"Plan sponsors with HDHP deductibles below the new minimums of $1,600 for self-only and $3,200 for family coverage will need to increase those deductibles in 2024. While the OOP maximums have increased for 2024, they are still below the maximum limits on cost sharing allowed in 2024 under the [ACA] of $9,450 for self-only and $18,900 for family coverage."  MORE >>

"ERISA does not require employers to offer health insurance. But for employers who choose to do so, the law holds them accountable to the coverage promises they make to employees. ERISA's goal is to ensure employers properly administer and explain their health plans to employees."  MORE >>

"Accident and health insurers and health maintenance organizations (HMOs) doing business in New York should consider new guidance from the New York Department of Financial Services ... Circular Letter 2023-2, issued on May 9, 2023, addresses the criteria to be used to determine a reasonable fee in an IDR context and reminds issuers and providers that they must submit all relevant information to the IDR entity at the time of application or upon the IDR entity's request."  MORE >>

15 pages. "This outline is designed to provide a general overview of the following laws pertaining to employee leaves of absence: the federal [FMLA], the New Jersey Family Leave Act, the New Jersey Security and Financial Empowerment Act, the New Jersey Temporary Disability Benefits Law, the New Jersey Workers' Compensation Act and the New Jersey Family Leave Insurance Law. This outline will also discuss in broad terms the interplay of these laws with each other and with employer leave of absence policies."  MORE >>

"Employees in Virginia will soon be eligible for up to 60 business days of unpaid organ donation leave and up to 30 days of unpaid bone marrow donation leave within a 12-month period."  MORE >>

"The most used drug in HCCI's data in 2021 was atorvastatin (various brand names, including Lipitor), a statin (i.e., to treat high cholesterol) with over 1 million unique users in HCCI's data.... The drug associated with the highest spending in HCCI's 2021 data was adalimumab (Humira), an anti-inflammatory drug used to treat rheumatoid arthritis. Adalimumab carried a price tag of over $7,000 for a 30-day supply in the HCCI data and was associated with close to $19 billion in spending when weighted to be representative of spending in the full ESI population in 2021."  MORE >>

"Similarities and differences were apparent among the insurers. While each had a similar number of NPIs and TINs included in their networks, the range of unique billing codes was extraordinary, ranging from fewer than 2,500 to more than 66,000.... Significant variation for each insurer is evident across all billing codes; similar variation can be seen among insurers.... This new pool of data is incredibly rich and offers many opportunities, but also poses some significant challenges related to the size, complexity, and quality of the data."  MORE >>

36 pages. "Most are satisfied with their current employer-provided coverage, and the vast majority prefer to get their coverage through their employer rather than through the federal or state government. A majority believe what they currently pay for coverage is reasonable, especially prescription drugs and copays and coinsurance.... A growing majority oppose taxing employee health benefits (+9% from June 2022) ... The vast majority consider it important for health insurance providers to cover telehealth services[.]"  MORE >>

"Both the House and Senate are considering multiple bipartisan bills concerning pharmacy benefit managers (PBMs), meaning action is likely this year. However, the timeline and path forward remain unclear, since the two bodies have not yet coordinated activity."  MORE >>

"[The authors] provide a simple guide on how to query and compile the insurer-disclosed data into a standardized pricing data set that can be used for empirical health policy research. [They] also identify a list of issues that insurers and policy makers could address to improve the usability of the data for the purpose of containing health care spending."  MORE >>

"A [recent OCR HIPAA] settlement agreement ... highlights the need for health plans and other HIPAA covered entities ensure servers are properly secured and that that they and every third party administrator, technology, audit, accounting and other plan service provider with access to protected health information can prove all necessary business associate agreements, security safeguards and other policies and practices are in place in the event of a HIPAA breach, audit or other compliance event."  MORE >>

"Under current regulations for price transparency disclosure by hospitals, insurers, and self-insured employers, CMS remains the only enforcer, and a politically ambivalent one at best. A bolder move would be to harness the fiduciary obligations of self-insured employer plan sponsors to act, in fact, not just in theory, as responsible stewards of their employees' health and welfare."  MORE >>

"The language in the Contractor's collective bargaining agreement with the union required the Contractor to assure that contributions for the Sub's employees be paid, but the language in the subcontractor agreement between the Contractor and Sub did not require the Sub to pay such contributions. The fringe benefit funds included pension/retirement and welfare funds." [Trustees of the Operating Engineers' Local 324 Pension Fund, v. Tri-City Groundbreakers, Inc., and Edw. C. Levy Co., No. 21-11080(E.D. Mich. Feb., 2023)]  MORE >>

"Flexible work hours were called out by 34% of employees and 40% of employers as a top benefit for remote workers. ... 26% of employees and 34% of employers named [work-provided equipment] a top remote-work benefit.... 17% of employees and 20% of employers named a home office stipend as a valuable perk for remote workers."  MORE >>

"Generative AI has the potential to transform the benefits communications landscape in a number of ways.... [1] Simplifying the complex and cumbersome ... [2] Creating content ... [3] Improving customer service ... [4] Generating ideas and brainstorming ... [5] Creating images."  MORE >>