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Health & Welfare Plans Newsletter

February 7, 2023

2 New Job Opportunities 2 New Job Opportunities


[Guidance Overview]

Consolidated Appropriations Act of 2023 Extends Telehealth Waivers

"The Act extends the following current telehealth flexibilities until 31 December 2024: [1] Expanding the definition of originating and geographic sites to include anywhere the patient is located, including the patient's home. [2] Expanding the types of practitioners eligible to furnish telehealth services ... [3] Delaying the in-person requirements under Medicare for mental health services through telehealth ... [4] Extending reimbursement for audio-only telehealth services.... [5] Extending the safe harbor exceptions under health savings account-eligible, high-deductible health plans for telehealth services."  MORE >>

K&L Gates

[Guidance Overview]

Upcoming Deadline icon Calendar Year Health Plans Must Submit Online CMS Report by March 1

"Reporting must be completed online ... A single disclosure to CMS form can be submitted for entities with subsidiaries if the plan year is the same for all subsidiaries.... If all options are either creditable or non-creditable, aggregate data may be provided for all options.... Employers must estimate how many Part D eligible individuals they expect to cover as of the first day of the plan year, excluding any retiree drug subsidy participants."  MORE >>


[Guidance Overview]

Upcoming Deadline icon COVID Health Emergencies Formally Ending in May: What Health Plan Sponsors Need to Know

"For most plan sponsors, the end of the Public Health and National Emergencies is a welcome development from a health plan management perspective. First-dollar coverage of COVID-19 tests, particularly at-home tests, has been a significant cost driver under most plans. Additionally, the Outbreak Period administrative deadline delays have been difficult to navigate (especially with respect to COBRA premium payments)."  MORE >>

Nixon Peabody LLP

[Guidance Overview]

Health Care Plans After Dobbs: What Employers Need to Know

"Make sure you know where your employees are located. In an age of remote work, even employers based in states such as California where the right to abortion healthcare has been confirmed, may have employees working remotely in other states which have restrictive abortion laws.... Set up a system to monitor legal developments in this area, ... at the state, local, and federal levels.... Review all relevant plan documents.... Consider new plans/plan designs.... Review applicable leave laws."  MORE >>

Boutwell Fay LLP, via Journal of Pension Benefits

[Guidance Overview]

Illinois Paid Leave for All Workers Act

"The employee is not required to provide a reason for the leave and does not need to submit documentation or proof to support the leave. An employer can require the employee to provide seven calendar days' notice prior to using the leave if the need for use is foreseeable.... If an employer does require notice for unforeseeable need, the procedures for such notice must be in a written policy."  MORE >>

Laner Muchin

[Guidance Overview]

Massachusetts Paid Family and Medical Leave Act Update

"Effective January 1, 2023, contribution rates have decreased for employers of all sizes.... In 2023, the maximum weekly benefit rate for covered employees is $1,129.82 ... increased from $1,084.31 in 2022.... Massachusetts law requires employers to notify new and existing employees of the 2023 updates to contribution rates and weekly benefit amounts under the PFML law and display an updated 2023 PFML law poster in the workplace."  MORE >>

Foley & Lardner LLP

Reference-Based Pricing: A Different Way of Doing Healthcare

"There are clear benefits, but implementing a reference-based pricing model takes time, support and a significant amount of employee education. If you're looking to make this change, here's how to get reference-based pricing right and implement it for your organization and your employees."  MORE >>

Corporate Synergies

Providing Family-Building Benefits (PDF)

"While self-insured health plans may have more flexibility to provide for coverage of certain family-building benefits, most fully-insured health plans do not offer comprehensive coverage for family-building.... Nevertheless, companies with insured and self-insured health plans are increasingly offering programs that cover a variety of family-building services without requiring a clinical infertility diagnosis."  MORE >>

Stradley Ronon, via Employee Benefit Plan Review

What Amazon's Subscription Drug Service Means for the Pharma Affordability Crisis

"Amazon's launch of RxPass is part of a sustained healthcare push by the company and represents an effort to increase the accessibility of pharmaceuticals in the United States. While the tech giant certainly has enough resources and capital to make a difference in this critical area, ... the current version of RxPass does not cover the specialty medicines that are causing the lion's share of financial hardship for Americans and their employers."  MORE >>



P4ESC Letter to House Representatives in Support of the Telehealth Benefit Expansion for Workers Act of 2023 (PDF)

"[The Telehealth Benefit Expansion for Workers Act of 2023 (HR 824)] would ... treat benefits for telehealth services offered under a group health plan or group health insurance coverage as excepted benefits.... Defining telehealth services as an excepted benefit would also allow employees not enrolled in the employer's group health plan to enroll in a standalone telehealth plan."  MORE >>

Partnership for Employer-Sponsored Coverage [P4ESC]

Benefits in General

How the PEO and Staffing Worlds Can Use Employee Benefits Complexity to Enhance Their Value Proposition

"There is actually a way to approach employee benefits complexities as a net-positive solution instead of a compliance chore. As we head into 2023, you can create some interesting enhancements to your value proposition and separate your organization from the pack by implementing a few simple changes."  MORE >>

Fisher Phillips

Employee Benefits Jobs

View job as Legal Director
            for Pension Rights Center

Legal Director

Pension Rights Center


View job as Legal Director for Pension Rights Center

View job as Retirement Plan Consultant
            for SetAway, LLC

Retirement Plan Consultant

SetAway, LLC

Remote / Bedford NH

View job as Retirement Plan Consultant for SetAway, LLC

Selected New Discussions

VEBA Restatement for New Trustee

"I have a client who acquired companies with two very old VEBAs. The VEBAs are trust documents and received favorable IRS determination letters on their Section 501(c)(9) status years ago. The VEBA trusts have been amended from time to time to appoint successor trustees. The client plans to move all retirement and welfare trusts to a new financial institution. The new trustee insists its standard trust document must be used for the VEBAs and will not agree to incorporate or even attach the old VEBA documents that received the IRS ruling. The new trusts are boiler plate and contain no description of the original VEBA members or benefits (e.g., retired union employee; retiree health benefits). The new generic trusts state the trust document plus the employer's welfare plans constitute the entire VEBA. I am concerned that the original IRS letters will no longer govern the VEBA's tax-exempt status if there is no provision of the original trust left and no description of eligible members or benefits in the new trust documents. Note that the employer maintains a retiree health plan document, but the VEBA funds only certain members' (union) benefits. The new trustee insists obliterating the old document will not affect the VEBA's tax-exempt status.

"I appreciate that a VEBA can be amended and that a new IRS ruling should not be necessary simply to name a new trustee. However, i feel that the original VEBA documents that received the favorable IRS letters should at least be incorporated by reference (at least to the extent they don't conflict with the new trust provisions). Any thoughts? I have considered amending the original VEBA trusts to incorporate the new trust documents (essentially doing through the back door what the new trustee won't allow through the front door)."

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Last Issue's Most Popular Items

The End Is Near: The COVID-19 National and Public Health Emergencies Are Scheduled to End in May


Plan Sponsors and Administrators: Prepare for the End of the COVID-19 Emergency

Morgan Lewis

COBRA Deadlines and the Upcoming Expiration of the COVID-19 National Emergency


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

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