logo logo

Health & Welfare Plans Newsletter

November 11, 2022

3 New Job Opportunities 3 New Job Opportunities


[Guidance Overview]

[Quiet] Extension of IRS Notice 2022-41 Now Includes Calendar Year Cafeteria Plans

"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 >>


[Guidance Overview]

IRS Releases Final Rule on ACA 'Family Glitch' and Allows Employers to Make a Cafeteria Plan Change

"[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 >>


[Guidance Overview]

Agencies Update Surprise Billing IDR Process Guidance for Final Regs and Release 2023 Fee Amounts

"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 >>

Thomson Reuters / EBIA

[Guidance Overview]

Rules to Remember About the Interaction Between COBRA and Medicare

"[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 >>

Groom Law Group

Despite TPA's Contractual Obligation, Employer May Still Be Liable for COBRA Notice Violation

"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 >>

The Wagner Law Group

The Unlikely Intersection Between ERISA and State Laws Regulating Abortion

"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 >>

Trucker Huss

The Pandemic and Inflationary Impact on the Health Care System

"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 >>

Medical Economics

Most and Least Expensive States for Health Care, Ranked

"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 >>

Forbes Advisor; subscription may be required

Getzen Model of Long-Run Medical Cost Trends: Update for 2023

"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 >>

Society of Actuaries

Who Has Past-Due Medical Bills and What Are the Impacts? (PDF)

"[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 >>

Employee Benefit Research Institute [EBRI]

Benefits in General

GAO Report on Nonstandard and Contracted Work Arrangements: Data from the 2020 Annual Business Survey and Analysis of 2021 10-K Filings

"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 >>

U.S. Government Accountability Office [GAO]

Employee Benefits Jobs

View job as Non-Qualified Client Service Manager
            for Newport, an Ascensus Company

Non-Qualified Client Service Manager

Newport, an Ascensus Company

Charlotte NC

View job as Non-Qualified Client Service Manager for Newport, an Ascensus Company

View job as Retirement Plan Quality Assurance (Seasonal)
            for ERISA Services, Inc.

Retirement Plan Quality Assurance (Seasonal)

ERISA Services, Inc.

Remote / Knoxville TN

View job as Retirement Plan Quality Assurance (Seasonal) for ERISA Services, Inc.

View job as Distribution Specialist
            for ERISA Services, Inc.

Distribution Specialist

ERISA Services, Inc.

Remote / Knoxville TN

View job as Distribution Specialist for ERISA Services, Inc.

Press Releases

DCIIA Retirement Research Center Announces Three New Advisory Councils

Defined Contribution Institutional Investment Association [DCIIA]

Webcasts and Conferences
(Health & Welfare Plans)

Health Plans Post-Dobbs: Issues, Insights, and Trends

December 8, 2022 WEBCAST

ALI CLE [American Law Institute Continuing Legal Education]

Last Issue's Most Popular Items

Are You Ready for District of Columbia's Transportation Benefits Equity Law?

Jackson Lewis P.C.

Evaluating Your Health Plan’s Diabetes Coverage

International Foundation of Employee Benefit Plans [IFEBP]

Things You Might Have Wrong About the Self-Funded Health Insurance Market

Forbes; subscription may be required

Unsubscribe  |   Change Email Address

Search Past Issues   |   Privacy Policy

Submit an Article   |   Contact Us   |   Advertise Here

Copyright 2022, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.

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

Links to web sites other than and are offered as a service to our readers. We are not involved in their production and are not responsible for their content.