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Health & Welfare Plans Newsletter
February 20, 2023
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9 New Job Opportunities
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[Guidance Overview]
DOL Issues Guidance on Handling Telework Under FLSA, FMLA
"With respect to hours worked, [FAB 2023-1] reiterates that the 1,250 hours determination for remote worker is based on
compensable hours of work under FLSA principles. With respect to the worksite size determination, the FMLA regulations explain that an employee's personal residence is not a worksite. Instead, whether a remote employee is FMLA-eligible is based on the size of the worksite from which 'they report to' or 'their assignments are made.' " MORE >>
Jackson Lewis P.C.
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[Guidance Overview]
Preparing for June 1 RxDC Reporting Deadline
"Several reporting entities have already contacted plan sponsors with requests for specific information necessary in order to file on the plan sponsor's behalf. These requests have strict deadlines with which plan sponsors must comply to ensure the reporting entity files on
its behalf in a timely manner (some are as soon as March 1, 2023).... Should you, as plan sponsor, be required to report on a portion of the RxDC information, you will need to set up an HIOS account with CMS online." MORE >>
Burnham Benefits
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[Guidance Overview]
March 1 Deadlines for Group Health Plans
"March 1 brings two annual deadlines for employers that sponsor a group health plan for their employees. [1] Medicare Part D -- Creditable Coverage Disclosure to CMS ... [2] HIPAA -- Breach Report to OCR." MORE >>
Venable LLP
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Ninth Circuit Holds Medical Providers to Terms of Oral Settlement with Health Insurance Company
"The parties ... entered into an oral settlement agreement on the record and agreed to settle and dismiss all of their claims and counterclaims. After the settlement conference, the parties could not agree on written language to execute their settlement.... The Ninth Circuit
affirmed the dismissal of the case ... The failure of the parties to sign a written settlement that executed the oral agreement has no effect on the validity of the parties' oral agreement." [Infoneuro Group v. Aetna Life Ins. Co., No. 22-55239 (9th Cir. Feb. 16,
2023; unpub.)] MORE >>
Roberts Disability Law
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Significant Percentage of Ground Ambulatory Service Claims Resulted in 'Surprise' Billings
"An effective way for employer-sponsored health plans to specifically address the requirements and challenges of the NSA is to adopt a 'pure' [reference based pricing (RBP)] plan.... Pure RBP plans that do not contract with providers should remain unaffected by NSA
because there aren't any out-of-network claims; nor is there any determination of a median in-network rate." MORE >>
aequum
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HHS Annual Report to Congress on HIPAA Privacy, Security, and Breach Notification Rule Compliance for Calendar Year 2021 (PDF)
25 pages. "OCR received 34,077 new complaints alleging violations of the HIPAA Rules and the HITECH Act, representing an increase of 25% from the number of complaints received in calendar year 2020. OCR resolved 26,420 complaints.... OCR resolved 13 complaint
investigations with Resolution Agreements and Corrective Action Plans and monetary settlements totaling $815,150, and two complaint investigations with civil money penalties totaling $150,000. OCR completed 573 compliance reviews and required subject entities to take corrective action or pay a civil money penalty in 83% (475) of these investigations." MORE >>
U.S. Department of Health and Human Services [HHS]
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How CBO Estimated the Budgetary Impact of Key Prescription Drug Provisions in the 2022 Reconciliation Act
"This slide deck focuses on three key drug-related policies that, together, are responsible for $129 billion of that reduction. To explain how the agency reached its estimate, the slide deck focuses on the effects of the three key policies in 2031." MORE >>
Congressional Budget Office [CBO]
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Benefits in General |
[Guidance Overview]
End of COVID-19 National Emergency Declarations
"[The DOL and IRS had ] issued guidance temporarily extending various deadlines applicable to [retirement] plans and to participants until the earlier of [1] one year from the date an individual was first eligible for relief or [2] 60 days after the end of the National
Emergency.... Group health plans are affected by the end of both the National Emergency and the Public Health Emergency declarations." MORE >>
Slevin & Hart, P.C.
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Employee Benefits Jobs |
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Consulting Actuary
Sentinel Benefits & Financial Group
Remote / Wakefield MA / Melville NY / Hybrid
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Actuary
Strongpoint Partners - HowardSimon
Remote
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Sr. Actuary
Nyhart, part of FuturePlan by Ascensus
Remote / GA
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Sr. Actuary
Nyhart, part of FuturePlan by Ascensus
Remote / Charlotte NC
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Sr. Actuary
Nyhart, part of FuturePlan by Ascensus
Remote / Tampa FL
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Last Issue's Most Popular Items |
DOL Continues Active ERISA Enforcement and Focus on Cybersecurity, Including Health and Welfare Plans
Morgan Lewis
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What Are the Temporary Reporting Requirements for Air Ambulance Services, and When Do They Apply?
Thomson Reuters / EBIA
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HHS Suspends Surprise Medical Billing IDR Payment Determinations
Thomson Reuters / EBIA
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BenefitsLink® Retirement Plans Newsletter, ISSN no. 1536-9587.
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