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Health & Welfare Plans Newsletter

May 19, 2023

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[Guidance Overview]

First Gag Clause Attestations Due December 31, 2023: What Group Health Plan Sponsors Need to Know

"Plan sponsors and carriers of fully insured plans are both required to submit a [Gag Clause Prohibition Compliance Attestation (GCPCA)]. [FAQs Part 57] provide that if the insurance carrier submits the GCPCA on behalf of the plan, the Departments will consider the plan (and insurer) compliant. Sponsors of fully insured plans, however, should confirm that the carrier will be submitting the GCPCA on the plan's behalf."  MORE >>

Hunton Andrews Kurth LLP

[Guidance Overview]

Preparing for the End of the COVID-19 Emergency: Deadline Tolling

"The DOL has indicated that plan fiduciaries should make reasonable accommodations to prevent the loss of or undue delay of benefit payments.... Plan sponsors might consider extending any upcoming deadlines to mitigate the impact on participants and beneficiaries during this transition.... Plan sponsors should consider reissuing prior disclosures made to participants about extension deadlines."  MORE >>

McDermott Will & Emery

[Guidance Overview]

IRS Issues Guidelines Regarding Substantiation of Expenses for Cafeteria Plans

"Chief Counsel Advice Memorandum 202317020 ... confirmed that it is not a compliant practice for employers to allow employees to self-certify or use certain other 'shortcut' mechanisms to substantiate that their medical expenses qualify for reimbursement."  MORE >>


[Guidance Overview]

Maryland Modifies Paid Family and Medical Leave Insurance Program, Including Implementation Delays

"[E]mployer and employee contributions to the Program will now begin on October 1, 2024, instead of October 1, 2023.... [E]ligible employees may begin using Program benefits on January 1, 2026, instead of January 1, 2025.... SB 828 [adopts] updated coordination of benefits language between FAMLI leave and employer-provided paid time off, including vacation, paid sick time, parental leave, and disability benefits."  MORE >>


[Guidance Overview]

Minnesota Passes State-Wide Earned Sick and Safe Leave Law

"The Minnesota legislature passed an Earned Sick and Safe Leave law (ESSL), [which] Governor Tim Walz has promised to sign ... The ESSL provisions, effective January 1, 2024, do not preempt other local paid sick and safe time laws but are similar to those in Minneapolis, St. Paul, and Bloomington ... All of the ordinances differ slightly, so employers must be conscious of the details. Duluth also has a paid sick and safe leave ordinance, but it differs more significantly from the other cities' laws."  MORE >>


Tenth Circuit Hears Argument on Preemption of Oklahoma PBM Legislation

"PCMA challenged the four provisions of the [Oklahoma] Act that: [1] Limit use of mail-order pharmacies; [2] Require [PBMs] to permit 'any willing pharmacy' to participate in the PBM's preferred network; [3] Prohibit cost-sharing discounts; [4] Restrict the ability of PBMs to deny or limit pharmacy contracts when a pharmacist is on probation with the state pharmacy board.... [The District Court held] that the challenged provisions of the Act were not preempted by ERISA. At oral argument, the Tenth Circuit seemed unconvinced by the state's arguments." [Pharmaceutical Care Management Assoc. (PCMA) v. Mulready, No. 19-0977 (W.D. Okla. Apr. 4, 2022; on appeal to 10th Cir. No. 22-6074, oral arg. May 16 2023)]   MORE >>

Miller & Chevalier

Benefits That Support Employees as Caregivers

"[1] Paid leave ... [2] Mental health services/EAP ... [3] Emergency/back-up care ... [4] Lifestyle spending accounts ... [5] Family planning and adoption benefits ... [6] Flexible work arrangements ... [7] Lactation support ... [8] Concierge services."  MORE >>

Cowden Associates, Inc.

Are U.S. Prescription Drug Prices 10 Times Those of Other Nations?

"[D]rug prices in the United States generally exceed those in other countries. The magnitude of the difference, however, varies depending on the drugs and the countries included in the comparison, among other factors."  MORE >>

KFF Health News


Can AI Solve the Problem of Rising Healthcare Costs?

"With some (potentially lifesaving) medications costing employers well over $1,000,000, do we really want an artificial intelligence tool determining who should and should not receive them in the future? Will AI be able to break from the status quo and craft innovative and effective solutions to the major challenges facing employers and employees? Or will it simply parrot back a compendium of popular approaches found on the internet?"  MORE >>

Chelko Center for Benefits Management

Benefits in General

[Guidance Overview]

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

"[C]ertain time periods and dates for special enrollment under [HIPAA], COBRA continuation coverage, and internal claims and appeals and external review [were] disregarded when determining the due dates for certain elections and other actions by employee benefit plans subject to ERISA and the Internal Revenue Code during the COVID-19 National Emergency. Retirement plan elections were also impacted by the Disregarded Periods."  MORE >>

Boutwell Fay LLP

Employee Benefits Jobs

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            for Pension Associates

Pension Consultant

Pension Associates

Remote / Stamford CT

View job as Pension Consultant for Pension Associates

Webcasts and Conferences
(Health & Welfare Plans)

Nuts & Bolts of Benefit Plan Administration

June 8, 2023 in OH

Worldwide Employee Benefits Network [WEB] - Northeast Ohio Chapter

thINc 360: The Healthcare Innovation Congress

June 20, 2023 in DC

thinc [The Healthcare Innovation Company]

Emotional, Physical & Financial Health and Wellbeing: Keeping Your Workforce Connected and Engaged

June 28, 2023 in MN

The Conference Board

Last Issue's Most Popular Items

Coverage of Medications Used for Weight Loss: What Employers Need to Know


Applying the ERISA Controlled Group and Affiliated Service Group Rules in the Health Care Industry

Foley & Lardner LLP

Is a Telehealth Benefit Subject to ERISA?

Thomson Reuters / EBIA

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

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