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Health & Welfare Plans Newsletter

May 1, 2023

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[Guidance Overview]

All Good Things Must Come to an End: The Expiration of OCR's Enforcement Discretion

"OCR is providing a 90-calendar-day period to give covered entities and business associates relying on the telehealth services notification additional time to come into full compliance with the HIPAA rules. There is not a similar transition period for the other notifications. OCR will continue to exercise enforcement discretion for violations of the HIPAA rules which occurred during the PHE and are covered by the notifications."  MORE >>


[Guidance Overview]

Timeline of End Dates for Key Health-Related Flexibilities Provided Through COVID-19 Emergency Declarations, Legislation, and Administrative Actions

"The Biden Administration recently announced that it will end the PHE on May 11, 2023 and FEMA has announced that the emergency incident period under the Stafford Act will also end on that date. Other related emergency declarations or provisions have already ended or are ending soon. [A] table provides a timeline identifying key health-related flexibilities and provisions specified by these various measures, the specific measure that determines their end date, and their end date."  MORE >>

Henry J. Kaiser Family Foundation

[Guidance Overview]

Maryland Moves to Revise Paid Family and Medical Leave Insurance Program Implementation Dates

"The date for covered employers -- those with fifteen or more employees -- to begin contributing to the program has been delayed from October 1, 2023, until October 1, 2024. SB 828 also delays implementation of the date when employees can submit claims for benefits from January 1, 2025, until January 1, 2026."  MORE >>

Ogletree Deakins

District Court Finds Insurer Properly Applied ERISA Plan Language Prorating Plaintiff's Lump Sum Pension Benefits as an Offset to Long-Term Disability Benefits

"Plaintiff contends that Reliance incorrectly interpreted the Plan's Lump Sum Payments provision -- specifically the phrase 'period of time,' and argues that, under the unambiguous terms of the Plan, the offset for other income received as a lump sum should be applied to the time period from his retirement until his death.... The Court found that Plaintiff's interpretation is contrary to the unambiguous language of the Plan." [Walker v. Reliance Standard Life Ins. Co., No. 22-109 (E.D. Tenn. Apr. 24, 2023)]  MORE >>

Roberts Disability Law

No Surprises Act Working as Intended, But Gaps Remain, Leaving Patients Vulnerable

"The analysis ... found that patients appear to be protected from services that previously left them exposed to surprise billing, like air ambulance services. Additionally, ... the NSA is 'getting consumers 'out of the middle' of payment disputes between providers and payors. However, gaps remains in the law for other services like ground ambulance, which one state regulator noted can result in patients being billed nine out of 10 times"  MORE >>

HealthLeaders Media

New Bipartisan Senate PBM Bill Would Increase Transparency

"[The Pharmacy Benefit Manager Reform Act (S 1339)] would require PBMs to annually disclose: [1] The amounts paid directly or indirectly in rebates, fees, or any other type of compensation to brokers, consultants, and advisors who referred the employer plan to the PBM; and [2] The amount received, or expected to be received, by a PBM in rebates, fees, alternative discounts, or other remuneration paid by other entities in the pharmacy supply chain."  MORE >>

HR Policy Association [HRPA]

Employees Believe Work Is Negatively Impacting Their Mental Health

"One in three U.S. employees say their job has had a negative impact on their mental health over the past six months ... [N]early half of U.S. employees (45 percent) have higher expectations for the level of mental health support their organizations should provide, compared to last year."  MORE >>

Society for Human Resource Management [SHRM]; membership may be required to view article


ERIC and 30+ Employer Groups Support 'Pharmacy Benefit Manager Reform Act'

"ERIC and the employer groups called on Congress to  ... [1] Require complete and unrestricted PBM transparency ... [2] Ban so-called 'spread pricing,' which allows a PBM to charge an employer or patient more than the PBM actually pays for a drug. [3] Require 100% pass-through of rebates, discounts, fees, and other payments from drug manufacturers ... [4] Apply fiduciary standards to PBMs[.]"  MORE >>

The ERISA Industry Committee [ERIC]

Employee Benefits Jobs

View job as Senior Retirement Analyst
            for Dunbar, Bender & Zapf, Inc.

Senior Retirement Analyst

Dunbar, Bender & Zapf, Inc.

Remote / Pittsburgh PA

View job as Senior Retirement Analyst for Dunbar, Bender & Zapf, Inc.

Selected New Discussions

105(h) Testing

"If I have a controlled group where one entity maintains a fully insured plan and another entity maintains a self-insured plan. For 105(h) testing purposes for the self-insured plan, it will consider those benefitting under the fully insured plan as 'not benefitting' under the self-insured plan, correct?"

BenefitsLink Message Boards

Press Releases

Spectrum Pension Consultants CEO, Petros Koumantaros Accepted Into Forbes Finance Council

Spectrum Pension Consultants, Inc.

Cohen & Buckmann, P.C. Expands ERISA and Employee Benefits Practice Jeffrey Mamorsky and Terry Moore Join the Firm

Cohen & Buckmann P.C.

Recordkeeper Enables Fiduciaries to Provide Superior Qualified Default Investment Alternatives (QDIAs)

Target Date Solutions

Webcasts and Conferences
(Health & Welfare Plans)

The End of the Covid-19 National Emergency: What Plan Sponsors Need to Know

May 25, 2023 WEBINAR

Boutwell Fay LLP

Last Issue's Most Popular Items

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

Internal Revenue Service [IRS]

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

Trucker Huss

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

Hunton Andrews Kurth LLP, via Employee Benefit Plan Review

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

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