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Health & Welfare Plans Newsletter

November 22, 2022

3 New Job Opportunities 3 New Job Opportunities


[Guidance Overview]

IRS Updates PCORI Fee Amount for Certain Payments Due in 2023

"[T]he amount used to calculate the PCORI fee payable for plan years ending on or after October 1, 2022, but before October 1, 2023, is $3.00 per covered life. For 2022 plan years ending on or before September 30, 2022, the PCORI fee due in 2023 is $2.79 per covered life. The IRS Form 720 report and corresponding PCORI fee payment for plan years ending in 2022 is due by July 31, 2023."  MORE >>


[Guidance Overview]

PCORI Fee Increases

"The IRS recently [announced] the updated PCORI fee as an even $3.00 per covered life, for all plan years ending on or after October 1, 2022, and before October 1, 2023. For plan years ending prior to that period, the fee is $2.79. This is the largest single increase in the fee, reflecting the effects of inflation."  MORE >>

HUB International

[Guidance Overview]

Colorado and Oregon Trigger Protections for Leaves Relating to Non-COVID Respiratory Illnesses

"Some states [have] enacted permanent changes to their leave laws that apply during a 'public health emergency,' which can apply both to COVID-19 as well as other public health emergencies. With reports of higher-than-average respiratory syncytial virus (RSV) and flu transmission, some of these public health emergency provisions are being triggered ... Colorado expands public health emergency leave to include absences relating to RSV, flu, and other respiratory illnesses ... RSV emergency declaration triggers protections under Oregon's mini-FMLA[.]"  MORE >>


Ninth Circuit: In De Novo Review of ERISA Benefit Decision, District Court Clearly Erred by Adopting Newly Presented Rationale

"[T]he Ninth Circuit held that when a district court reviews de novo an ERISA plan administrator's denial of benefits, the district court ... cannot consider new rationales argued for the first time in litigation, where the claimant did not have the opportunity to respond to the rationales during the administrative process, unless the claimant waives any objection to the reason being advanced for the first time in litigation." [Collier v. Lincoln Life Assurance Company of Boston, No. 21-55465 (9th Cir. Nov. 21, 2022)  MORE >>

Roberts Disability Law

Ninth Circuit: Insurer Waited Too Long to Challenge Claimant's Credibility

"The 9th Circuit and other courts have long blocked employee-benefit insurers from adding reasons after denying a claim, but Monday's decision is the first to 'clarify' that the rule also applies to judges, the opinion says. 'If the denial was not based on the claimant's credibility, the district court has no reason to make a credibility determination,' Circuit Judge Richard Paez wrote for the three-judge panel." [Collier v. Lincoln Life Assurance Company of Boston, No. 21-55465 (9th Cir. Nov. 21, 2022)]  MORE >>

Reuters; free registration may be required

Questions About DOL's Mental Health Parity Enforcement Push

"The [DOL] has vowed to continue its aggressive enforcement of a law requiring employer health plans to provide equal coverage for mental health and addiction treatments ... despite expected political pressure ... How hard will the Republican House push back? ... How will proposed rules clarify compliance? ... Are intellectual and developmental disabilities mental health issues?"  MORE >>

Hall Benefits Law

Navigating the Family Glitch Fix: Hurdles for Consumers with Employer-Sponsored Coverage

"[N]avigating Marketplace eligibility and enrollment requirements is complicated even without the new rules on the family glitch. This Issue Brief looks at some of the challenges consumers can expect to face in deciding whether to take advantage of the family glitch fix."  MORE >>

Henry J. Kaiser Family Foundation

Understanding Pharmacy Reimbursement Trends in Oregon: The High Costs of Low Prices (PDF)

156 pages. "[T]he incentives embedded in the current system appear to reward and encourage higher drug prices at pharmacies, resulting in higher out-of-pocket costs for patients who obtain their medications through cost sharing or those without prescription drug coverage at all."  MORE >>

Three Axis Advisors, for the Oregon State Pharmacy Association [OSPA]

California Aims to Maximize Health Insurance Subsidies for Workers During Labor Disputes

"Freezing health insurance benefits is a common tactic in a labor dispute because without them, workers might be more easily persuaded to concede to management's demands. But California lawmakers are giving an edge to strikers.... [E]ligible workers will have their premiums covered as if their incomes were just above the Medicaid eligibility level. The state would factor in the worker's federal subsidy and cover the difference."  MORE >>

Kaiser Health News

Benefits in General

[Guidance Overview]

2022 Annual Employee Benefits Compliance Checklist for Plan Administrators

"This checklist addresses plan amendments, notices and other considerations for qualified retirement plans, welfare plans, and stock-based and performance-based plans. A chart showing benefit and contribution limits for 2023 is included."  MORE >>

Williams Mullen

Employee Benefits Jobs

View job as Lead Plan Admin Analyst
            for Ameritas

Lead Plan Admin Analyst


Remote / Lincoln NE

View job as Lead Plan Admin Analyst for Ameritas

View job as Director, Compliance - Retirement Plans
            for Ameritas

Director, Compliance - Retirement Plans



View job as Director, Compliance - Retirement Plans for Ameritas

View job as Retirement Plan Data Consultant
            for The Standard

Retirement Plan Data Consultant

The Standard

Remote / OR

View job as Retirement Plan Data Consultant for The Standard

Press Releases

New Training on How to Build Authority as a Trusted 401(k) Advisor

OneAmerica® Again Among the Healthiest 100 Workplaces in America


Webcasts and Conferences
(Health & Welfare Plans)

FMLA Cheat Codes and ADA Hacks to Facilitate Leave Administration


The Employer Handbook

Medicare for Employers

December 6, 2022 WEBCAST


Last Issue's Most Popular Items

Federal District Court Certifies Transgender Discrimination Class Action Against Third-Party Administrator Under the ACA

ArentFox Schiff LLP

IRS Guidance Priorities for 2022-23 Reflect Few New Projects

Groom Law Group

Has Your Company Decided to Self-Fund Its Medical Plan? Don't Forget Privacy, Security, and Reporting Requirements

Dickinson Wright

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

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