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Health & Welfare Plans Newsletter

March 30, 2023

3 New Job Opportunities 3 New Job Opportunities


[Guidance Overview]

What to Expect When No More COVID Is Expected: Action Steps for Plan Sponsors

"[1] Ensure that plans are operated in compliance with pre-COVID written terms that were suspended during the pandemic, and consider whether any plan amendments are needed once the emergency period expires. [2] Review and amend operational procedures, summary plan descriptions, and COBRA notices. [3] Communicate with affected qualified beneficiaries specifically and with all plan participants more broadly regarding applicable deadlines."  MORE >>

Sidley Austin LLP

[Guidance Overview]

Upcoming Deadline icon Transparency Reporting: Second Prescription Drug (RxDC) Report Due June 1, 2023

"Employers should reach out to their issuers, TPAs or PBMs ... to confirm that they will submit the RxDC reports for their health plans. Employers should also update their written agreements with these third parties to reflect this reporting responsibility. Employers with self-funded plans should monitor their TPA's or PBM's compliance."  MORE >>


[Guidance Overview]

March 31 Air Ambulance Reporting Deadline Delayed

"Group health plans may contract with their insurer (if fully insured) or third-party administrator (if self-funded) to satisfy the reporting requirement. However, only agreements with an insurer will 'legally' shift the reporting obligation. Self-funded group health plans will need to rely on indemnification provisions to shift liability for compliance.... [T]he original reporting requirement for the 2022 calendar year was scheduled to be March 31, 2023. However, the reporting deadline is now delayed until the Departments issue final regulations."  MORE >>

Miller Johnson

[Guidance Overview]

The Time Is Now for Employers to Prepare for Illinois' Paid Leave for All Workers Act

"Employers will be prohibited from requiring employees to explain why they are taking leave and to provide supporting documentation. Employees may decide how much of their accrued paid leave to take, but an employer's policy may require that employees take a minimum of two hours of paid leave per occurrence. Employers may develop a notification policy; however, the policy must be reasonable and subject to [specified] limitations[.]"  MORE >>

Polsinelli PC

Senate Finance Committee Hearing on Pharmacy Benefit Managers and the Prescription Drug Supply Chain: Impact on Patients and Taxpayers

Video of March 30 hearing. Testimony by: [1] Robin Feldman, Hastings College of Law University of California San Francisco; [2] Karen Van Nuys, Ph.D.,University of Southern California Los Angeles; [3] Lawton Robert Burns, Ph.D., Wharton School, University of Pennsylvania; [4] Jonathan E Levitt, Frier Levitt Attorneys at Law; and [5] Matthew Gibbs, Pharm.D., Capital Rx.  MORE >>

Committee on Finance, U.S. Senate

2023 State Legislation on Prescription Drug Costs: Emerging Policy Trends

"At least 12 states have introduced bills that would require a patient's cost-sharing to be calculated at the point of sale and reduced by an amount equal to a certain percentage of [PBM] rebates.... Twenty-two states have limits on the amount a person pays for insulin and at least nine more could join them.... Another strategy is to restrict the use of copay accumulator policies, as 15 states and Puerto Rico currently do and 15 more states are considering."  MORE >>

National Conference of State Legislatures [NCSL]

Health Premiums and Consumers' Medical Costs May Be About to Soar, Even as Inflation Falls

"Prices for hospital services, the single biggest component of medical care, accelerated in December and even faster in January, to an annual rate of 5.5% ... Hospitals are pressing for higher payments as their long-term contracts with medical insurers come up for renewal. And greater market concentration caused by chains buying out smaller hospitals is helping to push medical inflation upward, as is the historically opaque nature of healthcare pricing."  MORE >>

Associated Press via AOL

Lower-Paid Employees Are Declining Employer Health Insurance and Workplace Benefits

"[T]he overall rate for employee medical enrollment decreased slightly to 73% in 2023, down from 76% in 2021 ... Workers with salaries less than $40,000 have the lowest medical enrollment rate at 56%, compared to 84% for individuals who earn more than $100,000. Overall, 45% of the employees that said they declined employer medical coverage indicated it was because the benefit was unaffordable[.]"  MORE >>

PLANSPONSOR; free registration may be required

Family-Building Benefits Are Part of Modern Employer Coverage

"Nearly half of U.S. employees (45%) cite fertility benefits, including IVF, surrogacy and adoption, as necessary when considering a new employer. Another 59% say that paid maternity and paternity leave are also important considerations. This suggests family-planning benefits have become a vital part of a comprehensive coverage plan."  MORE >>

HR Daily Advisor


Statement for Senate Finance Committee Hearing on Pharmacy Benefit Managers and the Prescription Drug Supply Chain: Impact on Patients and Taxpayers (PDF)

"To get a complete picture of PBM financials, ... greater clarity [is needed] on: [1] Complicated and opaque methods to determine pharmacy reimbursement. [2] Methods to steer patients towards PBM-owned or affiliated pharmacies. [3] Fees and clawbacks charged to pharmacies. [4] Potentially unfair audits of independent pharmacies. [5] The prevalence of prior authorizations and other administrative restrictions. [6] The use of PBM-defined specialty drug lists and associated specialty drug policies. [7] The effect of rebates and fees from drug manufacturers on formulary design and the costs of prescription drugs to payers and patients."  MORE >>

National Community Pharmacists Association [NCPA]

Employee Benefits Jobs

View job as Product Support Specialist - Compliance
            for / Wolters Kluwer

Product Support Specialist - Compliance / Wolters Kluwer


View job as Product Support Specialist - Compliance for / Wolters Kluwer

View job as Retirement Plan Specialist
            for Definiti

Retirement Plan Specialist



View job as Retirement Plan Specialist for Definiti

View job as Account Manager
            for U.S. Retirement & Benefits Partners

Account Manager

U.S. Retirement & Benefits Partners

El Paso TX / Hybrid

View job as Account Manager for U.S. Retirement & Benefits Partners

Press Releases

Aflac Adds Beneficiary Companion® Services to Its Group Premier Life Absence Disability Solutions Portfolio


T. Rowe Price to Acquire Retiree, Inc., Bolstering Retirement Income Capabilities

T. Rowe Price

Webcasts and Conferences
(Health & Welfare Plans)

Employee Benefit Plans Conference

April 24, 2023 in TN

Tennessee Society of CPAs

Employee Benefit Plans Conference


Tennessee Society of CPAs

Last Issue's Most Popular Items

Text of Agency FAQs About FFCRA, CARES Act, HIPAA Implementation, Part 58: End of the COVID-19 National Emergency and Public Health Emergency

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

What Does the End of the COVID-19 Public Health Emergency Mean for Health Benefits?

Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

Prohibition of Gag Clauses: Attestation Guidance for Employers


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

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