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Health & Welfare Plans Newsletter

January 25, 2023

2 New Job Opportunities 2 New Job Opportunities


[Guidance Overview]

DOL Increases 2023 Penalty Amounts for Health and Welfare Benefit Plan Violations

"Failure to timely file annual report Form 5500 subjects a plan sponsor to a penalty of $2,586 per day, starting on the date of the failure.... EBSA offers ... the Delinquent Filer Voluntary Compliance Program for late filers that voluntarily submit tardy Forms 5500. Penalty amounts under the program are significantly reduced to as little as $10 per day, but the filing under the amnesty program must be initiated by the late filer, not by federal enforcement."  MORE >>


[Guidance Overview]

High Deductible Health Plan Telehealth Relief, Extended Again

"The 2023 CAA telehealth relief is optional. Employers may, but do not have to, provide telehealth and other remote care services on a pre-deductible basis. However, employers that choose not to provide telehealth on a pre-deductible basis still must comply with FFCRA which ... requires group health plans to cover ... certain COVID-19 diagnostic tests and related services provided during telehealth visits until the end of the Public Health Emergency."  MORE >>

Snell & Wilmer L.L.P.

[Guidance Overview]

CRS Report: Health Care Provisions of the Budget Reconciliation Measure

65 pages. "[This report] provides a table with abbreviated summaries of each health provision in P.L. 117-169. Following the table, the report provides a detailed summary of each provision. Appendix A contains commonly used prescription drug and health insurance terms referenced throughout the report. Appendix B includes a table with a list of the abbreviations used in this report." [R47396 Jan. 24, 2023]  MORE >>

Congressional Research Service [CRS]

[Guidance Overview]

State-Mandated Disability and Paid Family and Medical Leave in 2023

"[A table outlines] updates to the state-mandated STD and PFML rates and model posters/notices available at the time of this article."  MORE >>


[Guidance Overview]

New York Announces 2023 HCRA Covered-Lives Assessment Rates

"New York's Department of Health (DOH) has posted the 2023 regional covered-lives assessment (CLA) rates and percentage surcharges for graduate medical education (GME) under the state's Health Care Reform Act (HCRA). The HCRA imposes on 'electing' health claim payors -- including self-funded plans -- an annual CLA, which is based on the number of covered individuals (and families) who live in New York.... The GME CLA rates and percentage surcharges vary among eight regions, and the applicable rate depends on where the covered individual resides or receives in-state hospital care."  MORE >>


Seventh Circuit Holds That Regulations in Effect at Time of Benefit Termination Govern Claim

"[T]he court rejected Standard's argument that applying the 2018 regulations to Mr. Zall's claim would violate general principles disfavoring retroactivity ... [T]hese rules disfavoring retroactivity apply only to substantive rules, and changes in procedural rules do not raise concerns about retroactivity. The court concluded that the 'Claims procedure' regulations at issue were 'purely procedural' and could therefore be applied to disputes arising before their enactment." [Zall v. Standard Ins. Co., No. 22-1096 (7th Cir. Jan. 19, 2023)]  MORE >>

Kantor & Kantor LLC

Upcoming Deadline icon Reminder: Annual Medicare Part D Disclosure to CMS Due by March 1 for Calendar Year Plans

"Plan sponsors are required to disclose to [CMS] whether their prescription drug coverage is creditable. The disclosure must be made to CMS on an annual basis or upon any change that affects whether the coverage is creditable.... The deadlines for all plan years beginning in 2023 are set forth in [a] table. For plan sponsors with calendar year plans, the deadline to comply with the annual disclosure requirement is March 1, 2023."  MORE >>

Burnham Benefits

No Surprises Act and Takeaways on Surprise Billing

"[F]rom April 15 to September 30, 2022, 90,078 disputes were submitted to the Federal IDR portal. The Departments originally estimated that 17,333 claims would be submitted as part of the Federal IDR process each year.... Some 71,513 disputes involved emergency services, which accounts for 82% of all disputes initiated for emergency or non-emergency services in this period. And over half of these disputes (70,071 disputes) involved services provided in a hospital emergency room."  MORE >>

McDermott Will & Emery

Medical Costs of Substance Use Disorders in the U.S. Employer-Sponsored Insurance Population

"In this economic evaluation of 162 million non-Medicare eligible enrollees with employer-sponsored health insurance in 2018, 2.3 million had an SUD diagnosis. The annual attributable medical expenditure was $15 640 per affected enrollee and $35.3 billion in the population; alcohol-related disorders ($10.2 billion) and opioid-related disorders ($7.3 billion) were the most costly."  MORE >>

U.S. Centers for Disease Control and Prevention [CDC], via JAMA Health Forum

The Impact of Paid Family Leave on Families with Health Shocks

"This paper analyzes the impact of paid family leave (PFL) policies in California, New Jersey, and New York on the labor market and mental health outcomes of individuals whose spouses or children experience health shocks.... PFL access leads to a 7.0 percentage point decline in the likelihood that the (healthy) wives of individuals with medical conditions or limitations who experience a hospitalization or surgery report 'leaving a job to care for home or family' in the post-health-shock rounds."  MORE >>

National Bureau of Economic Research [NBER]; purchase required for full document

Benefits in General

[Official Guidance]

IRS Disaster Relief Notice CA-2023-02, for Victims of Severe Winter Storms, Flooding, Landslides, and Mudslides in California

"Victims of severe winter storms, flooding, landslides, and mudslides beginning December 27, 2022, now have until May 15, 2023, to file various individual and business tax returns and make tax payments ... [I]ndividuals and households affected by severe winter storms, flooding, landslides, and mudslides that reside or have a business in Calaveras, Merced, Monterey, Sacramento, San Joaquin, San Luis Obispo, Santa Barbara, and Santa Cruz counties qualify for tax relief."  MORE >>

Internal Revenue Service [IRS]

Employee Benefits Jobs

View job as Retirement Plan Consultant
            for Ubiquity Retirement + Savings

Retirement Plan Consultant

Ubiquity Retirement + Savings


View job as Retirement Plan Consultant for Ubiquity Retirement + Savings

View job as Administrator
            for Pension Benefits Unlimited, Inc.


Pension Benefits Unlimited, Inc.

Remote / Irvine CA

Press Releases

The ERISA Industry Committee Outlines Objectives and Ongoing Pursuits to Protect and Enhance Employee Benefits

ERIC [ERISA Industry Committee]

Vizient Forms Strategic Partnership with MDsave to Power Its National Direct-to-Employer Surgical-Bundle Solution


Webcasts and Conferences
(Health & Welfare Plans)

HSA University

February 23, 2023 WEBINAR


Key Healthcare Provisions of the Consolidated Appropriations Act 2023

March 15, 2023 WEBINAR


Last Issue's Most Popular Items

Reductions in Force: COBRA and Internal Revenue Code Considerations (PDF)

Stradley Ronon, via Employee Benefit Plan Review

Diabetes Drugs Now Approved for Weight Loss Treatment: What Plan Sponsors Need to Know


2023 Federal Poverty Levels Can Impact Employer Shared Responsibility Affordability


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

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