"ISSUE: Whether Taxpayer is entitled to deduct estimated future retiree benefits as unpaid loss adjustment expenses (LAE) in its Year 1, Year 2, and Year 3 taxable years under Section 832(b)(5) ... or whether Section 404(a)(5) applies and TAM-124724-21 2 precludes deductibility of such amounts until the year in which retiree benefits are includible in gross income of the employee receiving the benefits."  MORE >>

"CMS has clarified processes and templates, better defined key terms, and continued some of the flexibility available for the first RxDC reporting cycle. However, important relief provided in the first reporting cycle has not been renewed, including the much-needed general good faith effort relief issued in FAQs Part 56. As a result, more plan sponsors may need to submit some amount of 2022 data directly to CMS (rather than relying entirely on their vendors)."  MORE >>

"[The DOL] has informally announced that despite the statutory end of the NE being 30 days earlier than expected, to avoid potential confusion and changes to administrative processes already in progress, the deadline of July 10, 2023, will remain the relevant date for COBRA, special enrollment, and other related deadlines under previous guidance.... Further clarification and formal guidance are still expected."  MORE >>

"[DOL, HHS and the Treasury Department] have published FAQs explaining how the end of the PHE will affect group health plans.... This article provides an overview of other issues raised under the FAQs, including how the end of the PHE will affect mandated coverage relating to COVID-19. Employers should review their plan documents and plan operations with respect to these issues."  MORE >>

"Although plans would no longer be required to cover [certain COVID-related] services, plan sponsors should consider to what degree maintaining coverage is cost-effective. Additional communication may be needed for plans that have a large benefit differential between in-network and out-of-network, as [there has been] an unusually high proportion of out-of-network providers being used for the COVID-19 testing."  MORE >>

"Employers already offering at least 40 hours of discretionary paid leave will not have to provide additional paid leave to comply with the act.... [E]mployers should decide whether to continue existing paid vacation or PTO policies that satisfy the act but require payout of unused PTO on employment separation or instead design a paid leave policy that complies with the act but does not require PTO payout on separation."  MORE >>

"Noting that a successful MHPAEA claim requires a participant to plead facts showing a disparity in the plan's treatment of MH/SUD and medical/surgical benefits, the court concluded that the participant's allegation was unsupported and contradicted plan language expressly applying the exclusion to both types of benefits." [L.L. v. Anthem Blue Cross Life and Health Ins., No. 22-0208 (D. Utah Mar. 13, 2023)]  MORE >>

"The U.S. Court of Appeals for the Fourth Circuit has ruled ... that a Board of Directors resolution intended to terminate a severance pay plan was insufficient because the plan's provisions required additional actions to amend or terminate the plan.' [Messer v. Bristol Compressors Int"l, LLC, No. 21-2363 (4th Cir. Apr. 3, 2023; unpub.)]  MORE >>

"The Fourth District stands alone in concluding that a PAGA claim for civil penalties can be based on alleged violations of the Healthy Workplaces, Healthy Families Act of 2014, a statute which expressly limits a plaintiff's remedies to equitable, injunctive, or restitutitonary relief. However, with several federal court and state trial court judges reaching the opposite conclusion, it is unlikely that this decision will be the final word on the subject." [Wood v. Kaiser Foundation Hospitals, No. D079528 (Calif. Ct. App 4th Dist. Feb. 24, 2023)]  MORE >>

"The best response to the NSA is still an approach that is both strategic and compliance oriented. Reference-Based Pricing (RBP) is one of the fastest growing solutions in health benefits cost management to avoid unreasonable or excessive provider charges -- potentially lowering the cost of coverage and employee point of purchase cost sharing."  MORE >>