"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 >>

"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 >>

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 >>

"[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 >>

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 >>

"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 >>

"[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 >>

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 >>

"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 >>

"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 >>

"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 >>

"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 >>

"[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 >>

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 >>