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Health & Welfare Plans Newsletter

March 14, 2023

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[Guidance Overview]

Most Employers Will Be Required to File ACA Returns Electronically Beginning in 2024

"Under the final rules, employers filing 10 or more returns must file Forms 1094 and 1095 electronically. The 10-form threshold is determined based on the total number of forms the employer must file with the IRS, including the Forms 1094 and 1095, as well as other information returns, such as Forms W-2 and Forms 1099, income tax returns, excise tax returns, and employment tax returns, including those that are not required to be e-filed, such as forms 940 and 941."  MORE >>

Woodruff Sawyer

[Guidance Overview]

Health Plans Must Submit Gag Clause Attestations by Dec. 31, 2023

"A gag clause is a contractual term that directly or indirectly restricts specific data and information that a health plan or issuer can make available to another party. Effective Dec. 27, 2020, the CAA generally prohibits group health plans and issuers offering group health insurance from entering into agreements with health care providers, TPAs or other service providers that include certain gag clause language."  MORE >>


[Guidance Overview]

Gag Clause Compliance Attestation Requirements for Plan Sponsors

"Fully-insured and self-insured group health plans generally must submit the Gag Clause Prohibition attestation. This includes: Health plans covered by Title I of ERISA; State and local governmental health plans; and Church health plans that are subject to the Internal Revenue Code. Group health plan sponsors should confirm whether their plan service providers or third-party administrators will submit the attestation on the plan's behalf."  MORE >>

Sherman Howard

[Guidance Overview]

Illinois Employers Must Provide 40 Hours of Paid Leave for Any Reason

"Illinois Governor Pritzker signed into law the 'Paid Leave for All Workers Act,' which will allow most Illinois employees up to 40 hours of paid leave per year, for any purpose, starting on January 1, 2024. This will represent a sea change for many employers in the state.... Illinois will become just the third state, after Maine and Nevada, to adopt paid leave that can be used for any reason."  MORE >>

ArentFox Schiff LLP

[Guidance Overview]

Illinois Passes Paid Leave for 'Any Reason'

"The law expands paid leave beyond Cook County and Chicago's paid sick leave ordinances, making paid leave for any reason available to Illinois employees who are beyond these localities.... [L]eave accrual requirements will commence Jan. 1, 2024."  MORE >>


Court Nullifies Puerto Rico's Law on Employee Entitlements

"The decision will impact employees' statutory benefits and rights, including vacation pay, sick leave, meal periods, holiday bonuses, and severance pay.... [E]mployers in Puerto Rico may want to review and revise their employment practices and policies to comply with the state of the law prior to July 20, 2022, the effective date of Law 41-2022." [Financial Oversight and Management Bd. for Puerto Rico v. Urrutia No. 22-0063, 17 BK 3283-LTS (D. Puerto Rico Mar. 3, 2023)]  MORE >>

Society for Human Resource Management [SHRM]; membership may be required to view article

Exceptional Usefulness and Quality icon 2023 Annual Report of ABA Subcommittee on the FMLA: 2022 Court Cases (PDF)

This 207-page report describes, and organizes by topic in detail, over 300 FMLA decisions of federal and state courts from November 1, 2021 through October 31, 2022.  MORE >>

American Bar Association Section of Labor and Employment Law, Committee on Federal Labor Standards Legislation, Subcommittee on the Family and Medical Leave Act

Novo Nordisk to Slash Insulin Prices by Up to 75%

"Novo, one of the biggest sellers of insulin in the U.S. and around the world, said Tuesday it would cut the list price of its NovoLog insulin by 75% and the prices for Novolin and Levemir by 65% starting in January 2024. In addition, Novo plans to cut prices for its unbranded insulin products to match the reduced price of Novo's corresponding brands."  MORE >>

The Wall Street Journal; subscription may be required

Medicaid Redetermination and Its Impact on Employer Medical Plans

"The Medicaid redetermination process will result in numerous individuals losing their current Medicaid coverage. Loss of Medicaid coverage is a HIPAA special enrollment right, allowing individuals to return to employer-sponsored coverage mid-year if they provide notice within 60 days.... Employers may see a significant uptick in covered employees and family members in the coming months."  MORE >>


AHIP-Led Coalition Aims to Reduce Coverage Losses Amid Pending Medicaid Redeterminations

"AHIP and several other healthcare organizations launched the Connecting to Coverage Coalition ... in an effort to make the upcoming Medicaid redetermination process run smoothly. The coalition's website includes studies on Medicaid redeterminations and frequently asked questions for enrollees. AHIP also released a report that shows 53.6% of those who will lose coverage will transition to employer-sponsored insurance and 21.2% will become uninsured."  MORE >>

MedCity News

New Bill Would Let Connecticut Small Businesses Pool Resources for Health Insurance

"Businesses with fewer than 51 employees [would] be able to join together with other members of their industry association to purchase medical insurance plans for their employees."  MORE >>

Westchester and Fairfield County Business Journals

Employee Benefits Jobs

View job as 5500 Team Lead
            for 401k Generation

5500 Team Lead

401k Generation

Altamonte Springs FL / Hybrid

View job as 5500 Team Lead for 401k Generation

Press Releases

Pentegra Publishes Advisor Study on 3(16) Fiduciary Outsourcing in Conjunction with Second Annual 3(16) Day


Webcasts and Conferences
(Health & Welfare Plans)

Employee Benefits Inflection Point 2023: Finding the Right Balance in Benefit Trends

March 23, 2023 WEBINAR


ERISA Basics National Institute 2023

June 6, 2023 in NV

American Bar Association Joint Committee on Employee Benefits [JCEB]

Last Issue's Most Popular Items

Federal Requirements on Private Health Insurance Plans

Congressional Research Service [CRS]

IRS Increases ACA Employer Mandate Penalties for 2024


'Gag Clause' Prohibition Attestation Required by Year End

HUB International

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

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