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Health & Welfare Plans Newsletter

April 28, 2023

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[Official Guidance]

Exceptional Usefulness and Quality icon Text of IRS Chief Counsel Advice 202317020: Claims Substantiation for Payment or Reimbursement of Medical and Dependent Care Expenses (PDF)

"Reimbursements of section 213(d) medical expenses to an employee from a health FSA provided in a section 125 cafeteria plan are included in the gross income of such employee if any expense of any employee reimbursed by the health FSA is not fully substantiated including if any expenses below a certain threshold are not substantiated.... In addition, an employer may not exclude reimbursements of dependent care expenses from an employee's gross income if any expenses of any employee under the dependent care assistance program are not substantiated after the expense has been incurred."  MORE >>

Internal Revenue Service [IRS]

[Guidance Overview]

Actions for Benefit Plan Sponsors to Take in Preparation for the End of the COVID-19 National Emergencies (PDF)

"[This article provides] a summary of the deadlines that the end of the Outbreak Period will impact and the steps that plan sponsors and administrators should take to prepare. Keep in mind that plan sponsors and administrators will need to assess each affected individual to determine whether the tolling deadline ends one year from the date the individual was first eligible for relief or 60 days after the announced end of the COVID-19 national emergency."  MORE >>

Hunton Andrews Kurth LLP, via Employee Benefit Plan Review

[Guidance Overview]

Group Health Plans Must Submit Gag Clause Attestations by December 31, 2023

"[P]lan sponsors should review their agreements with their TPAs and other service providers to identify gag clauses and amend accordingly. Plan sponsors should also coordinate with their insurers and service providers to determine who will be submitting the required attestation."  MORE >>

Trucker Huss

[Guidance Overview]

Bloomington MN Clarifies Requirements Under Its Earned Sick and Safe Leave Ordinance

"The City of Bloomington's Earned Sick and Safe Leave (ESSL) Ordinance is set to go into effect on July 1, 2023. In light of the upcoming effective date, the City recently posted Initial Rules implementing the Ordinance and providing additional guidance to employers."  MORE >>

Jackson Lewis P.C.

Federal Independent Dispute Resolution Process: Status Update (PDF)

"Between April 15, 2022 and March 31, 2023 disputing parties initiated 334,828 disputes through the federal IDR portal. This case load is nearly fourteen times greater than the Departments initially estimated the caseload would be over the course of a full calendar year.... Certified IDR entities rendered payment determinations in 42,158 disputes.... Overall, certified IDR entities have closed 106,615 disputes as of March 31,2023, over four times the volume the Departments initially estimated for a calendar year."  MORE >>

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

Senate Finance Committee Releases Framework for Pharmacy Benefit Manager Reform

"The framework identifies four 'key challenges' within the PBM industry requiring policy solutions: [1] a lack of transparency into financial flows and incentives that inform drug pricing, [2] barriers to pharmacy access, [3] 'behind-the scenes' practices that impede competition and drive up out-of-pocket costs, and [4] misaligned incentives resulting from the relation between PBM compensation and drug list prices.... The framework provides ... examples of legislative solutions under current Committee consideration."  MORE >>

Wiley Rein LLP

2023 Benefits Enrollment Communication Trends

"More than half of employers (52%) have taken action to enhance the enrollment experience, while another third (34%) are looking to do so.... 84% of companies are citing a greater emphasis on DEI.... 2 in 5 employees are expected to work remotely in the future. Be sure you're meeting employees where they are, no matter the location, time of day, or what device."  MORE >>

Willis Towers Watson

Workplace Supplemental Health Product and Disability Insurance Sales Had Strong Year in 2022

"New annualized premium for supplemental health products jumped 12% in 2022. U.S. workplace disability new premium increased 8% in 2022. U.S. workplace life insurance new premium fell 1% from 2022."  MORE >>


Employee Benefits Jobs

View job as Retirement Plan Administrator
            for Estate and Pension Advisory Board (EPAB)

Retirement Plan Administrator

Estate and Pension Advisory Board (EPAB)

Remote / Cherry Hill NJ

View job as Retirement Plan Administrator for Estate and Pension Advisory Board (EPAB)

Selected New Discussions

DCAP Reimbursements After Return From Leave

"Hypothetical scenario: Employee properly elects to contribute $1,200 ($100 per month) to to her dependent care reimbursement plan (DCAP) account for 2023. Employee incurs $400 of qualified expenses in January and February of which she obtains reimbursement of $200 (because that's all she had contributed at that time). On March 1, 2023, she goes on leave (FMLA or non-FMLA leave; I don't think it matters) and elects to cease DCAP contributions at that time. On July 1, 2023, she returns from leave and elects to restart the DCAP. Can she use the $200 that she contributed in January and February (but was unable to use then) to reimburse expenses incurred in July through the end of the year or is that $200 forfeited? The cafeteria plan regulations discuss this for health FSA contributions (yes, she would be able to) but I have not been able to find anything discussing DCAP contributions."

BenefitsLink Message Boards

Webcasts and Conferences
(Health & Welfare Plans)

AICPA & CIMA Employee Benefit Plans Conference


American Institute of CPAs [AICPA]

Last Issue's Most Popular Items

CMS Fact Sheet: Hospital Price Transparency Enforcement

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

Health Plans Must Prepare for the End of COVID-19 Public Health and National Emergencies

Hanson Bridgett LLP

NLRB Requires Changes to Employee Severance and Other Agreements

White & Case LLP

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

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