"[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 >>

"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 >>

"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 >>

"[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 >>

"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 >>

"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 >>

"[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 >>

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 >>

"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 >>

"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 >>