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Health & Welfare Plans Newsletter

March 28, 2023

2 New Job Opportunities 2 New Job Opportunities


[Official Guidance]

Prescription Drug Data Collection (RxDC) Reporting Instructions: Section 204 Data Submission Instructions for the 2022 Reference Year (PDF)

70 pages; Mar. 3, 2023. "Section 204 requires group health plans and health insurance issuers offering group or individual health insurance coverage to submit information about prescription drugs and health care spending to [HHS], [DOL], and the Department of the Treasury.... The RxDC report also collects information on total spending on health care services, including health care premium, enrollment, and spending broken down by hospital costs, provider and clinical service costs for primary and specialty care (separately), and other medical costs, including wellness services.... The deadline for the 2022 reference year report is June 1, 2023."  MORE >>

Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

The End of the COVID-19 Emergency: Mental Health Parity

"The end of the [national emergency (NE)] and the [public health emergency (PHE)] will require modifications to group health plans' and health insurance issuers' MHPAEA testing as it relates to financial requirements and quantitative treatment limits. The NE and the PHE also affect the design and operation of some employee assistance plans (EAPs). The NE and the PHE allowed plan sponsors to expand coverage under excepted benefit EAPs in certain respects without risking their status as the Health Insurance Portability and Accountability Act (HIPAA)-excepted benefits."  MORE >>

McDermott Will & Emery

[Guidance Overview]

What Medical Expenses Qualify as Tax Deductible Under Section 213 of the Internal Revenue Code?

"These Sec. 213 FAQs clarify what medical services and products qualify for deduction or reimbursement. Overall, a physician's prescription or recommendation for a particular medical service or product will be a significant factor in determining whether an employee may deduct or reimburse an expense using tax savings accounts. The same applies to medical services or products treating a physician-diagnosed disease."  MORE >>

Jackson Lewis P.C.

[Guidance Overview]

Severance Agreements: NLRB General Counsel Issues Guidance

"While the [Memorandum GC 23-05] answered some questions, it raised many more.... [T]here are several, practical steps that an employer can take now. [1] Review confidentiality and non-disparagement provisions in severance agreements to ensure that they are narrowly-tailored to protect the employer's business needs.... [2] Include a severability clause in severance agreements. [3] Consider adding a 'savings' clause to severance agreements."  MORE >>

Godfrey & Kahn S.C.

[Guidance Overview]

Upcoming Deadline icon San Francisco Health Care Security Ordinance: Form Due May 1

"Employers covered by the San Francisco Health Care Security Ordinance must submit their Annual Reporting Form to the San Francisco Office of Labor Standards Enforcement (OLSE) on or before May 1, 2023. Covered Employers should also be aware that effective January 1, 2023, OLSE released a new poster to be posted in all workplaces with Covered Employees (and to be distributed to remote Covered Employees), as well as issued new 2023 required Health Care Expenditure rates."  MORE >>

Davis Wright Tremaine LLP

Ninth Circuit Sharpens Predominance Requirement: Looking Behind Plaintiffs' Fiction in Dismantling Class Certification

"The Ninth Circuit ... viewed the plaintiffs' framing of the class remedy as 'reprocessing' as an end run around the commonality requirement of Rule 23, because 'reprocessing' is 'the means to the remedy that [the plaintiffs] seek,' not the remedy itself.... Wit reflects the increasing potency of the predominance requirement of Rule 23 for defendants: highlighting how the plaintiffs' requested remedy will actually play out in reality can be a compelling tool in dismantling plaintiffs' fiction of class remedy." [Wit v. United Behav. Health, No. 20-17363 (9th Cir. Jan. 26, 2023; petition for rehearing filed Mar. 10, 2023)]  MORE >>

Covington & Burling LLP.

Cigna's PBM, Two Others Sued in Ohio Over Drug Price Fixing

"Ohio on Monday filed a lawsuit accusing Cigna Group (CI.N), Humana Inc (HUM.N) and others of colluding to drive up prescription drug prices by charging exorbitant fees for pharmacy benefit management services. The lawsuit ... comes amid growing scrutiny by state and federal regulators of pharmacy benefit managers (PBMs) like Cigna's Express Scripts unit, which is named as a defendant." [Yost v. Ascent Health Serv. Inc. Express Scripts, Inc. and Cigna Group, No. 23 CV H 03 0179 (Del. Cty. Ohio complaint filed Mar. 27, 2023)]  MORE >>

Reuters; free registration may be required

Rising Health Care Costs Should Set Off Alarm Bells for Plan Sponsors

"Employers are projecting a 5.4% average increase in health benefit costs per employee in 2023 ... Per-employee health benefit costs topped $15,000 in 2022, with smaller employers -- those with fewer than 500 employees -- spending more per capita than large employer ... [E]mployees' satisfaction with their overall benefits fell to 61% in 2023, down from 64% in 2022. The 2023 satisfaction level is the lowest point in the past decade."  MORE >>

PLANSPONSOR; free registration may be required

Can Employers Provide Surrogacy Benefits on a Tax-Favored Basis?

