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Health & Welfare Plans Newsletter
February 2, 2023
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7 New Job Opportunities
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[Guidance Overview]
End of COVID-19 Outbreak Period
"With the declaration of the end of the National Emergency on May 11, 2023, the 60-day clock to end the Outbreak Period will start. This means that effective on July 10, 2023 (60 days after the end of the National Emergency) all of the pre-pandemic rules ... will
go back to their normal timeframes." MORE >>
Kushner & Company
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[Guidance Overview]
Another Health Plan Reporting Deadline Is 'In the Air'
"Under a Tri-Agency Proposed Rule, health plans could be required to report information relating to air ambulance services by March 31, 2023. As this proposed deadline approaches, plan sponsors should reach out to their third party administrators to determine what
assistance, if any, will be provided relating to these reporting requirements." MORE >>
Seyfarth
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[Guidance Overview]
CRS Report on Mental Health Parity and Coverage in Private Health Insurance: Federal Requirements
16 pages. "This report explains these MH/SUD benefit coverage and parity requirements, as well as the types of private health insurance plans subject to such requirements. It includes a brief review of relevant legislative history -- including changes enacted in
December 2022 -- and a discussion and examples of required federal agency activities (e.g., oversight and reporting)." [R47402 Feb. 1, 2023] MORE >>
Congressional Research Service [CRS]
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[Guidance Overview]
Proposed Regs Would Create 'Individual Contraceptive Arrangement,' Rescind Contraceptive Coverage Mandate's Moral Exemption
"[T]he agencies have proposed to add a new 'individual contraceptive arrangement' through which individuals enrolled in plans or coverage sponsored or arranged by entities with religious objections could access no-cost contraceptive services without the involvement of
their employer, group health plan, plan sponsor, or insurer. A provider or facility that furnishes contraceptive services in accordance with the individual contraceptive arrangement would be reimbursed through an arrangement with an Exchange insurer, which would request an Exchange user fee adjustment to cover the costs." MORE >>
Thomson Reuters / EBIA
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[Guidance Overview]
2023 State Paid Family and Medical Leave Contributions and Benefits (PDF)
27 pages; Feb. 1, 2023. "The Colorado and Oregon PFML programs began collecting contributions in January 2023. Oregon's program will begin paying benefits in September 2023, and Colorado benefit payments will begin in 2024. Maryland will begin collecting
contributions in October 2023 and begin benefit payments in 2025. Delaware will not begin collecting contributions until 2025, with benefits first available in 2026. New Hampshire's PFML program began paying benefits to eligible state employees in January 2023, while Vermont will do so starting July 2023." MORE >>
Mercer
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[Guidance Overview]
St. Paul and Bloomington, Minnesota Amend Their Sick and Safe Time Ordinances
"Amendments to St. Paul's sick and safe time ordinance clarify that employees accrue leave when working in the city, even if their employer does not have a physical presence there; establish the standard of proof for retaliation claims; expand the statute of limitations from
one to two years; and address other administrative issues. Amendments to Bloomington's sick and safe time ordinance clarify that employers can allow employees to accrue leave on a pro-rata basis rather than in whole-hour units; require leave accrued and used to be on paystubs; institute fines for certain first-time violations; and establish fines for these and other violations." MORE >>
Littler
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(Mothering) Justice Denied: Legislative Amendments to Michigan Paid Sick Leave Upheld
"[T]he current Paid Medical Leave Act (PMLA) will remain in place. The PMLA exempts employers with fewer than 50 employees from providing paid sick leave ... Moreover, the PMLA eliminated a provision in the voter initiative that would have allowed employees alleging a
violation of that act to bring a civil action for appropriate relief, including, but not limited to, payment for unused earned sick time, rehiring or reinstatement, payment of back wages, as well as liquidated damages and attorney's fees." [Mothering Justice v. Michigan,
No. 362271 (Mi. Ct. App. Jan. 26, 2023)] MORE >>
Jackson Lewis P.C.
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Employers Prioritize New Healthcare Vendor Solutions
Infographic. "9 in 10 employers use their vendor strategy to achieve these goals ... Most sought-after capabilities of new vendor partners ... Mental health and wellbeing solutions remain key areas of focus for 2024 ... Engaging members is a key challenge ...
