"[The final regulations] [1] extend the deadline to furnish Forms to individuals and [2] allow employers and coverage providers to satisfy their obligation to 'furnish' the Forms to certain individuals by posting the Forms on a website.... [T]his alternative manner of furnishing [does] not apply with regard to full-time employees.... Treasury and the IRS concluded that ... there is insufficient statutory authority to eliminate the Form 1095-B requirement."  MORE >>

"Since January 1, 2020, temporary relief has permitted high deductible health plans (HDHPs) to provide telehealth services at low or no cost prior to meeting the required deductible in order to preserve HSA eligibility for plan participants. Currently, this temporary relief is set to expire December 31, 2022, which may impact certain plan designs[.]"  MORE >>

"In light of OCR's guidance and the growing risk of litigation, health care entities should review the use and disclosure of their website data, determining what information constitutes PHI and reviewing compliance with both HIPAA and other laws with respect to any data sharing."  MORE >>

"The IRA will add to a complex American drug pricing system that entails intricate price metrics, discounts, and rebates across different payers. Consequently, like previous drug pricing legislation, the IRA will probably have important unintended consequences.... [This article explores] likely consequences in areas related to prices and include an appendix with an example of how drug manufacturers might react to the provisions of the IRA to minimize revenue loss[.]"  MORE >>

"The proposed rule builds on recently implemented requirements for standardized plans, network adequacy, and fair marketing standards.... It also includes modifications to risk adjustment, Advance Premium Tax Credit (APTC) policy, marketplace transitions, user fees, and other marketplace standards.... [This article focuses] on proposed market reforms and consumer assistance improvements."  MORE >>

"Further expanding generous protected employee leaves, California now will require most private employers to provide up to five days of bereavement leave for a covered family member's death. Assembly Bill 1949, which Governor Newsom signed, takes effect on January 1, 2023.... Other than California, only Oregon, Illinois, and Maryland have state bereavement leave laws covering private employers. Illinois' expanded bereavement leave law also takes effect on January 1, 2023."  MORE >>

"[T]his new Ninth Circuit decision indicates for the first time that it is 'clear error' for a district court to adopt 'newly presented rationale when applying de novo review.' Even rationale focused on a claimant's credibility must be affirmatively stated in the claim denial, if considered, or it will be deemed a 'newly presented rationale' and must be excluded from consideration by the district court if asserted in the litigation." [Collier v. Lincoln Life Assurance Company of Boston, No. 21-55465 (9th Cir. Nov. 21, 2022)]  MORE >>

"[The court] reaffirmed its prior position that 'MultiPlan should be considered a plan fiduciary as to conduct that relates to the fiduciary duties owed to plan participants, namely, the repricing of plan members' claims.' ... Although the court had declined to find a blanket waiver of privilege in its prior ruling, the court changed its mind here.... The court also went through the sampling of documents it reviewed in camera and explained how they were improperly withheld in contravention of the court's previous rulings." [LD v. United Behavioral Health, No. 20-02254 (N.D. Cal. Dec. 2, 2022)]  MORE >>

"What is open enrollment and why is it more important now than ever for employers and employees? ... Why should open enrollment be a year-long effort and how is this beneficial for employers and employees? ... How can employers determine which benefits are top of mind for employees? ... How can employers use open enrollment and wellness benefits to help meet diverse and personalized employee needs? ... What open enrollment trends do you see now and what can you predict about future open enrollment cycles?"  MORE >>

"[1] Benefit expenses are often lower outside the U.S.... [2] It's important to test the waters.... [3] For voluntary benefits, focus on the basics."  MORE >>

"[M]any insurers have begun moving toward a 'supermarket' of various offerings, most likely amassing many segment-centric assets.... [Tailoring] health plan offerings reactively to consumer demand ... is achieved by adding hybrid products that address specific customer needs or by stitching together a marketplace of add-on point solutions.... [S]ome insurers are using the startup approach to design new care models and coverage plans. The risk is that it requires scale to succeed."  MORE >>

"Together, ... three PBMs control about 80% of the total PBM market ... But beyond the big three PBMs is a swarm of some 60 smaller, up-and-coming PBMs. Even if they are operating in a small slice of the pie relative to the towering dominance of the big three, ... [the] global PBM market is projected to increase from $495 billion in 2022 to $740 billion by 2029 ... Some of the smaller PBMs are niche players.... However, others say they are aiming to disrupt the PBM sector and challenge the big three with new ways of managing the use and cost of drugs."  MORE >>

"All covered job postings must include a general description of all benefits offered for the specific available position ... If the general description of benefits changes after a posting has been published, the job posting must be updated.... [T]he law applies to any employer who conducts business activity in Washington, regardless of whether the company has any employees in Washington or any physical presence in Washington.... A posting for a remote role must comply with Washington law if the position could be performed by a Washington-based employee. Employers cannot avoid coverage by excluding Washington applicants[.]"  MORE >>