23 pages. "This proposed rule would make several clarifications and update the definitions currently used to determine whether a consumer is eligible to enroll in a Qualified Health Plan (QHP) through an Exchange; a Basic Health Program (BHP), in States that elect to operate a BHP; and for some State Medicaid and Children's Health Insurance Programs (CHIPs)."  MORE >>

"[N]on-grandfathered group health plans are still required to cover items and services recommended by the USPSTF before March 23, 2010. In addition, the Braidwood decision did not invalidate preventive services requirements deriving from the ACIP recommendations or HRSA guidelines, so non-grandfathered plans must continue to cover those items and services as well. What is left unanswered in the Departments' guidance is Braidwood's impact on USPSTF recommendations that were issued before March 23, 2010, but have been modified since that date."  MORE >>

"Plan sponsors opting for a reversal of the additional previously mandated benefits should review all plan communications related to announcements about coverage for COVID-19 diagnosis, treatment, and preventive services ... If duration was not communicated, or if the notice was issued in an earlier plan year, then the participants need to be notified within a 'reasonable time' in advance of the reversal.... Plan sponsors that are considering extending deadlines beyond what is required by the end of the Outbreak Period should discuss with insurers and stop-loss carriers."  MORE >>

"[T]he Fourth Circuit found that a unanimous written consent adopted by a plan sponsor's board of directors was insufficient to terminate the company's severance plan, because the plan's governing document required that plan amendments be 'in writing by the Human Resources department.' " [Messer v. Bristol Compressors Int'l, LLC, No. 21-2363 (4th Cir. Apr. 3, 2023; unpub.)]  MORE >>

Links to video, statement of Chairman Rep. Bob Good (R-VA), and statements by witnesses [1] Mrs. Tracy Watts, Mercer; [2] Ms. Marcie Strouse, Capitol Benefits Group; [3] Ms. Sabrina Corlette, J.D., Georgetown University"s Health Policy Institute; and [4] Mr. Joel White, Council for Affordable Health Coverage (CAHC)."  MORE >>

"More than half (55%) said employee misclassification is the most common potential problem when it comes to ACA compliance. And 1 in 4 respondents said they had been audited by the IRS for potential non-compliance.... 3% of respondents said their ACA compliance requirement were overly burdensome, 21% said the requirement were somewhat burdensome, and 27% said the requirements were not burdensome."  MORE >>

"As the cost of healthcare continues to increase, employers, plan sponsors, and health plans are looking for cost containment strategies.... This white paper is intended to support decision-making processes for evaluating and implementing point solutions. It includes a discussion of the various financial arrangements common to point solutions, and the advantages, disadvantages, and customer considerations for each type of arrangement."  MORE >>

"[T]he seemingly instinctive desire to pursue individual arbitration in lieu of class litigation may need to be reevaluated.... [A]rbitration of ERISA fiduciary breach claims may still emerge as a useful tool to the defense bar, but the focus may need to shift away from arbitration as a means to avoid altogether the prospects of class action litigation, and in favor of crafting arbitration agreements that will make such litigation more manageable."  MORE >>