  MORE >>

Morgan Lewis

[Guidance Overview]

Guide to the Philadelphia Ordinance on Commuter Benefits

"[T]he bill specifies that companies offer at least one of the following employee commuter transit benefit programs: [1] Standard pre-tax transit (not parking) benefit or pre-tax bike benefit ... [2] An employer-paid standard tax-free transit benefit.  ... [3] Any combination of the two program types ... [T]he bill also requires employers to give employees educational materials to help them understand the new benefits."  MORE >>

HealthEquity

Explaining Litigation Challenging the ACA's Preventive Services Requirements

"If the plaintiffs succeed on either the constitutional or the religious claims, the government's ability to require insurance plans to cover evidence-based preventive services without cost-sharing may be limited.... This brief explains the preventive services coverage requirements, the basis of the lawsuit, next steps in the litigation, and the potential implications." [Braidwood Management, Inc. v. Becerra, No. 20-0283 (N.D. Tex. Sep. 7, 2022)]  MORE >>

Henry J. Kaiser Family Foundation

2022 Employer Health Benefits Survey

"In 2022, the average annual premiums for employer-sponsored health insurance are $7,911 for single coverage and $22,463 for family coverage.... Thirty-three percent of covered workers at small firms are enrolled in a plan where the employer pays the entire premium for single coverage. This is the case for only 6% of covered workers at large firms.... Among firms offering health benefits, 40% of small firms and 55% of large firms provide workers the opportunity to complete a health risk assessment.... Among firms with 50 or more workers offering health benefits, 87% of small firms and 96% of large firms cover the provision of some health care services through telemedicine in their largest health plan."  MORE >>

Henry J. Kaiser Family Foundation

Must We Offer COBRA to Retiring Employees If They Remain Eligible for Coverage for 18 Months After Retirement?

"While the company pays 100% of the premium for active employees, it pays only 60% of retiree coverage, with the retirees paying the other 40%.... Even though it may seem that retirees are able to continue their same coverage under the plan without interruption, the increased premium charged to retirees is considered a loss of coverage for COBRA purposes."  MORE >>

Thomson Reuters / EBIA

Montana Backs Away from Innovative Hospital Payment Model. Other States Are Watching.

"Montana didn't invent reference-based pricing, but the state made waves by having a health care plan of that size set prices for all services, not just certain procedures, such as knee replacements. Now, Montana is positioning itself to tweak its model, just as more states and employers, seeking to cut costs, consider adopting it."  MORE >>

Kaiser Health News

Benefits in General

Recent Successful Challenges to IRS Actions and Positions (PDF)

14 page.s "With respect to both the notice and comment period requirements of the Administrative Procedure Act and its expansive reading of the substance-over-form doctrine, the IRS has suffered appellate court losses with respect to employee benefit plans in recent years. Situations in which these types of challenges can be made are not a staple feature of the employee benefits practice of most practitioners, but in a situation in which it appears IRS may have exceeded its authority, it is important to know the types of procedural and substantive challenges to IRS actions that can be successfully advanced."  MORE >>

The Wagner Law Group, via New York University 2022 Review of Employee Benefits and Executive Compensation

Employee Benefits Jobs

View job as Senior Plan Consultant
            for Sentinel Benefits & Financial Group

Senior Plan Consultant

Sentinel Benefits & Financial Group

Remote / Wakefield MA

View job as Senior Plan Consultant for Sentinel Benefits & Financial Group

View job as Plan Consultant
            for Sentinel Benefits & Financial Group

Plan Consultant

Sentinel Benefits & Financial Group

Remote / Wakefield MA

View job as Plan Consultant for Sentinel Benefits & Financial Group

View job as Senior Defined Contribution Consultant
            for Loren D. Stark Company

Senior Defined Contribution Consultant

Loren D. Stark Company

Remote

View job as Senior Defined Contribution Consultant for Loren D. Stark Company

View job as Documents Consultant
            for Newport, an Ascensus Company

Documents Consultant

Newport, an Ascensus Company

Remote / Minneapolis MN

View job as Documents Consultant for Newport, an Ascensus Company

View job as Enrolled Actuary
            for FuturePlan, by Ascensus

Enrolled Actuary

FuturePlan, by Ascensus

Remote

View job as Enrolled Actuary for FuturePlan, by Ascensus

View job as Intermediary Sales Consultant
            for T. Rowe Price

Intermediary Sales Consultant

T. Rowe Price

Owings Mills MD

View job as Intermediary Sales Consultant for T. Rowe Price

Press Releases

The Plan Sponsor University Announces New Service for 401(k) and 403(b) Plan Sponsors

The Plan Sponsor University [TPSU]

Finnegan Honored With ASPPA’s Harry T. Eidson Founders Award

ASPPA [American Society of Pension Professionals & Actuaries]

Webcasts and Conferences
(Health & Welfare Plans)

Are Health Plans Satisfied with Their PBMs?

November 9, 2022 WEBCAST

EPIC

Last Issue's Most Popular Items

2023 Quick Benefit Facts (PDF)

Mercer

IRS Finalizes 'Family Glitch' Fix

Willis Towers Watson

2023 IRS Limits for Retirement, Social Security, and Health Benefits; 2023 PBGC Premiums

Milliman

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

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