"For the time period of April 1 to June 30, 2023, 27 Part B rebatable drugs have an adjusted coinsurance rate based on the inflation-adjusted payment amount. People with Traditional Medicare and Medicare Advantage who use these drugs may, depending on other health coverage they may have, pay a reduced amount for their coinsurance during this specific quarter." [Also available: Fact Sheet on Medicare Prescription Drug Inflation Rebate Program Part B Rebatable Drug Coinsurance Reduction, and Guidance on Inflation Rebates in Medicare.]  MORE >>

"The ACA employer mandate generally requires that ALEs offer coverage to full-time temps or interns in the same manner as regular full-time hires to avoid potential penalties. However, employers frequently take advantage of cost-saving strategies such as utilizing the ACA's limited non-assessment period to delay the offer of coverage to the first day of the fourth full calendar month of employment."  MORE >>

"The Departments clarify that gag clauses include restrictions on the disclosure of provider rates regardless of whether the TPA considers them 'proprietary,' or provisions that allow access to provider-specific cost and quality-of-care information only at a TPA's discretion. In addition, provisions that indirectly operate to restrict access to or disclosure of applicable information violate the prohibition on gag clauses -- even if they don't expressly restrict disclosure."  MORE >>

"For employers voluntarily providing paid vacation, state wage-and-hour laws often fail to specify whether the employer must pay out unused accrued vacation on employment separation or can implement a use-it-or-lose-it policy that requires forfeiture of vacation not used by a specified date ... [R]ecent developments in Colorado and Maine illustrate the mix of court rulings and state laws that employers must track when crafting vacation policies."  MORE >>

"In general, after May 11, 2023, group health plans will no longer be required to cover testing, preventive services, and vaccines for COVID-19 without cost-sharing. However, the requirement under the CARES Act that non-grandfathered group health plans must cover in-network preventive services and vaccines for COVID-19 is not tied to the ending of the PHE."  MORE >>

"[T]he Act does not preempt the Chicago Minimum Wage and Paid Sick Leave Ordinance or the Cook County Earned Sick Leave Ordinance, and employers that provide employees with paid sick leave in compliance with the Chicago or Cook County ordinances will not be required to provide an additional 40 hours of paid leave. However, the Act does apply to employers with Chicago or Cook County-based employees who are not currently covered by those ordinances."  MORE >>

"[C]overed employees accrue one hour of paid leave for every 40 hours worked, for up to a total of 40 hours earned in any designated 12-month period. Employers may also satisfy the paid time off requirement by granting, or 'frontloading,' all 40 hours of paid leave at the beginning of the designated benefit year. Employees must be permitted to carry over up to 40 hours of unused paid leave to the next benefit year, except where an employer frontloads the full 40 hours."  MORE >>

"The court noted that RingCentral made all decisions regarding which benefits would be offered to employees, and what contributions would be required for those benefits. Plaintiffs were required to establish a connection between Sequoia's actions and their contributions, but RingCentral's intermediary actions broke that connection ... The Ninth Circuit then turned to plaintiffs' second standing theory, which was that they retained an equitable ownership interest in the Tech Benefits Program's trust fund ... The court held that this argument ran afoul of the Supreme Court's decision in Thole." [Winsor v. Sequoia Benefits & Ins. Servs., LLC, No. 21-16992 (9th Cir. Mar. 8, 2023)]  MORE >>

"Nearly three years ago, ERIC challenged amendments to the New Jersey WARN Act that would impose a series of requirements forcing employers in every industry to create ongoing administrative systems affecting severance benefits. Because these requirements violate [ERISA], ERIC filed suit to prevent overreach by the State and invalidate the amended law." [The ERISA Industry Committee v. Asaro-Angelo, No. 20-10094 (D.N.J. motion filed Mar. 14, 2023)]  MORE >>

"President Biden's proposed 2024 budget includes substantial additional amounts for continued funding of the implementation and enforcement of the No Surprises Act (NSA) and the transparency laws passed along with the NSA, including prohibitions on gag clauses regarding price and quality information, the required disclosure of indirect compensation for brokers and consultants with respect to employer-sponsored health plans, required reporting on pharmacy benefits and drug costs, and enforcement of the mental health parity comparison requirements."  MORE >>

"Carriers are required to [1] provide coverage of artificial insemination ... [2] cover drugs associated with artificial insemination procedures ... [3] cover the cost of In Vitro Fertilization (IVF)-related drugs for three cycles annually.... These 2024 changes represent an expansion of fertility benefits compared to what was available this year."  MORE >>