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Health & Welfare Plans Newsletter
October 27, 2022
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6 New Job Opportunities
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[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]
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[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]
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[Guidance Overview]
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
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[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
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[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
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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
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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
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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
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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
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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
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Employee Benefits Jobs |
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Press Releases |
The Plan Sponsor University Announces New Service for 401(k) and 403(b) Plan Sponsors
The Plan Sponsor University [TPSU]
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Finnegan Honored With ASPPA’s Harry T. Eidson Founders Award
ASPPA [American Society of Pension Professionals & Actuaries]
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Webcasts and Conferences (Health & Welfare Plans) |
Are Health Plans Satisfied with Their PBMs?
November 9, 2022 WEBCAST
EPIC
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Last Issue's Most Popular Items |
2023 Quick Benefit Facts (PDF)
Mercer
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IRS Finalizes 'Family Glitch' Fix
Willis Towers Watson
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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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