Most employers intend to add or enhance their vendor solutions ... Actions you can take now." MORE >>
Willis Towers Watson
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Addressing Employee Requests to Overturn TPA Benefit Determinations
"Employers that sponsor self-insured health plans have greater flexibility with respect to many aspects of plan administration than a typical fully insured plan. However, there are three main issues for employers to consider upon receiving an employee request to overturn the
third-party administrator's (TPA's) adverse benefit determination to deny a claim or appeal for the self-insured health plan.... [1] The ERISA plan precedent; [2] The stop-loss provider limitations; and [3] Preserving the Firestone deferential standard of review." MORE >>
Newfront
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Deadline Approaching for Medicare Part D Creditable Coverage Disclosure to CMS
"March 1, 2023 is the deadline for sponsors of calendar year plans to complete an online disclosure form with [CMS], indicating whether the plan's prescription drug coverage is creditable or non-creditable." MORE >>
Cowden Associates, Inc.
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Insurer Price Transparency Rule: What Has Been Disclosed?
"The Insurer Price Transparency Rule provides a potentially excellent opportunity for patients, payers, researchers, policymakers, and other market participants and stakeholders to understand pricing behaviors in the broad health care market. [This article describes] the size and
content of pricing information disclosed by insurers during the first six months following the rule's implementation, identify its limitations, and suggest research, practice, and policy implications." MORE >>
Health Affairs Forefront
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[Opinion]
Wit vs. UBH Part 2: Ninth Circuit Should Rethink Inadequate UBH Ruling
"On Jan. 26, the U.S. Court of Appeals for the Ninth Circuit withdrew its prior memorandum disposition in Wit v. United Behavioral Health and replaced it with an entirely new opinion. Although more detailed than the initial disposition of the appeal, the new ruling is
still a major disappointment to mental health advocates and behavioral health providers, and raises numerous questions about the future of [ERISA] class actions[.]" [Wit v. United Behav. Health, No. 20-17363 (9th Cir. Jan. 26, 2023)] MORE >>
DeBofsky Law
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[Opinion]
ERIC Letter to Senators Citing Concerns with the 'Pharmacy Benefit Manager Transparency Act' (PDF)
"[T]he PBMTA [S 127] contains numerous problematic provisions ... This legislation was drafted without the input or
priorities of employers, who sponsor health benefit plans for more than 155 million Americans, and who are the primary customers of PBMs.... PBMTA's language can be interpreted to erode the protections ERISA provides ... Rather than attempt to mandate or pressure 'point-of-sale rebates,' Congress should work to end the rebate system, and achieve actual and transparent drug prices.... While PBMTA does include limited
language requiring transparency from PBMs, this language is wholly inadequate." MORE >>
The ERISA Industry Committee [ERIC]
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Benefits in General |
Examining the Financial Wellbeing of the U.S. Public Service Workforce (PDF)
31 pages. "This report highlights where pockets of financial insecurity among public sector workers persist, summarizes the range of existing benefits for these employees, and demonstrates that benefits and support provided to public employees in building their own savings is a
proven pathway for people to achieve financial security. That is, while public sector employers help create financial security for most of their employees, they can amplify these efforts to increase the number of workers who are financially secure." MORE >>
Mission Square Research Institute
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Employee Benefits Jobs |
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Press Releases |
Marc Fosse Joins Seyfarth to Co-Chair Executive & Equity Compensation Practice
Seyfarth Shaw LLP
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The ERISA Industry Committee Calls on the U.S. Patent and Trademark Office to Improve the Patent Access Process to Enhance Prescription Drug Competition
ERIC [ERISA Industry Committee]
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MassMutual Further Evolves and Expands Suite of Employee Benefits
MassMutual
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Last Issue's Most Popular Items |
Preparing ERISA Plans for the End of the COVID-19 Emergency Periods
Michael Best
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Statement of Administration Policy Establishing the End of COVID-19 Declared Emergencies (PDF)
Executive Office of the President
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Text of IRS Publication 969: Health Savings Accounts and Other Tax-Favored Health Plans (PDF)
Internal Revenue Service [IRS]
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BenefitsLink Retirement Plans Newsletter, ISSN no. 1536-9587.
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