"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 >>

"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 >>

"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."

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"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 >>

"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 >>

"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 >>

"[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 >>

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 >>

"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 >>