"Plan sponsors will need to decide whether to continue covering COVID-19 tests and vaccines at the enhanced level ... Plan sponsors should review any communications and plan materials regarding coverage of COVID-19 tests and vaccines and determine whether they need to issue a summary of material modifications (SMM) or amend their plan  ... Plan sponsors should review the SBC for the current plan year and determine whether [advance] notice of any changes must be sent to participants."  MORE >>

"The Notice implements various changes previously proposed by CMS, including [1] requiring provider networks to comply with network adequacy standards and delaying the implementation of appointment wait time standards, [2] standardizing plan options, [3] adding special enrollment periods to increase ease of obtaining coverage, [4] strengthening markets, and [5] bolstering program integrity."  MORE >>

"[1] What steps should a person take if they have an offer of employer-sponsored health insurance? ... [2] When can eligible employees enroll in employer-sponsored insurance ... [3] For people who enroll in employer-sponsored insurance during a special enrollment period, when will their coverage start? ... [4] What happens if someone misses the deadline to enroll in employer-sponsored insurance? ... [5] Can a person enroll in a marketplace plan if they have an offer of employer-sponsored insurance? Will they be eligible for financial help?"  MORE >>

"With the January 2023 changes to the FDA protocol, many group health plan sponsors began exploring adding mifepristone to the plan's pharmacy benefit, since it no longer had to be dispensed in-person by a health care provider.... [It] is unclear whether pharmacies will continue to pursue certification to dispense mifepristone while the Texas case proceeds through the appellate process." [Alliance for Hippocratic Med. v. U.S. Food & Drug Admin., No. 22-0223 (N.D. Tex. Apr. 7, 2023; S. Ct. No. 22A902 grant of application for stay of District Court order Apr. 21, 2023)  MORE >>

"The Pharmacy Benefit Manager Transparency Act 2023 [S 127] is aimed at helping drive down costs for seniors by holding PBMs accountable for the use of anti-competitive business practices.... Telehealth usage now represents about 40% of behavioral health visits ... Significant policy changes in response to the COVID-19 public health emergency accelerated ... widespread use of telehealth services ... not all policy changes will continue permanently[.]"  MORE >>

"Proper plan sponsor HSA use requires employee participation to be voluntary, although employers may use automatic enrollment; employers cannot limit the ability of employees to transfer assets to different HSA administrators; employers cannot limit the use of HSA funds or withdrawals; employers cannot influence employees' HSA investment decisions; and employers must offer a reasonable availability of investment options,"  MORE >>

"While 99% [of employers] agreed that effective and timely access to in-network behavioral health providers is important; 31% expressed dissatisfaction with efforts to identify and address gaps in network access. Tele-behavioral health was important to 95% of employers and 65% were satisfied around these services. Only 34% of employers agreed that their behavioral health directories were an accurate reflection of the providers available to plan participants."  MORE >>

"Victims of severe storms, straight-line winds and tornadoes in Oklahoma from April 19 to April 20, now have until August 31, to file various individual and business tax returns and make tax payments ... [I]ndividuals and households ... that reside or have a business in McClain and Pottawatomie counties qualify for tax relief."  MORE >>