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Health & Welfare Plans Newsletter

May 17, 2023

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[Guidance Overview]

IRS Announces 2024 Limits for HSAs, HDHPs and Excepted Benefit HRAs

"All of the dollar limits currently in effect for 2023 will change for 2024, with the exception of one limit. The HSA catch-up contribution for individuals ages 55 and older will not change as it is not subject to cost-of-living adjustments."  MORE >>

McDermott Will & Emery

[Guidance Overview]

The Section 125 Tag-Along Rule

"The tag-along rule derives from the Section 125 permitted election change event rules to allow employees to enroll existing dependents mid-year upon experiencing a qualifying life event. Employers can also rely upon the tag-along rule to enroll the employee where necessary to facilitate a dependent's mid-year enrollment."  MORE >>


[Guidance Overview]

The End of the COVID Emergency and Its Impact on Group Health Plan Coverage Requirements

"[FAQs Part 58] make clear that high deductible health plans (HDHPs) can continue to cover pre-deductible COVID-19 testing and treatment without affecting eligibility for a health savings account (HSA). However, the FAQs state that this relief will only last until the IRS issues further guidance."  MORE >>

Husch Blackwell

[Guidance Overview]

Third Party Administrator and Pharmacy Benefit Manager Licensing and Compliance Developments

"Florida Governor Ron DeSantis recently signed a new law that significantly increases the regulation of pharmacy benefit managers (PBMs) doing business in Florida. The new law will go into effect on July 1, 2023.... [It] will significantly change how PBMs are regulated in Florida and will dramatically expand the Florida OIR's authority to license and regulate PBMs."  MORE >>

Polsinelli PC

Seventh Circuit Affirms That ERISA Plan Sponsors Do Not Act as Participants' Fiduciaries and Must Follow the Terms of the Plan as Written

"More than 10 years after Plaintiffs filed suit ... the Seventh Circuit put to rest the idea that a sponsor of an ERISA welfare-benefit plan is a fiduciary of the plan's participants. Instead, per the ruling in Carlson, the sponsor is obligated to follow the terms of the plan as written. When the plan grants the sponsor discretion to determine who qualifies, the sponsor may exercise that discretion and may even change the way it exercises that discretion over time." [Carlson v. Northrop Grumman Severance Plan & Northrop Grumman Corp., No. 22-1764 (7th Cir. May 8, 2023)]  MORE >>

Duane Morris LLP, via Lexology; free registration required

Tenth Circuit Finds United Behavioral Health Arbitrarily and Capriciously Denied Residential Treatment Benefits to Minor with Severe Mental Health Disorders

"The court rejected United's argument that the ERISA regulations only require an administrator to explain the basis of disagreement with treating physicians with respect to long-term disability claims.... The detailing of more precise requirements in ERISA disability claims does not absolve United of providing a full and fair review for health benefit claims.... ERISA holds administrators to their greater fiduciary duty. This includes not only complying with the specific duties imposed by the plan or the minimum standards imposed by the regulations, but engaging in activities that achieve the objective of the plan." [D. K. v. United Behav. Health, No. 21-4088 (10th Cir. May 15, 2023)]  MORE >>

Roberts Disability Law

Assessing Your Health Plan's Service Provider Compensation

"Members of the ERISA plaintiffs' bar have signaled interest in seeking to hold health plan fiduciaries responsible for reviewing service provider compensation disclosures and ensuring that plans pay no more than reasonable fees for brokerage and consulting services. This may apply equally to unfunded and fully insured health plans ... Based on the types of claims and allegations raised in retirement plan excessive fee litigation, there are several action items health plan fiduciaries may consider to mitigate risk."  MORE >>

Morgan Lewis

Infertility Coverage Remains Limited

"[C]overage of fertility treatments can be hard to find in many corners of health insurance even as it grows briskly with big employers who see it as a must-have benefit to keep workers.... Clouding this picture are insurer concerns about cost as well as questions about how much fertility coverage should be emphasized or mandated versus helping people find other ways to build families, such as adoption."  MORE >>

Fox 23 News

Employers View Well-Being as Key Part of Workforce Strategy, Despite Economic Pressures

"Despite ongoing economic pressures, many employers said this heightened focus on well-being resulted from the physical and mental toll of the pandemic and indicated that they would maintain or boost their investment in well-being programs. More specifically, nine in 10 (90%) employers stated that the current economic environment would not lead to a reduction in their investment in well-being and three in 10 (31%) planned to increase their investment."  MORE >>

Business Group on Health

House Members Press Cigna for Clarification After Investigative Report Accuses Insurance Company of Denying Claims Without Reading Them

"80 percent of Medicare Advantage coverage denials were overturned, suggesting that Cigna's PXDX review process is leading to patients paying out-of-pocket for medical care that should be covered under their insurance policy contract. The Chairs requested Cigna turn over documents related to the PXDX process and answer [specified] questions by May 30, 2023."  MORE >>

Energy & Commerce Committee, U.S. House of Representatives

Benefits in General

[Official Guidance]

Text of EBSA Technical Corrections to Final Regs: Annual Reporting and Disclosure

"On February 24, 2023, [EBSA] published a final rule on annual reporting requirements under Title I of [ERISA] This document contains two technical changes to the regulations: it changes the operational date of the final rule amendments to the regulations ... [and] corrects a typographical error in the lettering of a paragraph in the regulations.... This final rule is effective May 31, 2023. The operational date of the amendments ... is changed from April 25, 2023, to May 31, 2023."  MORE >>

Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

Employee Benefits Jobs

View job as DB/DC Plan Administrator
            for Benefit Associates, Inc.

DB/DC Plan Administrator

Benefit Associates, Inc.

Remote / Huntington Beach CA

View job as DB/DC Plan Administrator for Benefit Associates, Inc.

Selected New Discussions

PFML Reported in Form 5500

"We have more and more clients from NY and MA for instance who want PFML reported in the Form 5500 for health and welfare. It is deemed as self-insured. We need to list the benefit code on page two. Would you suggest using 4Q and note list PFML? We assume to list PFML in the SAR as well. Any thoughts/feedback?"

BenefitsLink Message Boards

Press Releases

JULY Announces Third Acquisition Transaction of 2023 with HTLF’s Retirement Plan Recordkeeping and Administration Business

JULY Business Services

Webcasts and Conferences
(Health & Welfare Plans)

Employee Leaves & Accommodations: The Fundamentals and Common Pitfalls

May 23, 2023 WEBINAR

Fisher Phillips

Last Issue's Most Popular Items

Text of IRS Rev. Proc. 2023-23: 2024 Inflation Adjusted Amounts for Health Savings Accounts (HSAs) and Excepted Benefit Reimbursement Arrangements (HRAs) (PDF)

Internal Revenue Service [IRS]

Controlled and Affiliated Service Group Rules for Retirement and Cafeteria Plans: An Overview


The Consolidated Appropriations Act and PBM Transparency

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

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