"While explicit, direct violations of the prohibition on gag clauses may not be difficult to determine, provisions that have the effect of restricting the disclosure of information or data in violation of the gag clause prohibitions may not be obvious."  MORE >>

"Self-insured plans may contract with a third-party administrator to submit the attestation on the plan's behalf; however, the obligation to make a complete and accurate attestation ultimately remains with the plan, not the TPA. For fully-insured plans, while the plan and the issuer are each required to annually submit the attestation, if the issuer submits an attestation on behalf of the fully-insured plan, both will be deemed to have satisfied the attestation requirement."  MORE >>

"While [employers have] long had a fiduciary duty to ensure that those funds are spent prudently, most have relied on insurers and other middlemen to define benefits, negotiate prices with physicians and hospitals, and pay claims. Now new federal policies are adding pressure to companies to make sure they're not squandering employees' health benefit money."  MORE >>

"HHS has proposed regulations that would adopt a set of standards for the electronic exchange of clinical and administrative data to support prior authorizations and health care claims adjudication.... [T]he approach is for covered entities to gain experience with several standard electronic attachment types so that technical and business issues can be identified to inform potential future rulemaking for other electronic attachments standards."  MORE >>

"The field assistance bulletin and opinion letter serve to educate employers on the complexities associated with determining the FMLA eligibility of a remote workforce and managing reduced-schedule requests in a manner that addresses employers' obligations under both the FMLA and [ADA]."  MORE >>

"DOL notes in its opinion that a 'serious health condition' under the FMLA and a 'disability' under the ADA are different concepts and must be analyzed separately.... [T]he opinion notes that the FMLA refers to 'workweeks,' and not hours worked. Therefore, if an employee is regularly scheduled to work more than 40 hours per week, he is entitled to more than 480 hours of FMLA leave per twelve-month period."  MORE >>

"When the PHE ends, health plans will no longer be required to cover COVID-19 tests, either diagnostic or OTC, or testing-related services with no cost-sharing. Employers should consider whether they want to continue to cover COVID-19 tests as required by a doctor or OTC without cost sharing.... [If] an employer decides to continue covering testing at no cost, they should consider how this affects any employer-sponsored high-deductible health plan (HDHP)."  MORE >>

"30% of women surveyed (age 35-plus) would not consider fertility treatments, such as egg preservation, in vitro fertilization (IVF), adoption, or surrogacy because of the high cost. However, a majority (81%) feel it's important that an employer provides fertility benefits and support."  MORE >>

"So far, more than 1,250 local governments have opted out of the contentious Colorado program requiring employers to provide paid family and medical leave. That number stands to grow as the new March 31 deadline to opt out approaches."  MORE >>