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Health & Welfare Plans Newsletter

November 2, 2022

2 New Job Opportunities 2 New Job Opportunities


Healthcare Affordability Crowds Out Wages

"Drug prices (93%), high-cost claims (87%) and hospital costs (79%) are most significant cost drivers of employer-sponsored health benefits coverage for employees and their families. ... [A]lmost half (47%) of employers are using centers of excellence and within the next 1-3 years many employers are considering tiered networks (46%), site of care (43%), contracting and performance guarantees tied to Medicare pricing, and reference-based pricing (36%)."  MORE >>

National Alliance of Healthcare Purchaser Coalitions

How Employers Are Leveraging Benefits to Recruit and Retain Workers

"Common strategies [to curb costs] include making changes to plan design (39%), increasing deductibles or out-of-pocket maximums and implementing narrow networks (30%), and offering contingent cash in lieu of insurance for spousal plan selection (21%).... Benchmarking employee benefits is necessary for employers to ensure they attract the best talent and get the most out of their current employees."  MORE >>

Treasury & Risk; free registration required

Companies Seek Fast Return on Benefits Tweaks Amid Economy Fears

"The types of initiatives employers are considering include going out to bid for their health insurers and pharmacy benefit managers to try to get lower prices ... [B]enefits such as support for caregivers, for which there has been employer interest in the past two years, 'may not be top of mind now' because the return on investment is longer term ... Employers also are looking at more limitations on health provider networks and coverage plans that encourage employees to go the 'best quality, most efficient providers'[.]"  MORE >>

Bloomberg Law

Cash for Colonoscopies: Colorado Tries to Lower Health Costs Through Incentives

"[E]mployers in the state are banding together to negotiate lower prices for health care services. The state government is one of 12 employers that have agreed to join the alliance and will be the first to use the newly negotiated rates and consumer incentives. The goal is to disrupt what's considered a dysfunctional market for health care by encouraging employers and employees to make better choices and forcing health systems in the state -- which have some of the highest prices and profits in the country -- to cut their rates."  MORE >>

Kaiser Health News

Independent Review Prevents 'Cat's Paw' Liability in FMLA Retaliation Claim

"The Tenth Circuit upheld the district court's dismissal in favor of the employer, finding that the employee did not submit sufficient evidence to establish a 'cat's paw' theory of liability because she had failed to show that those responsible for her firing were influenced by the retaliatory motives of her supervisor.... [The court] noted that the employer's policy of obtaining considerations by independent decision makers when making FMLA termination decisions insulated the employer against allegations that the supervisor's bias led to her firing." [Parker v. United Airlines, Inc., No. 21-4093 (10th Cir. Sep. 26, 2022)]  MORE >>

The Wagner Law Group

Benefits in General

Bill Passed by House Would Increase ERISA Litigation by Changing Administrator Discretion and Arbitration Provisions

"[The Employee and Retiree Access to Justice Act (ERAJA)] amends ERISA in two important ways that will lead to much more ERISA retirement plan litigation.... [1] ERAJA would invalidate and render unenforceable any arbitration provisions, class action waivers, and representation waivers for the purposes of claims brought under ERISA Section 502 as well as common law claims.  ... [2] ERAJA would also legislatively remove the ability of plans to give the plan administrator discretion in deciding claims and having the administrator's decision be given deference by a reviewing court[.]"  MORE >>

Murphy Austin

Employee Benefits Jobs

View job as DC Plan Administrator
            for Pension Management Consultants, Inc.

DC Plan Administrator

Pension Management Consultants, Inc.

Remote / Modesto CA

View job as DC Plan Administrator for Pension Management Consultants, Inc.

View job as Sr Retirement Plan Consultant
            for SetAway, LLC

Sr Retirement Plan Consultant

SetAway, LLC

Remote / Bedford NH / MA / ME / VT

View job as Sr Retirement Plan Consultant for SetAway, LLC

Selected New Discussions

Waiver of Pre-Authorization Requirement: Scope of the Newborns' and Mothers' Health Protection Act of 1996

"I'm not someone who processes claims, but we help administer a few plans. The TPA denied the following services, saying that they needed to be pre-authorized. The Newborns' and Mothers' Health Protection Act of 1996 says that pre-authorization is not needed for the 48 or 96 hour hospital stay in regards to having a baby, but do these services also fall under the no need to pre-authorize?

* Private Room, Med/Surg/Gyn
* Private Obstetrical Room
* Drugs, General
* IV Solution Drugs
* Lab, General
* Immunology Lab
* Hematology Lab
* Emergency Room; General
* Delivery Room
* General Other Diagnostic Service"

BenefitsLink Message Boards

Press Releases

Allianz Lifetime Income+ Annuity Now Available in Plans Nationwide


Voya Financial to acquire Benefitfocus, Inc.

Voya Financial

Webcasts and Conferences
(Health & Welfare Plans)

Navigating Murky Waters: Ethics for ERISA and Executive Compensation Lawyers

December 13, 2022 WEBCAST

American Bar Association Joint Committee on Employee Benefits [JCEB]

Mental Health Parity Rules and Requirements for Plan Sponsors and Administrators

January 4, 2023 WEBCAST


Last Issue's Most Popular Items

Top Compliance Issues for Health and Leave Benefits in 2023


IRS Expands Mid-Year Cafeteria Plan Change Opportunities to Address 'Family Glitch'


The Annual Form 5500 Audit: DOL Broadens Criteria for Independent Qualified Public Accountants

Faegre Drinker

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

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