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Health & Welfare Plans Newsletter

January 31, 2023

3 New Job Opportunities 3 New Job Opportunities


[Guidance Overview]

A New Normal? Omnibus Bill Extends High Deductible Health Plan Telehealth Safe Harbor

"HDHPs can continue to offer first-dollar coverage for telehealth and other remote care services while preserving participants' eligibility for health savings account ('HSA') contributions. The two-year extension continues the relief until January 1, 2025."  MORE >>


[Guidance Overview]

Coming to Illinois in 2024: Paid Leave for Any Reason

"To date, thirteen states have enacted paid family and medical leave, with several others proposing to adopt such statewide mandates. The Illinois Paid Leave for all Workers Act goes one step further than these other state paid leave programs in that it does not limit the employee's use of leave to specific, defined circumstances. In fact, the Act explicitly prohibits employers from requiring employees to provide a reason for their leave or provide documentation or certification in connection with their leave."  MORE >>

Foley & Lardner LLP

[Guidance Overview]

Get Ready for Paid Time Off for Any Reason, for Illinois Employees in 2024

"For employees to take advantage of the paid leave, they must have been employed for 90 days following the effective date of the law, or 90 days following the start of their employment, whichever is later.... Employers may require employees to provide up to seven calendar days' notice before the paid leave is used if use of the paid leave is foreseeable."

   MORE >>

Constangy, Brooks, Smith & Prophete LLP

How Much Weight Do Independent Doctor Paper Reviews Get, and Should Rule 52 Bench Trials Be Used to Resolve De Novo Review Cases

"A new case highlights that, in cases applying de novo review, Rule 52 bench trials should be used -- especially when there are factual debates on the diagnosis or severity of impairment of a claimant.... [The case also] highlights that Independent Medical Exams (IME) may be needed more frequently, at least in the Fourth Circuit, due some overly broad language in the opinion concerning the weight to be given 'paper reviews.' " [Tekmen v. Reliance Standard Life Ins. Co., No. 20-1510 (4th Cir. Dec. 16, 2022)]  MORE >>

Lane Powell PC

Value-Based Insurance Design Lowers Costs and Improves Quality

"Employers need to think not only about how much they spend on healthcare but also how well they spend it. There are several changes that can help employers who want to apply value-based insurance design to improve their health plan design and get more health for their money -- not just less sick."  MORE >>

The Alliance

Employer-Sponsored Coverage Stabilized and Uninsurance Declined in the Second Year of the COVID-19 Pandemic

"Using data from the Household Pulse Survey ... [the authors] examined trends in health coverage during 2021 and early 2022 among nonelderly adults.... Despite rising employment, rates of employer-sponsored coverage remained flat ... [W]hen the public health emergency ends, many people currently enrolled in Medicaid might no longer be eligible ... Policy makers and employers should be prepared to help people who lose Medicaid eligibility identify and navigate enrollment in alternative sources of health insurance, including both [ACA] Marketplace and employer-sponsored coverage."  MORE >>

Health Affairs Forefront

State 2023 Legislative Agendas Include Paid Leave, Benefits

"[M]ore states [may] join about a dozen others currently mandating paid family and medical leave (PFML). Illinois and Minnesota top the list, but more than 10 other states have bills pending ... [S]tate legislators will likely focus on pharmacy benefit managers (PBMs) ... Several states (like Florida, Montana, South Carolina and Wyoming) are looking to make it easier to provide [telehealth[ services across state lines ... particularly related to mental health.... Fertility treatments and abortion-related services are prevalent in this year's [mandated coverage] bills."  MORE >>



American Academy of Actuaries Comment Letter to CMS on Proposed Notice of Benefit and Payment Parameters for 2024 (PDF)

10 pages. "[The] Committees are commenting on risk adjustment, lifelong permanent conditions, gender dysphoria hierarchical condition category, meaningful difference & non-standardized plans, exchanges directing re-enrollment for cost-sharing reduction (CSR)-eligible enrollees, the implications of a special enrollment period (SEP) that mirrors the Medicare Advantage SEP for the loss of a significant provider, prohibiting issuers participating in exchanges on the federal platform from terminating dependent child coverage, age calculation standards for stand-alone dental plan issuers, and network adequacy."  MORE >>

Individual and Small Group Markets Committee and Risk Sharing Subcommittee of the American Academy of Actuaries Health Practice Council

Benefits in General

The DOL's 2023 Regulatory Agenda: New Rules for 401(k)s and Group Health Plans

"The agenda includes a variety of actions the DOL plans for the coming months, including: [1] A proposed rule updating the definition of 'fiduciary' ... [2] A request for comment on pooled employer plans ... [3] A request for comment on ways to improve the effectiveness of retirement plan disclosures required under ERISA ... [4] A proposed rule updating the Voluntary Fiduciary Correction Program ... [5] Continuation of efforts ... to improve Form 5500 ... [6] A final rule amending rules implementing the [MHPAEA] ... [7] A final rule that would revise the department's ... process for granting prohibited transaction exemptions."  MORE >>

Treasury & Risk; free registration required

Employee Benefits Jobs

View job as Compliance Analyst
            for Pentegra

Compliance Analyst


Remote / West Harrison NY

View job as Compliance Analyst for Pentegra

View job as 401(k) Retirement Plan Administrator
            for Red Oak Retirement

401(k) Retirement Plan Administrator

Red Oak Retirement

Remote / Towson MD

View job as 401(k) Retirement Plan Administrator for Red Oak Retirement

View job as Senior Retirement Analyst
            for Dunbar, Bender & Zapf, Inc.

Senior Retirement Analyst

Dunbar, Bender & Zapf, Inc.

Remote / Pittsburgh PA

View job as Senior Retirement Analyst for Dunbar, Bender & Zapf, Inc.

Selected New Discussions

Section 129 (DCAP) W-2 Reporting for Failed Test

"My team has told me that we failed section 129 non-discrimination test last year and made the appropriate adjustments prior to the end of the plan year. But they have told me that the W-2s still reflected the full election/contribution amount and not adjusted for the amounts that were considered taxable therefore added as imputed income. I just spoke Payroll, and they said this is how it should be done. But I have also read that only the amount considered pre-tax (tax favored) should be reported on the W-2 box 10. Does anyone know what is correct or is either fine as long as the imputed income is reflected correctly for the plan year?"

BenefitsLink Message Boards

Press Releases

OneDigital Announces Two Leadership Appointments for Growing Wealth Management Practice


Industry Legend Retires: Rich Hochman, J.D.


Webcasts and Conferences
(Health & Welfare Plans)

International Employee Benefits Products

March 15, 2023 WEBINAR

Conference of Consulting Actuaries

Last Issue's Most Popular Items

CMS Fact Sheet: Proposed Regs for Coverage of Certain Preventive Services Under the ACA

Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Text of Proposed Regs: Coverage of Certain Preventive Services Under the ACA

U.S. Department of Health and Human Services [HHS]; U.S. Department of Labor [DOL]; and U.S. Treasury Department

Third-Party Administrators May Be on the Hook for ACA's Anti-Discrimination Rules

Lane Powell

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

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