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Health & Welfare Plans Newsletter

December 20, 2022

2 New Job Opportunities 2 New Job Opportunities

 

[Official Guidance]

Text of IRS Notice 2023-04: Calculating the Qualifying Payment Amounts in 2023 (PDF)

"[T]his notice provides the percentage increase for calculating the qualifying payment amounts for items and services furnished during 2023 for purposes of sections 9816 and 9817 of the Internal Revenue Code, sections 716 and 717 of [ERISA], and sections 2799A-1 and 2799A-2 of the Public Health Service Act ... [T]he percentage increase from 2022 to 2023 is 1.0768582128. Further, pursuant to this notice, plans and issuers may round any resulting qualifying payment amounts to the nearest dollar."  MORE >>

Internal Revenue Service [IRS]

[Guidance Overview]

IRS Finalizes Automatic 30-Day Extension for Furnishing ACA Forms

"In November 2021, the IRS proposed a permanent, automatic 30-day extension, without the need for filing with the IRS. The recently finalized rules made that proposal final. This means that although the filing deadline technically remains January 31, employers and coverage providers that deliver the forms to employees/covered persons within 30 days after January 31 still satisfy compliance requirements."  MORE >>

HUB International

[Guidance Overview]

Vermont Governor Announces Family and Medical Leave Insurance Plan

"The program, called the Vermont Family and Medical Leave Insurance Plan (VT-FMLI), will be rolled out in 2023 for state workers ... The coverage will be available to private employers in 2024, and beginning in 2025, individual employees and self-employed workers can purchase individual coverage if their employers do not offer it."  MORE >>

Jackson Lewis P.C.

[Guidance Overview]

How Employers Can Prepare for Oregon's Paid Family Leave Program

"Oregon's Paid Family Leave program commences on January 1, 2023.... [M]ost Oregon employers must alert employees about the program and begin paying into the state insurance plan. The law requires employers post the Oregon Employment Department's model notice at the worksite and distribute the same notice to remote workers.... [F]or most employers, the law requires Oregon employers withhold and remit contributions to the program starting January 1, 2023."  MORE >>

Jackson Lewis P.C.

Third Circuit Finds ERISA Waiver of Premium Claim 'Deemed' Exhausted and Affirms Award of Life Insurance Benefits

"[T]he court explained that because First Reliance failed to ... make a decision within 45 days of receipt of the claim with at most two 30-day extensions, Rizzo is deemed to have exhausted the administrative remedies available under the plan and entitled to file suit ... The Third Circuit also found First Reliance's denial of the WOP claim to be arbitrary and capricious. Even assuming First Reliance's decision was substantively reasonable because there was some evidence that Mr. Rizzo could perform sedentary work, the decision was not procedurally reasonable." [Rizzo v. First Reliance Standard Life Ins. Co., No. 20-1144 (3d Cir. Dec. 16, 2022)]  MORE >>

Roberts Disability Law

Ninth Circuit Lets Plan Recoup Dissipated Tort Settlement from Future Medical Benefit Payments (PDF)

11 pages. "[A] recent decision from the Ninth Circuit appears to present a possible end-run around Montanile. After reviewing this case and the plan's recoupment clause, this article will examine the potential application of recouping overpayments to other contexts which could facilitate plan administration. A discussion of some of the practical challenges likely to be encountered by plans implementing this remedy will follow ... This article will conclude with a review of some of the policy considerations that plan sponsors should take into account in designing a recoupment provision so as to ameliorate the potentially harsh impact of such clauses." [Mull v. Motion Picture Industry Health Plan, No. 20-56315 (9th Cir. Jul. 25, 2022)]  MORE >>

J. Stewart Borrow,

Preventative Healthcare Benefits Help Retain and Engage Employees

"Successful employers are focusing on benefits that boost workplace health and engagement, especially in the wake of COVID-19. This includes much needed preventative healthcare offerings that help with hiring and retention by: Emphasizing what really matters to employees ... Prioritizing employees' physical and mental health ... Increasing employee pay and company profit."  MORE >>

HR Daily Advisor

250,000 New York City Municipal Retirees Face Controversial Switch to Privatized Health Insurance

"An arbitrator is directing New York City to quickly move ahead with a plan to transfer some 250,000 municipal retirees from their current Medicare coverage to a Medicare Advantage plan operated by a private insurer -- despite ongoing and persistent efforts by some retirees to block the move."  MORE >>

Gothamist

Employee Benefits Jobs

View job as Healthcare Valuation Actuary
            for United Actuarial Services, Inc.

Healthcare Valuation Actuary

United Actuarial Services, Inc.

Remote / Carmel IN

View job as Healthcare Valuation Actuary for United Actuarial Services, Inc.

View job as Retirement Plan Analyst
            for Benetrends Inc

Retirement Plan Analyst

Benetrends Inc

Remote / Lansdale PA

View job as Retirement Plan Analyst for Benetrends Inc

Press Releases

Nolan Financial Announces Launch of New Executive Benefits Website

Nolan Financial

DOL Recovers $6.3M for Employee Stock Ownership Plan Participants After Investigation Finds Manipulation of Company Share Value

Employee Benefits Security Administration [EBSA], U.S. Department of Labor

Webcasts and Conferences
(Health & Welfare Plans)

The Dynamics of Health Insurance Within Families

January 26, 2023 WEBCAST

EBRI [Employee Benefit Research Institute]

Last Issue's Most Popular Items

2022 Year-End Compliance Wrap-Up

HealthEquity

Cafeteria Plans: Amendment Deadline in 2022 and Optional Change-in-Status Event Available in 2023

Vorys

Estimated Impact of the Expiration of the COVID-19 Public Health Emergency on All Types of Health Coverage (PDF)

Urban Institute

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

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