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Health & Welfare Plans Newsletter

March 31, 2023

2 New Job Opportunities 2 New Job Opportunities


[Guidance Overview]

HHS Releases Revised Instructions for Upcoming Prescription Drug and Health Care Spending Reports

"The instructions confirm that account-based plans (such as HRAs) and plans that provide only excepted benefits (e.g., limited-scope dental and vision plans, hospital or other fixed indemnity insurance, and disease-specific insurance) are not required to submit a report."  MORE >>

Thomson Reuters / EBIA

[Guidance Overview]

Severance Agreement Provisions Scrutinized in New NLRB Guidance

"[Highlights from Memorandum GC 23-05 include:] Lawful confidentiality and non-disparagement provisions are limited to prohibitions on unlawful conduct.... Overbroad provisions violate the NLRA even if a departing employee does not sign the severance agreement or requests that the overbroad provisions be included.... Other employment-related agreements and severance provisions may violate the NLRA."  MORE >>

Fenwick & West LLP

[Guidance Overview]

Illinois Enacts Paid Leave Law Guaranteeing Paid Leave for Most Employees for Any Reason

"Both the Illinois and Nevada laws specifically provide that employees do not have to disclose the reason for their leave to their employer. Under the Illinois law, employers are precluded from requesting documentation to support the need for a leave. Further, the Illinois law requires only seven days' advanced notice when the need for the leave is foreseeable."  MORE >>

Nelson Mullins

Texas District Court Nullifies Portions of Preventive Care Mandate

"In a closely watched case challenging the constitutionality of the ACA's requirement for health plans to cover certain preventive care on a first dollar basis, a Texas district court held that the requirement violates the Constitution.... The judge found the members of the [Preventive Services Task Force (PSTF)] were unlawfully appointed, which voided any of their recommendations. This determination is effective immediately and retroactive to March 23, 2010. Further, the court stated that the PrEP mandate (which covers treatment for the prevention of HIV) violates individual plaintiffs' 'rights under the Religious Freedom Restoration Act and is therefore DECLARED unlawful.' " [Braidwood Management, Inc. v. Becerra, No. 20-0283 (N.D. Tex. Mar. 30, 2023)]  MORE >>


DOL Releases 2023 Annual Self-Insured Health Plans Report to Congress, Analyzing 2020 Data

"Because many group health plans are exempt from filing Form 5500, the report does not reflect the full universe of plans. Nevertheless, the data clearly reveal an increase in the use of self-insured health plans."  MORE >>

Thomson Reuters / EBIA

High-Cost Health Care Claimants: Health Care Spending and Chronic Condition Prevalence Among Top Spenders (PDF)

"The share of enrollees spending $100,000 or more per year on health care rose 50 percent from 0.60 percent in 2013 to 0.90 percent in 2021.... The share spending $1,000,000 or more doubled, increasing from 0.005 percent in 2013 to 0.01 percent in 2021. The share spending $2,000,000 or more was 2.5 times larger in 2021 relative to 2013.... Certain chronic conditions like heart disease, mental disorders, connective tissue disease, and nervous system disorders have become more prevalent among the top spenders over time."  MORE >>

Employee Benefit Research Institute [EBRI]

Uptake of Biosimilars Remains Low Among People with Employer-Sponsored Insurance

"In five of seven drug classes, biosimilars accounted for one-third or less of ESI use ... Biologic drug prices were 20%-50% higher than prices of associated biosimilars ... Reference biologic use and prices remain high in ESI."  MORE >>

Health Care Cost Institute

2023 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds (PDF)

267 pages. "The Medicare projections have been significantly affected by the enactment of the Inflation Reduction Act of 2022 (IRA).... The Board of Trustees assumes that the IRA will affect the ultimate long-range growth rates for Part B and Part D drug spending differently.... Actual fee-for-service per capita spending has been consistently below the pre-pandemic projections throughout the public health emergency ... [T]here is an unusually large degree of uncertainty with the COVID-related impacts [and] future projections could change significantly as more information becomes available.... The estimated depletion date for the HI trust fund is 2031, 3 years later than projected in last year's report. "  MORE >>

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


A Texas Judge Just Invalidated The Preventive Services Mandate. What Happens Next?

"Judge O'Connor's decision applies only to preventive care recommendations adopted after 2010, when the [ACA] was adopted. Many important recommendations, including mammograms to screen women over the age of 50 for breast cancer, were adopted before then. But nearly all of the recommendations have been updated since 2010, so employers and insurers may find themselves bound by out-of-date recommendations. And lots of recommendations, including those on PrEP, were adopted after 2010 and won't be binding at all." [Braidwood Management, Inc. v. Becerra, No. 20-0283 (N.D. Tex. Mar. 30, 2023)]  MORE >>

Health Affairs Forefront

Benefits in General

April Is Financial Literacy Month: Recommendations for Your Employee Benefits Engagement Campaign

"Connect the dots between your company's health care and wealth programs to get employees' workplace benefits and savings in sync. Generate interest in your company's HSA-eligible consumer-driven health plan, life insurance and retirement savings programs ahead of open enrollment season. Increase utilization of employer-sponsored financial wellness coaching, college savings and short-term loans programs."  MORE >>


Fact Sheet: 2023 Social Security and Medicare Trustees Reports (PDF)

"The Hospital Insurance (HI) Trust Fund will be able to pay 100 percent of total scheduled benefits until 2031, 3 years later than reported last yea ... The Old-Age and Survivors Insurance (OASI) Trust Fund will be able to pay 100 percent of total scheduled benefits until 2033, 1 year earlier than reported last year.... If the OASI Trust Fund and the DI Trust Fund projections are added together, the resulting projected fund (designated OASDI) would be able to pay 100 percent of total scheduled benefits until 2034, 1 year earlier than reported last year."  MORE >>

U.S. Department of the Treasury

Employee Benefits Jobs

View job as Regional Client Manager
            for ACCG Retirement Services

Regional Client Manager

ACCG Retirement Services

Remote / GA

View job as Regional Client Manager for ACCG Retirement Services

View job as Retirement Plan Fee Benchmarking Associate
            for CAPTRUST

Retirement Plan Fee Benchmarking Associate


Raleigh NC / Hybrid

View job as Retirement Plan Fee Benchmarking Associate for CAPTRUST

Press Releases

JULY Announces Acquisition of Turning Point Associates

JULY Business Services

Eleven OneDigital Retirement Advisers Win PlanAdviser’s Top Retirement Plan Advisers for 2023


PLANADVISER Names 13 CAPTRUST Advisors to List

CAPTRUST Financial Advisors

FuturePlan Expands Retirement Plan Options with New Employer Aggregated Plan

FuturePlan, by Ascensus

MPI Significantly Increases Retirement Plan Advisor Capabilities and Competitiveness with the Launch of New Stylus Web

Markov Processes International, Inc. [MPI]

Last Issue's Most Popular Items

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

Sidley Austin LLP

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


March 31 Air Ambulance Reporting Deadline Delayed

Miller Johnson

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

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