11 pages. "Prior to the COVID-19 PHE, there were no federal requirements that private health insurance plans offer telehealth coverage, nor were there prohibitions on such coverage. Certain other federal requirements presented difficulties for private health insurance plans that sought to quickly add telehealth coverage as part of their response to the COVID-19 PHE. [This report describes] the federal flexibilities created in response to such issues and when those flexibilities are to end." [R47424 Feb. 14, 2023]  MORE >>

"Employers who are contemplating whether to provide COBRA subsidies should determine the eligibility for, the amount and duration of, and method by which to provide the subsidies and ensure they obtain approval from their carrier (if fully insured) or their stop-loss provider (if self-insured), as needed. To minimize potential conflict or liability, employers should explicitly outline these details in any severance agreement and communications to terminated employees."  MORE >>

"Married couples are generally limited to a $5,000 total dependent care FSA contribution limit between both spouses combined per calendar year. Both spouses generally need to be working for the employee to have daycare expenses that are eligible for dependent care FSA reimbursement. Exceptions apply if the spouse is looking for work, a full-time student, or incapable of self-care."  MORE >>

"Following years of proposed rules, public comment, and litigation, the RADV Final Rule contains three key takeaways that will impact MA stakeholders: [1] It implements extrapolation of RADV audit findings commencing payment year 2018; [2] It rejects a Fee-For-Service (FFS) adjuster for MA risk adjustment that would have limited the financial impact of the RADV Final Rule for Medicare Advantage Organizations (MAOs); and [3] It clarifies that MA overpayment self-reporting and repayment requirements for MAOs will be forthcoming from CMS."  MORE >>

"Illinois will join Maine and Nevada in requiring that employers provide paid time off for any reason.... The [Paid Leave for All Workers Act] applies to all private employers regardless of size.... An employer generally does not have to comply with the act, however, if the employer is already covered by a municipal or county ordinance that requires the employer to provide any form of paid leave, including paid sick leave (for example, in Chicago and Cook County)."  MORE >>

"New York will offer 12 weeks of fully paid parental leave benefits to more than 10,000 state employees ... The policy, which begins immediately and covers nonunionized employees, applies to bonding with a newborn, foster or adopted child."  MORE >>

"Applicable large employers have until February 28, if paper filing, and March 31, if filing electronically, to submit their Forms 1094-C and 1095-C to the IRS for compliance with the ACA.... [It] is not uncommon for a service provider to make an error while completing this form, which could result in an employer incorrectly reporting that it did not achieve the 95% threshold."  MORE >>

"Create new and improve existing digital tools for locating mental health providers and estimating cost for services ... Streamline the findability of in-house educational materials and resources online ... Partner with and promote third-party vendors specializing in mental well-being"  MORE >>

"Wages and salaries increased 5.1 percent for the 12-month period ending in December 2022 and increased 4.5 percent for the 12-month period ending December 2021. Benefit costs increased 4.9 percent over the year and increased 2.8 percent for the 12-month period ending December 2021."  MORE >>

"Identifying risk is crucial in the due diligence process, and employee benefits present companies with significant financial and regulatory risk. It's imperative to use actuarial software to identify inefficiencies within a health plan's pricing and employee contribution structure, which often reveals downside financial risk based solely on employee enrollment patterns. Also, a regulatory review will ensure a target is compliant with applicable government regulations like ERISA, ACA, and IRS guidelines for pre-tax benefits."  MORE >>