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Health & Welfare Plans Newsletter

June 5, 2023

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[Guidance Overview]

Healthcare Reform Preventive Services (PDF)

16 presentation slides review [1] The most recent recommendations from the US Preventive Services Task Force, along with developments in the ongoing legal challenge to those ACA requirements. [2] Changes to COVID-19 vaccine and testing requirements now that the public health emergency has officially ended. [3] Proposals to modify religious exemptions and eliminate moral exemptions from ACA"s contraceptive coverage rule and related litigation.  MORE >>

Mercer

[Guidance Overview]

Minnesota's New Paid Family and Medical Leave, and Mandated Sick Leave

"Minnesota has become the 12th state to adopt a statewide paid program for employees during family and medical leaves. It also joined the more than 40 state and local jurisdictions mandating paid sick leave. Eligible Minnesota employees will be entitled to up to 48 hours of paid sick and safe leave and 20 weeks of family leave benefits."  MORE >>

Jackson Lewis P.C.

[Guidance Overview]

Florida Passes the Florida Prescription Drug Reform Act

"SB1550 takes effect on July 1, 2023, and imposes significant new requirements on PBMs.... [1] Licensing and reporting requirements for PBMs. [2] Required contractual terms for agreements between a PBM and a pharmacy benefits plan or program and agreements between a PBM and a participating pharmacy. [3] Annual attestation requirement."  MORE >>

OneDigital

[Guidance Overview]

Colorado Sick Leave Requirements Expanded to Cover Absences for Bereavement and Inclement Weather

"[An] employer in Colorado [must] allow an employee to take protected leave to: [1] 'grieve, attend funeral services or a memorial' ... [2] 'care for a family member whose school or place of care has been closed due to inclement weather, loss of power, loss of heating, loss of water, or other unexpected occurrence or event that results in the closure of the family member's school or place of care'; or [3] 'evacuate the employee's residence due to inclement weather, loss of power, loss of heating, loss of water, or other unexpected occurrence or event that results in the need to evacuate the employee's residence.' SB 23-017 is expected to take effect on August 7, 2023."  MORE >>

Ogletree Deakins

Ninth Circuit Revives ERISA Breach of Fiduciary Duty Claim for Longtime Miscalculation and Payment of Disability Benefits

"Aetna provided Morris with individualized consultations with benefit counselors, consulted with her by phone about her benefit amount numerous times, and communicated with Morris's financial institutions to verify her benefit amount. The court found that these actions amounted to a fiduciary act." [Morris v. Aetna Life Insurance Company, No. 21-56169 (9th Cir. Jun. 2, 2023; unpub.)]  MORE >>

Roberts Disability Law

Departments Enforce Protections for Autism Treatments Under the MHPAEA

"[A]ccording to estimates from [CDC] ... approximately 1 in 36 children in the United States may have some form of [autism spectrum disorder (ASD)]. Given the prevalence of this disorder and the benefits that can come from early childhood intervention, enforcement for treatment options has become a priority for the Departments."  MORE >>

OneDigital

Rethinking How Employers Address High-Cost Healthcare Claims

"High-cost claims have become the single fastest-growing healthcare cost for employers in the last decade and were identified as one of the 'most significant threats to employer-sponsored healthcare' in a recent ... survey. This report offers insights and action steps to help employers mitigate the effect of high-cost claims."  MORE >>

National Alliance of Healthcare Purchaser Coalitions

How Your Benefit Programs Can 'Invest in Our Planet'

"Customizing discounts and expanding these programs to include energy efficient appliances, electric vehicles, solar panels and sustainable travel is an easy way to highlight 'green' practices ... Providing just one day of volunteer time off per year can afford employees much-desired time to support their favorite organizations[.]"  MORE >>

Willis Towers Watson

Benefits in General

[Official Guidance]

Text of EBSA Meeting Notice for ERISA Advisory Council

"[T]he 216th open meeting of the [ERISA Advisory Council] will be held on July 17-19, 2023 ... [in] Washington, DC ... The meeting will also be accessible via teleconference and some participants, as well as members of the public, may elect to attend virtually.... On July 17 and July 19, the purpose of the open meeting is for Advisory Council members to hear testimony from invited witnesses on ... [1] Long-Term Disability Benefits and Mental Health Disparity, and [2] Recordkeeping in the Electronic Age.... On July 18, the purpose of the open meeting is for the [DOL] to consult with the Advisory Council on section 2509.95-1 of title 29, Code of Federal Regulations (relating to the fiduciary standards under [ERISA] when selecting an annuity provider for a defined benefit pension plan), as required by Section 321 of the SECURE 2.0 Act[.]"  MORE >>

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

Employee Benefits Jobs

View job as Senior Benefits Administrator
for First Hill Trust Company

Senior Benefits Administrator

First Hill Trust Company

Remote / Seattle WA / Hybrid

View job as Senior Benefits Administrator for First Hill Trust Company

Selected New Discussions

Marriage and Family Therapy Coverage

"We have a self-funded client whose attorney mentioned the DOL recently subpoenaed a TPA regarding plan documents that exclude Marriage & Family Therapy. The attorney feels the self-funded medical plan may want to be amended to cover it based on the DOL's subpoena/the topic being on the radar. Does anyone have knowledge of which case this is in reference to? If so, can you please link it? The TPA (BUCA) hasn't heard anything of such a subpoena and has no clients that cover Marriage and Family Therapy. I've got e-mails out to our internal Compliance Team and the TPA's. Any other advice? We do not have a client with any carrier that covers this type of therapy at present."

BenefitsLink Message Boards

Webcasts and Conferences
(Health & Welfare Plans)

Defending Against ERISA Wrongful Denial of Benefits Claims: Procedural and Substantive Strategies

July 26, 2023 WEBINAR

Strafford

Last Issue's Most Popular Items

Four Key (and Surprising) Points for Navigating FMLA Leave

Ogletree Deakins

Maximize Employer-Sponsored Health Plan Savings with Reference-Based Pricing

OneDigital

Seventh Circuit Affirms Plan Sponsor’s Discretion for Severance Benefits

Groom Law Group

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

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