"While the deadline to provide the Forms to employees officially remains January 31st annually, the adoption of the built-in 30-day extension pushes this out to March 2, 2023 for the 2022 tax year ... Going forward, this date will continue to be March 2nd unless it is a leap year, in which case the extension will go to March 1st instead. Also, if the date were to fall on a weekend in a particular year then the Forms would be due on the subsequent business day."  MORE >>

"Paper IRS returns (permitted if less than 250 returns) must be filed no later than February 28, 2023. Otherwise, the deadline for filing electronic returns is March 31, 2023. Individual statements must be furnished to participants by March 2, 2023. There are special distribution and filing requirements for employers with employees in California to comply with the state's individual mandate to provide minimum essential coverage. Forms 1095-B or 1095-C must be distributed to participants no later than January 31, 2023. This deadline has not been extended to comport with the federal deadline extension."  MORE >>

74 pages. "A practical step-by-step guide for employers transitioning to self-insured plans or reviewing compliance for established plans. Addressing ACA reporting, CAA transparency, HIPAA, ERISA, PCORI, Section 105(h), COBRA, domestic partner, LOA, and other considerations. A quick reference checklist for the main areas of concern when maintaining a self-insured group health plan."  MORE >>

60 pages. "Understanding supplemental-type benefits designed to recruit and retain employees beyond the standard H&W offerings. Covers fringe benefits (specialty HRAs, LSAs, commuter, education/student loan, adoption benefits) that add tremendous value. Reviews many potential compliance pitfalls that many have not considered."  MORE >>

"The legislation provides funding to assist states in their enforcement of the CAA, 2021 requirement that health plans and insurers prepare comparative analyses of any nonquantitative treatment limitations on mental health or substance use disorder coverage. The legislation also eliminates the right of self-insured non-federal government health plans to opt out of [MHPAEA] compliance. Effective immediately, no such new elections may be made, and elections expiring 180 days or more after December 29, 2022, may not be renewed."  MORE >>

"In [FAQs Part 56], the Departments pledged to not take enforcement action against any plan or issuer that makes a good faith effort to comply and establishes a submission grace period through January 31, 2023.... In recognition of the extensive reporting obligations and the compliance difficulties facing plan sponsors with multiple health plan vendors, the FAQ provides only limited enforcement relief. Plan sponsors that have submitted RxDC reports may consider whether they should adjust their reports considering the FAQ[.]"  MORE >>

"Tiered systems classify health care providers into tiers using a combination of cost and quality metrics. Participants pay a higher price to use the higher cost or less efficient providers in plan networks.... Initiatives aimed at the purchase point of health care also are becoming more prevalent ... Responding organizations continue to offer cost-saving initiatives aimed at controlling the utilization rate of health care services."  MORE >>

"Section 1557's application to employer-sponsored health plans remains in flux. As we wait for the proposed regulations to be finalized, plan sponsors, insurers, and TPAs should monitor developments and be mindful of plan provisions that could invite costly legal challenges." [Kadel v. Folwell, No. 19-0272 (M.D. N.C. Dec. 5, 2022)]  MORE >>

"Under Rule 56,[3] summary judgment is permitted only 'if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.' Several courts have modified that rule in ERISA litigation; however, ... the U.S. Court of Appeals for the Fourth Circuit pointed out last month how summary judgment has been misused in ERISA litigation and rejected the approach taken by other circuit courts of appeal." [Tekmen v. Reliance Standard Life Ins. Co., No. 20-1510 (4th Cir. Dec. 16, 2022)]  MORE >>

Benefits-related items from EBSA and from the Wage and Hour Division (WHD) (changes from the Fall 2021 DOL Regulatory Agenda are noted):

Prerule Stage

• Requirements Related to Advanced Explanation of Benefits and Other Provisions Under the Consolidated Appropriations Act, 2021
• Improving Participant Engagement and Effectiveness of ERISA Retirement Plan Disclosures
• Pooled Employer Plans

Proposed Rules

• Improvement of the Form 5500 Series and Implementing Related Regulations Under ERISA
• Definition of the Term 'Fiduciary'
• Provider Nondiscrimination Requirements for Group Health Plans and Health Insurance Issuers in the Group and Individual Markets
• Mental Health Parity and Addiction Equity Act and the Consolidated Appropriations Act, 2021
• Short-Term Limited Duration Insurance; Update
• Coverage of Certain Preventive Services Under the [ACA]
• Definition of 'Employer' under Section 3(5) of ERISA -- Association Health Plans (New)
• Independent Dispute Resolution Operations (New)

Final Rules

• Pension Benefit Statements -- Lifetime Income Illustrations
• Implement SECURE Act and Related Revisions to Employee Benefit Plan Annual Reporting on the Form 5500
• Amendment of Abandoned Plan Program
• Prohibited Transaction Exemption Procedures
• Requirements Related to Air Ambulance Services, Agent and Broker Disclosures, and Provider Enforcement (New)

MORE >>

Partial list of benefit-related provisions (changes from the Spring 2022 IRS Regulatory Agenda are noted):

Proposed Rules

• Reporting and Notice Requirements for Deferred Vested Benefits Under Section 6057
• Nondiscrimination Relief for Closed Defined Benefit Plans
• Provider Nondiscrimination Requirements for Group Health Plans and Health Insurance Issuers in the Group and Individual Markets
• Mental Health Parity and Addiction Equity Act and the Consolidated Appropriations Act, 2021
• Requirements in Connection With Coverage of Certain Preventive Services
• Requirements Related to Advanced Explanation of Benefits and Other Provisions Under the Consolidated Appropriations Act, 2021
• Trust Arrangements That Utilize Cash Value Insurance Policies to Provide Welfare Benefits (New)
• Certain Trust Arrangements Seeking to Qualify for Exception for Collectively Bargained Welfare Benefit Funds under Section 419A(f)(5) (New)
• Independent Dispute Resolution Operations

Final Rules

• Update to Minimum Present Value Requirements for Defined Benefit Plan Distributions
• Application of Normal Retirement Age Regulations to Governmental Plans
• Additional Rules Regarding Information Reporting of Minimum Essential Coverage
• Withholding on Certain Retirement Plan Distributions Under Section 3405(a) and (b)
• MEPs and the Unified Plan Rule
• Guidance on 401(a)(9) Required Minimum Distributions
• Information Reporting of Health Insurance Coverage and Other Issues Under Sections 6055 and 6056
• Requirements Related to Air Ambulance Services, Agent and Broker Disclosures, and Provider Enforcement

   MORE >>