"This [chart] explains key 2023 compliance deadlines for employer-sponsored group health plans. It also outlines group health plan notices employers must provide each year.... [The chart] shows the deadline that applies to calendar-year plans. For non-calendar-year plans, [some of] these deadlines will need to be adjusted to reflect each plan's specific plan year."  MORE >>

"The new amount of the PCORI Fee is $3.00 per covered life. That is a $.21 increase from the prior year.... Covered lives include all spouses, dependents, retirees, and COBRA beneficiaries covered by the plan. The PCORI Fee also applies to HRAs. Even if your health plan is fully-insured, you must still pay the PCORI for your self-insured HRA."  MORE >>

"Respiratory syncytial virus (RSV) and influenza cases are surging across the United States while COVID-19 continues to spread. Faced with hospital beds filling up and experts warning that this could be one of the most severe respiratory illness seasons in recent years, two states -- Oregon and Colorado -- have declared public health emergencies that will impact state sick and family leave requirements as workers struggle with the illnesses or to care for sick children."  MORE >>

"Cigna pharmacy and Express Scripts will join UnitedHealth Group's OptumRx in moves next year that will create competition from less expensive biosimilars and bring potential cost savings to the U.S. healthcare system. Because Humira is so expensive at more than $50,000 a year per patient, Cigna's decision means potentially thousands of patients could be shifted in 2023 to cheaper alternatives and save Cigna and Express Scripts clients and the U.S. healthcare system potentially billions of dollars a year."  MORE >>

"CSR load factors and the methods for calculating them have come under scrutiny recently, with suggestions for using the CSR load to achieve policy goals, such as increasing available premium subsidies or influencing enrollee plan choices. Although these may be worthwhile goals, there are questions about the appropriateness of certain methods for calculating the CSR load and whether the resulting loads are actuarially justified."  MORE >>

"While the Collier decision makes sense from a fairness perspective because it precludes defendants from ambushing the plaintiffs with new grounds for a denial that they lacked an opportunity to rebut during the claim process, the decision is in considerable tension with rulings from the U.S. Court of Appeals for the Seventh Circuit. That court has taken an entirely different view of de novo review in ERISA cases that is more akin to civil procedure norms that call for a plenary hearing of civil actions." [Collier v. Lincoln Life Assurance Company of Boston, No. 21-55465 (9th Cir. Nov. 21, 2022)]  MORE >>

"The sabbatical is a perk that companies of all sizes are increasingly rolling out in an effort to enhance their total rewards program.... Many employers are exploring this idea as a way to keep valued employees or provide a phased route toward retirement.... As employers consider how to design the sabbatical program to best achieve their goals, here are some potential employee benefits landmines to anticipate and avoid."  MORE >>