"The fee will now be $3.00 per plan enrollee, up from $2.79 for the 2022 plan year.... For plan years ending in 2022, PCORI is due by July 31, 2023. For plan years ending January 2023 through September 2023, PCORI fees are not due until July 31, 2024."  MORE >>

"Under the revised guidance, cafeteria plans -- regardless of plan year -- can be amended to allow prospective midyear election changes from family coverage to employee-only coverage (or family coverage including one or more already-covered related individuals) under a group health plan that is not a health FSA and provides minimum essential coverage if [certain] conditions are satisfied[.]"  MORE >>

"The final regulations focus on ... [1] The factors that an IDR entity should consider when making a payment determination as part of the IDR process; [2] The requirements for an IDR entity's written decision; and [3] The disclosures by plans and issuers regarding the qualifying payment amount (QPA) to address 'downcoding'.... The final regulations are applicable with respect to items or services provided or furnished on or after October 25, 2022, for plan years beginning on or after January 1, 2022."  MORE >>

"[T]he employer remains liable for noncompliance, even if it has an enforceable agreement with its vendor to ensure compliance, unless the plan is fully-insured and the agreement is with the insurer.... [T]here is no way for an employer to confirm on the HIOS module that a vendor uploaded the file(s) it agreed to upload ... [T]he employer should obtain written assurance from the plan's vendor(s) and rely on contractual provisions for recourse if a vendor fails to fulfill its RxDC reporting service as agreed."  MORE >>

"The modifications in the proposed regulations are intended to provide more robust data exchange, improved coordination of benefits, and expanded financial fields that would avoid the need to manually enter certain data. To this end, the proposals would modify the current retail pharmacy standards by altering the use or structure of data fields, inserting new data segments, and adding new functionality."  MORE >>

"As food insecurity deepens, Americans are also struggling to pay for critical health care expenses. Many have cancelled or postponed plans in the past 12 months to see a specialist (14%), take a prescribed medication (10%) or get an annual physical (11%) due to high inflation, the survey said. And almost one-fifth of Gen Z (17%) and millennials (19%) have cancelled or postponed plans in the past 12 months to see a mental health professional."  MORE >>

"During the first three quarters of 2022, there were an estimated 9 million NSA eligible claims, or about 0.5% of all commercial claims. Of these, 275,000 claims were submitted to IDR for dispute resolution. Health plans have received a total of 110,000 IDR batches."  MORE >>

"Thus far, no specific group of employees has been awarded a final judgment granting military leave pay, but as the cases are working their way to final resolution, it has become clear that potentially valid paid military leave claims may be brought against employers who cannot distinguish paid leave provided in non-military settings from that sought for military service absences. A few of the significant recent decisions addressing these claims are discussed below."  MORE >>

"Victims of Illinois severe storm and flooding occurring between July 25 and 28, 2022, now have until February 15, 2023, to file various individual and business tax returns and make tax payments ... [I]ndividuals and households affected by the severe storm and flooding that reside or have a business in St. Clair county qualify for tax relief."  MORE >>

"How do you know what benefits to offer? ... The benefits all generations want ... Health and family planning benefits by generation ... Financial planning benefits by generation ... Work-life flexibility and training benefits by generation."  MORE >>