"Generally, employer-provided surrogacy/gestational carrier benefits are taxable to the employee. They are not typically provided through the employer's group health plan but rather through a written policy outside of the group health plan. Certain state laws may limit or prohibit surrogacy/gestation carrier contracts."  MORE >>

Willis Towers Watson

The Quiet Privatization of Government Health Insurance Programs

"Although privately run Medicare and Medicaid plans are still highly regulated and funded by the government, the commercialization has complicated efforts to rein in medical spending and unleashed fierce partisan fights like the ongoing one over Medicare Advantage."  MORE >>

MSN News

Benefits in General

[Official Guidance]

IRS Disaster Relief Notice MS-2023-02, for Victims of Severe Storms, Straight-Line Winds and Tornadoes in Mississippi

"Victims of severe storms, straight-line winds and tornadoes in Mississippi from March 24, 2023, to March 25, 2023, now have until July 31, 2023, to file various individual and business tax returns and make tax payments.... [I]ndividuals and households affected by severe storms, straight-line winds and tornadoes that reside or have a business in Carroll, Humphreys, Monroe, and Sharkey counties qualify for tax relief."  MORE >>

Internal Revenue Service [IRS]

Employee Benefits Jobs

View job as Healthcare Actuarial Consultant
            for BPAS

Healthcare Actuarial Consultant



View job as Healthcare Actuarial Consultant for BPAS

View job as Enrolled Actuary
            for Prime Pensions, Inc.

Enrolled Actuary

Prime Pensions, Inc.


View job as Enrolled Actuary for Prime Pensions, Inc.

Selected New Discussions

Direct Bill of Health Insurance Premiums to Employee While on Leave

"While an employee is out on leave and not receiving a paycheck, the employer direct bills the employee for their health insurance premium. The employee pays the premium with after-tax dollars. When the employee returns to work, does the employer have any reporting or other obligation regarding the fact that if the employee had been actively working, the premiums would have been paid with pre-tax dollars?"

BenefitsLink Message Boards

COBRA Information and SPD

"Suppose a Section 125 plan provides only FSA and DCAP. They also have a 'cash in lieu' option where anyone eligible for the company group health insurance can either have a certain amount contributed to the 125 plan to be used for benefits, or they can elect to receive it in cash, taxable in their normal paychecks. The COBRA provisions, if applicable, are 'administered' by a third party. Is it allowable for the employer to attach to the SPD a written COBRA explanation provided by the third party? Or must it be in the SPD as part of a self-contained single document? I don't, EVER, have anything whatsoever to do with COBRA, so I essentially know nothing about how COBRA information must be presented. Employer is a retirement plan client of ours, so I'm trying to assist them somewhat with questions, but this is out of my bailiwick. I don't think the the third party 'administrator' is apparently being very helpful, or necessarily even doing documents -- not like a typical TPA in the retirement plan world. Their 125 document provider from way back is long gone."

BenefitsLink Message Boards

Press Releases

Employee Benefit Research Institute Announces Appointment of Barb Marder as President and CEO

EBRI [Employee Benefit Research Institute]

John Hancock Retirement Selects Wayne Park as New CEO Bringing Decades of Experience Working Alongside Intermediaries, Plan Sponsors, and Participants as a Champion of Retirement Readiness

John Hancock Retirement

Webcasts and Conferences
(Health & Welfare Plans)

McLaren Update: Lessons From the NLRB GC’s Recent Guidance on Confidentiality and Nondisparagement Clauses

April 4, 2023 WEBINAR

Ogletree Deakins

Compliance Considerations for Self-Insured Plans

April 18, 2023 WEBINAR


Narrow Networks, Big Ideas: Where Is It a Good Fit?

April 18, 2023 WEBINAR

Corporate Synergies

No Surprises Act Enforcement: How to Prepare for a DOL Audit

April 25, 2023 WEBINAR

American Bar Association Joint Committee on Employee Benefits [JCEB]

Last Issue's Most Popular Items

ERISA Case Signals New Theories for Plaintiffs' Bar


RxDC Frequently Asked Questions

MZQ Consulting, LLC

NLRB's General Counsel Foreshadows More Expansive Restrictions on Separation Agreements

Blank Rome LLP

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

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