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Health & Welfare Plans Newsletter

May 11, 2023

5 New Job Opportunities 5 New Job Opportunities


[Guidance Overview]

IRS Explains FSA Substantiation Rules

"These rules are not new, so it is not clear why there was a need for the [Chief Counsel Memorandum] at this time. The issuance of this CCA might signal that the IRS is beginning to educate auditors on the substantiation rules and the tax consequences of not complying with these rules.... [A frequent question] is whether it is necessary to substantiate very small expenses, such as those in the $5 or less range. Based on this and earlier IRS guidance, the answer from the IRS' perspective is yes."  MORE >>

Groom Law Group

[Guidance Overview]

PCORI Deadline Is Just Around the Corner

"Self-insured plan sponsors can satisfy their compliance obligations by completing and filing Form 720, with its accompanying 720-V payment voucher. Although Form 720 is a quarterly return, for PCORI, Form 720 is filed annually only, by July 31. The updated form can be found here, and the PCORI fee reporting can be found in Part II, Line 133."  MORE >>


[Guidance Overview]

Plan Sponsor Considerations for COVID-19 Vaccine Coverage at the End of the COVID-19 Emergency Declarations

"[G]roup health plan sponsors should consider ... [w]hether the group health plan will continue to cover out-of-network COVID-19 vaccines at no cost, or at all. Insured plans should reach out to their insurers to confirm what the insurer has decided to cover. Self-insured plans should work with their third party administrators to determine what coverage options are available after the end of the PHE."  MORE >>


Self-Funded Health Plans: Breaking the Myths to Find Cost Savings

"Size is not the determining factor in whether your company should self-fund its health plan.... The only real risk a company with a self-funded health plan takes on is cash flow variability.... Companies that self-fund save money in the long term -- usually 8 -- 10% on average.... Self-funded plans are significantly more flexible -- meaning you can design your plan, decide whether you want to comply with state mandates or not, and carve out portions of your plan to different vendors that specialize in different areas."  MORE >>

Woodruff Sawyer

PBMs, the Brokers Who Control Drug Prices, Finally Get Washington's Attention

"The three biggest PBMs ... control about 80% of prescription drug sales in America ... While serving as middlemen among drugmakers, insurers, and pharmacies, the three corporations also own the highest-grossing specialty drug and mail-order pharmacies.... [T]he complexity and obscurity of their role in the drug marketplace have skeptics wondering whether legislation advancing in the House and Senate will actually help patients or lower prices at the pharmacy counter."  MORE >>

KFF Health News


Health Care Megatrends: Patient Care

"Over the next five years, primary care will be enhanced to provide more comprehensive care, manage patients, and reduce costs.... Increased demand, general public concern, and more access channels point to a trend that should finally culminate in mental health parity.... Improving maternity care is finally being recognized as a major issue and is rising on the agenda for politicians, insurance plans, and health systems.... Multiple factors are converging to alter behavioral and social factors to improve health outcomes."  MORE >>

Health Affairs Forefront

Benefits in General

Clarifying the 'Reasonable Fee' Rule

"[N]either the DOL nor ERISA defines steps for determining the reasonableness of vendors' fees.... Years spent interpreting ERISA's vague vendor monitoring principle to employers have led to the formulation of five proven compliance action steps. [1] Read the vendor's disclosures.... [2] Verify that vendors adhere to their contracts.... [3] Establish key performance indicators.... [4] At least annually assess and confirm vendors' compensation for reasonableness.... [5] Factor the broad view into vendor management."  MORE >>

Roland Criss

Employee Benefits Jobs

View job as Distribution Specialist
            for Atlantic Pension Services Inc.

Distribution Specialist

Atlantic Pension Services Inc.

Remote / Kennett Square PA / DE / MD / NJ

View job as Distribution Specialist for Atlantic Pension Services Inc.

View job as Actuary
            for Alerus




View job as Actuary for Alerus

View job as ESOP Consultant
            for FuturePlan, by Ascensus

ESOP Consultant

FuturePlan, by Ascensus

Remote / Chicago IL

View job as ESOP Consultant for FuturePlan, by Ascensus

View job as Client Service Manager
            for Newport, an Ascensus Company

Client Service Manager

Newport, an Ascensus Company

Remote / Houston TX

View job as Client Service Manager for Newport, an Ascensus Company

View job as Recordkeeping Service Consultant
            for NestEggs Retirement Plan Services Inc.

Recordkeeping Service Consultant

NestEggs Retirement Plan Services Inc.


View job as Recordkeeping Service Consultant for NestEggs Retirement Plan Services Inc.

Selected New Discussions

Employee Voluntarily Drops Group Coverage in Favor of Medicare -- Qualifying Event for COBRA?

"Employee wants to voluntarily drop group health coverage mid plan year (remain an active employee) and enroll in Medicare. The employer allows for this as a Life Event for dropping coverage, but I don't believe this a COBRA event as it is a voluntary drop of coverage and not an actual COBRA event. This in turn will affect the employee's spouse/dependents. Because the CMS website is very generic in this response and my reference materials don't mention voluntary drop, I'm having difficulty in providing information that will satisfy the employee, client, etc."

BenefitsLink Message Boards

Press Releases

Boost Your Equity Comp Literacy With The myStockOptions Glossary App

DataPath Receives Two Communicator Awards

DataPath, Inc.

Annuity Offers Due Diligence with ERISA Expert Standards; Bridging the Gap Between Institutional and Retail For 401(k) Plans

Annuity Research & Consulting™ [ARC]

Vestwell Partners with Leading Advisory and Asset Management Firms


Last Issue's Most Popular Items

HHS Fact Sheet: End of the COVID-19 Public Health Emergency

U.S. Department of Health and Human Services [HHS]

The Presidentially Declared COVID-19 National Emergency Is Over

Miller Johnson

DOL Publishes a New (Eggplant-Colored) FMLA Poster

FMLA Insights

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

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