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Health & Welfare Plans Newsletter

February 27, 2023

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[Guidance Overview]

Certified IDR Entities to Resume Payment Determinations for Services Furnished Before October 25, 2022

"Effective February 27, 2023, Certified IDR Entities will resume issuing payment determinations for disputes related to services and items furnished prior to October 25, 2022.... The announcement comes just two weeks after the Departments directed Certified IDR Entities to hold all pending payment determinations ... IDR payment determinations for services and items furnished on or after October 25, 2022 are still on hold, pending additional guidance from the Departments."  MORE >>

Sheppard Mullin

[Guidance Overview]

Bloomington and St. Paul's Sick and Safe Time Ordinances Get Checkups in the New Year

"Bloomington's Ordinance previously specified employees earn one hour of ESST for every thirty hours worked.... [T]he amendments added language granting employers discretion to permit accrual of ESST in fractions of an hour instead of block hour-units.... St. Paul's revisions to its ESST Ordinance focus on providing ESST for every employee working within the geographic boundaries of St. Paul, regardless of the physical location of the employer."  MORE >>

Jackson Lewis P.C.

[Guidance Overview]

Abortion-Related Time Off After Dobbs: How the FMLA and Other Laws Might Apply (PDF)

"Employers must ... address the question of whether they are required to provide time off for abortion-related care, including possible requisite travel time, under federal laws, such as the [FMLA], the Americans with Disabilities Act (ADA), and the Pregnancy Discrimination Act (PDA) ... or under comparable state and local laws. While the legal landscape is anything but clear, there are certainly arguments that abortions (even if elective), and any accompanying travel time, could be the basis for leaves under one or more of these laws."  MORE >>

Epstein Becker Green

Fourth Circuit: Court Cannot Equitably Toll Deadline to Convert Life Insurance Policy to Individual Coverage

"The court explained that under [Amara] ERISA Section 502(a)(1)(B) does not permit modifying an ERISA plan's terms to provide a workaround [of] its conversion deadline. The plan administrator did not abuse its discretion in deciding that the terms of the plan do not provide for equitable tolling." [Hayes v. Prudential Ins. Co. of Am., No. 21-2406 (4th Cir. Feb. 23, 2023)]  MORE >>

Roberts Disability Law

Moving to an ICHRA Does Not Have Significant Impact on Overall Plan Participation

"[C]hanging from traditional group insurance to an ICHRA model had little impact on overall participation; however, older employees are more likely to enroll in an ICHRA than younger employees despite generally having to pay more.... [E]nrollees are generally electing more prevalent HMO/EPO plans on the individual market and are often buying down from their current coverage.... [W]hen individual plans are less expensive, employers contribute lower monthly subsidies and reduce their benefits budget."  MORE >>


CMS Plans to Implement Stricter Enforcement Efforts to Boost Hospital Price Transparency Compliance

"Approximately 30% of hospitals remain noncompliant with the PTR.... CMS has shared several changes that are being explored for future implementation: [1] Standardized reporting.... [2] Conspicuous link placement.... [3] Streamlined enforcement efforts."  MORE >>

Squire Patton Boggs

Benefits in General

[Official Guidance]

Text of IRS Information Release: May 15 Tax Deadline Extended to Oct. 16 for Disaster Area Taxpayers in California, Alabama and Georgia

"Disaster-area taxpayers in most of California and parts of Alabama and Georgia now have until Oct. 16, 2023, to file various federal individual and business tax returns and make tax payments ... Previously, the deadline had been postponed to May 15 for these areas." [See updated Disaster Relief Notices for California (CA-2023-02), Alabama (AL-2023-01) and Georgia (GA-2023-01)]  MORE >>

Internal Revenue Service [IRS]

[Guidance Overview]

IRS Dramatically Expands Electronic Filing Mandate in 2024

"Generally, an organization filing 10 or more returns or statements (previously more than 250) in a calendar year will be required to file electronically in 2024. The regulations also require e-filing of certain returns and other documents not previously required to be e-filed.... Filers must aggregate almost all return types covered by the regulation to determine whether a filer meets the 10-return threshold."  MORE >>


Employee Benefits Jobs

View job as Retirement Plan Relationship Manager
            for ERISA Services, Inc.

Retirement Plan Relationship Manager

ERISA Services, Inc.


View job as Retirement Plan Relationship Manager for ERISA Services, Inc.

Last Issue's Most Popular Items

Text of Agency FAQs Part 57: Prohibition on Gag Clauses on Price and Quality Information in Provider Agreements (PDF)

U.S. Department of Health and Human Services [HHS]; U.S. Department of Labor [DOL]; and U.S. Treasury Department

HHS Issues Updated National Medical Support Notice and Instructions

Thomson Reuters / EBIA

IRS Issues Final Regulations Expanding Mandatory Electronic Filing of Information Returns

Thomson Reuters / EBIA

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

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