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Health & Welfare Plans Newsletter

January 16, 2023

3 New Job Opportunities 3 New Job Opportunities


[Guidance Overview]

Upcoming Deadline icon Deadlines Approaching for ACA Reporting and Similar State Reporting

"Generally, reporting that relates to health coverage in one calendar year is due early in the following calendar year. With respect to health coverage in 2022, the ACA deadlines range from February 28 to March 31, 2023, and the state deadlines range from January 31, 2023 to April 30, 2023. All of the reporting discussed in this alert relates to health coverage in 2022."  MORE >>

Venable LLP

[Guidance Overview]

Upcoming Deadline icon Looming Deadline for Pharmacy Reporting

"CMS FAQs indicate that plan sponsors can delegate CAA reporting to their vendors, and reporting does not need to be consolidated with one entity. Note that self-funded plans will still retain liability for reporting, but in the case of fully insured plans, liability can be delegated to issuers in writing. Also, if you changed service providers since 2020, you will need to contact your prior service providers and solicit their assistance."  MORE >>

Winston & Strawn LLP

[Guidance Overview]

California Publishes 2023 Rates for State Disability Benefits and San Francisco Paid Parental Leave

"The change in contribution rates and the Maximum Weekly Benefit Amount are relevant to employers who must comply with San Francisco's Paid Parental Leave Ordinance (PPLO). The city of San Francisco requires most employers with 20 or more employees worldwide to supplement PFL benefits received by employees to bond with a new child.... The Assessment Rate is relevant to employers that maintain a state-approved voluntary plan (VP), which is a disability insurance plan that an employer can offer to its California employees as a legal alternative to mandatory DI and PFL. "  MORE >>

Jackson Lewis

Sixth Circuit Clarifies Notice Requirements for FMLA Intermittent Leave

"The court explained the unforeseeable leave regulation 'never mentions intermittent leave.' However, the foreseeable leave regulation includes specific procedures that apply to intermittent leave requests. Based on its interpretation of those two regulations, the court held intermittent leave is a type of foreseeable leave.... The court reiterated employers can establish call-in procedures and may deny FMLA leave if an employee fails to follow them. However, an employee cannot be faulted for failing to comply with such a policy if it is unclear or the employee lacked notice of it." [Render v. FCA US LLC, No. 21-2851 (6th Cir. Nov. 16, 2022)]  MORE >>

Frost Brown Todd LLC

Tenth Circuit Upholds Summary Judgment Ruling for United Airlines in FMLA Suit

"The court reasoned that United’s policy of using an independent decisionmaker to investigate and terminate employees insulated the company from allegations that the supervisor’s bias led to Parker’s termination. Retaliation requires a causal link between Parker taking FMLA leave and her termination. United broke that causal link by using an independent decisionmaker to determine whether to adopt the supervisor’s recommendation to fire Parker." [Parker v. United Airlines, Inc., No. 21-4093 (10th Cir. Sep. 26, 2022)]   MORE >>

Hall Benefits Law

Captives: Claims Handling

"A captive's successful risk management has the following key components: [1] Use of the risk management team concept -- forecast and be ready to act. [2] Tailored plan of action -- focus on prevention -- plan for mitigation. [3] Data analysis -- study history -- build future improvement."  MORE >>

Assured Partners

Changes in Health Insurance Coverage, 2019-2021: Geographic and Demographic Patterns in the Uninsured Rate

"This Issue Brief examines the composition of the population that is uninsured and highlights changes in uninsured rates by geography and demographic factors from 2019 to 2021, during a time of significant federal policy efforts to expand coverage.... [T]he national uninsured rate declined during this period, with larger coverage gains for younger adults; Latino, American Indian, and Alaska Native individuals; non-English speaking adults; and people living in states that recently expanded Medicaid."  MORE >>

Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS]

Employee Benefits Jobs

View job as DB/DC Plan Administrator
            for Benefit Associates, Inc.

DB/DC Plan Administrator

Benefit Associates, Inc.

Remote / Huntington Beach CA / NY

View job as Enrolled Actuary
            for Prime Pensions, Inc.

Enrolled Actuary

Prime Pensions, Inc.


View job as Enrolled Actuary for Prime Pensions, Inc.

View job as Retirement Plan Administrator
            for Retirement Solutions Specialists, LLC

Retirement Plan Administrator

Retirement Solutions Specialists, LLC

Remote / Jacksonville FL

View job as Retirement Plan Administrator for Retirement Solutions Specialists, LLC

Selected New Discussions

Employer Provides Employee Discount on Its Physical Therapy Services: Does That Create an ERISA Plan?

"A physical therapy practice offers all employees (doesn't matter full-time, part-time, HCE, NCHE) and their families a workplace perk. They have a policy where employees and families receive a discount on any physical therapy services they need. The employee provide insurance information and insurance is then billed. The employee is responsible for paying all cost share amounts. After that, the employee pays no more than $75 per visit. My questions are: [1] Is this structure permissible? [2] Does this policy create an ERISA-covered plan that would require a plan document, 5500, etc.?"

BenefitsLink Message Boards

Last Issue's Most Popular Items

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Ogletree Deakins

Worker Satisfaction with Health Benefits Is Lower; Mental Health Is More Important (PDF)

Employee Benefit Research Institute [EBRI]

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

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