"In revisiting Notice 2022-41 (on November 9), it appears that the limitation on the applicability of this Guidance to only 'non-calendar year' cafeteria plans has been removed [from the first sentence under the Guidance heading], so that this additional permitted election change event may now be adopted for any cafeteria plan, even calendar year cafeteria plans." [BenefitsLink note: Compare archived copy of the original Notice, as published by IRS on October 11, 2022.]  MORE >>

"[If] an employer plan's family tier premiums are high, adopting these changes may cause a decrease in enrollment in the plan, which can impact employer costs and claims experience. Additionally, if the employee's family obtains coverage on the exchange while the employee remains on the employer's plan, the family would potentially have increased costs with multiple deductibles and maximum out-of-pocket limits."  MORE >>

"The process guidance has been updated to reflect final regulations, issued in August 2022, that addressed the factors that certified IDR entities may consider in selecting a party's payment amount and additional disclosure requirements for plans and insurers that 'downcode' billed claims ... The updated process guides are effective as of October 25, 2022, and apply to items and services furnished by an out-of-network provider on or after that date, for plan or policy years beginning on or after January 1, 2022."  MORE >>

"[1] Entitlement means enrollment.... [2] The effective date of Medicare is key, not the application date.... [3] Medicare enrollment before (but not on or after) termination of employment/reduction in hours extends COBRA.... [4] Medicare enrollment is almost never actually a qualifying event.... [5] Medicare enrollment after COBRA enrollment can end COBRA early for that person only."  MORE >>

"the district court rejected the employer's argument that it had made a good faith effort to provide the employee with a COBRA election notice by instructing the TPA to send the notice to the employee's last known address.... [T]he court determined that delegating the task of sending the notice to the TPA did not insulate the employer from liability for failing to provide the employee's updated address to the TPA.... In contrast, the court dismissed the employee's claims against the TPA." [Howard v. Ivy Creek of Tallapoosa, LLC, No. 20-0213 (M.D. Ala. Sep. 22, 2022)]  MORE >>

"This article analyzes whether laws such as the recently passed Texas Heartbeat Act -- which imposes civil liability upon, and allows for injunctive relief against, persons who 'aid and abet' abortions -- are preempted by [ERISA], in the context of health plans that provide travel expense reimbursement for abortion-related services."  MORE >>

"The onset of COVID-19 prompted a surge in demand for clinical health services. At the same time, the extenuating circumstances of the pandemic limited physical access to care. Concurrently, the government response to the pandemic included massive increases in public spending on medical services and products. As a result, health care revenue from employer-sponsored plans sharply declined following a drop in health services utilization as providers cancelled elective care and as patients practiced social distancing by avoiding health facilities."  MORE >>

"Health care costs averaged over $10,000 per person in 2020, but the exact amount varied by state. [Forbes] compared all 50 states and the District of Columbia across 11 key metrics using data from the Kaiser Family Foundation ... South Dakota topped the list of states with the most expensive health care, while Michigan is the cheapest."  MORE >>

"Government subsidies and spending soared in 2020 to meet the challenges of the pandemic. Health expenditures leapt from 17.6% of GDP to 19.7% [in 2020], and then dropped to 18.8% in 2021, and will fall again to 18.2% (projected) in 2022, but are expected to return to the long-run trend by 2024 and gradually rise thereafter. However, during the next few years most attention will be paid to dealing with complex aftershocks from the flood of COVID funding in 2020 and 2021, a surge of inflation in 2022, and a looming recession in 2023."  MORE >>

"[T]he percentage of Americans who report past-due medical bills has remained in the low 20 percent range since 2015, down from 26 percent in 2012.... Among individuals with health insurance, one-quarter (24 percent) reported past-due medical bills, compared with 35 percent of uninsured individuals."  MORE >>

"GAO was asked to review what available data show about companies' use of nonstandard and certain contracted work arrangements, and reported effects on topics such as workplace safety, wages, and access to benefits. This report provides preliminary observations[.]" [GAO-23-106212]  MORE >>