"The Tri-Agencies issued Frequently Asked Questions addressing the impact of the Braidwood decision on the ACA's preventive care mandate, including guidance on certain preventive care services that must continue to be covered under the ACA and how the ruling impacts first dollar coverage under high deductible health plans."  MORE >>

"The DOL makes clear that plans and issuers must still continue to cover items and services with an 'A' or 'B' rating recommended or updated by UPSTF prior to March 23, 2010, without cost sharing. While the Braidwood decision is in effect, items and services with an 'A' or 'B' rating on or after March 23, 2010 no longer have to be covered without cost sharing."  MORE >>

"The Court noted that ERISA itself does not require a participant or beneficiary to exhaust administrative remedies in order to bring an action under Section 502 of ERISA ...  Instead, ERISA mandates an opportunity for administrative review ...  and the Ninth Circuit has treated completion of this administrative review as a 'prudential exhaustion' requirement." [Jackson v. The Guardian Life Insurance Company of America, No. 22-3142 (N.D. Cal. Apr. 13, 2023)]  MORE >>

"71%, of patients said their insurance plans covered biomarker tests, one-quarter said they were required to obtain prior authorization for the tests. Nearly one-third of respondents said their insurance did not cover the tests."  MORE >>

"Although a record-high percentage of consumers (39%) say they intend to buy life insurance in the next year, younger people are driving the demand with 50% of millennial and 44% of Gen Z respondents wanting coverage[.]"  MORE >>

"[If] enacted in its current form, SB 616 would modify the required paid sick leave accrual method to require that California employees have no less than 56 hours of accrued sick leave or paid time off by the 280th calendar day of employment or each calendar year, beginning January 1, 2024."  MORE >>

"and contracts between PBMs and insurers and health maintenance organizations need to include limits on patient cost-sharing for drugs, according to the House staff analysis. But the House bill would significantly expand regulation of the industry."  MORE >>

"The Sixth Circuit determined that the district court erred by concluding that the CBA covered workers in the construction industry based only on the title of the parties' CBA  ... Based on this title, the court held that the class of workers for whom fringe benefit contributions must be made is limited to employees performing covered work in the construction industry, and no other industries. The court explained that headings and titles do not replace or limit the plain meaning of the text." [Trustees of Sheet Metal Workers Loc. 7 Zone 1 Pension Fund v. Pro Servs., Inc., No. 22-1566 (6th Cir. Apr. 21, 2023)]  MORE >>

"Health savings accounts are growing in use and popularity as an employee benefit. With advantages both in health care spending and long-term retirement savings, employers can present the benefit in multiple ways."  MORE >>