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Health & Welfare Plans Newsletter

June 8, 2023

3 New Job Opportunities 3 New Job Opportunities


[Guidance Overview]

RxDC Reporting Requirement: Lessons Learned

"[1] Employers 'own' the D1 data.... [M]any vendors were willing to collect this data from their clients and file D1s (usually if the client adhered to a strict deadline), but some could not.... [2] The CMS HIOS system isn't 'employer friendly.' ... [3] HIOS wasn't intended to be used by individual employers.... [4] Coordination of data is likely to be a significant issue.... [5] Compliance with plan documentation requirements remains a significant issue.... [6] CMS can determine if an employer group does not file a D1.... [7] We don't know what RxDC reporting enforcement will look like."  MORE >>

MZQ Consulting, LLC

[Guidance Overview]

Upcoming Deadline icon PCORI Fee Due by July 31

"The Patient-Centered Outcomes Research Institute (PCORI) fee must be paid on Form 720 by July 31, 2023. Employers will need to include the PCORI fee in the one Form 720 that they file for the applicable second quarter, which is due by July 31, 2023. For the 2022 plan year, the PCORI fee per covered life depends on when the plan year ends."  MORE >>


[Guidance Overview]

IRS Doubles Down on Substantiation of Health and Dependent Care Expenses

"Even though the IRS allows self-certification in some contexts (for example, participants can self-certify for hardship and other withdrawals from tax-qualified retirement plans ...), the IRS has held firm that self-certification is not allowed for cafeteria plans.... the IRS, by following the proposed regulations in [Chief Counsel Advice Memorandum 202317020], is giving taxpayers fair warning that it does not agree with many of the shortcuts currently being used."  MORE >>

BDO Center for Healthcare Excellence and Innovation

[Guidance Overview]

Look-Back Method Is Beneficial But Complex Way to Calculate FMLA Time Off

"The look-back method of calculating how much Family and Medical Leave Act (FMLA) time off an employee has used during a 12-month period is the best way for employers to prevent FMLA leave abuse.... [E]very time an individual takes FMLA leave -- continuous, intermittent or reduced schedule -- the employer determines the individual's leave entitlement by offsetting the weeks of FMLA leave based on what was used in the preceding 12-month period[.]"  MORE >>

Society for Human Resource Management [SHRM]; membership may be required to view article

[Guidance Overview]

CMS Releases Updates to Hospital Pricing Transparency Rule

"CMS will now require a noncompliant hospital to submit a CAP within 45 days of receipt of the CAP request. A hospital must also fully comply with price transparency guidelines within 90 days of CMS issuing the request.... Failure by a hospital to submit a CAP to CMS within the 45-day deadline or failure by a hospital to comply within 90 days with price transparency guidelines will now result in the automatic imposition by CMS of [civil monetary penalties]."  MORE >>

Sheppard Mullin

[Guidance Overview]

Nevada Ends Public Accommodations COVID-19 Paid Leave

"The requirement for covered public accommodations facilities in Nevada's Clark and Washoe Counties to provide paid time off for employees experiencing COVID-19 symptoms or who have been exposed to COVID-19 expired May 17, 2023. The requirement ended when Governor Joe Lombardo signed Senate Bill No. 441, which repealed several COVID-era policies."  MORE >>


[Guidance Overview]

Colorado Amends Paid Sick Leave Law; Public Health Emergency Leave for COVID-19 Ends this Week

"In addition to the HFWA's original covered absences, once effective, the amended list of covered reasons for use of paid sick leave will include absences related to bereavement leave and certain closures or evacuations due to inclement weather, loss of power, or other unexpected events. The SB 23-017 amendments go into effect on August 7, 2023."  MORE >>

Seyfarth Shaw LLP

[Guidance Overview]

New Growth of State and Local Paid Leave Developments in the State of Washington

"Washington Paid Family and Medical Leave Act has been amended to, among other changes, provide employers with access to claim information that may be helpful in administering concurrent leave and supplemental benefit programs.... Seattle is the first city to pass permanent paid sick and safe time requirements for app-based, gig economy workers."  MORE >>


Ways and Means Committee Adopts Bills That Would Expand Health Benefit Options, Increase Flexibilities for Small Business Workers

"Workers and small businesses would get more flexibility and choice in their health insurance benefits under six bills adopted by the Ways and Means Committee. The legislation allows small businesses to reimburse employees for buying qualified health insurance, increases flexibility to better cover health care services for workers, and frees up small businesses to better serve their employees and customers."  MORE >>

Committee on Ways and Means, U.S. House of Representatives

Senate, House, and Agency Proposals Seek to Increase PBM Oversight

"In conjunction with the surge in state legislative efforts to regulate the pharmacy benefit manager (PBM) industry, Congress and federal agencies have ramped up PBM oversight efforts as part of the ongoing battle to lower prescription drug costs.... [This article highlights] recent Senate activity as well as a proposed bipartisan Senate and House bill that would impact PBM activity in the Medicaid-managed care space."  MORE >>


Employee Benefits Jobs

View job as DC Retirement Plan Analyst
            for Trinity Pension Consultants

DC Retirement Plan Analyst

Trinity Pension Consultants

Akron OH / Hybrid

View job as DC Retirement Plan Analyst for Trinity Pension Consultants

View job as Retirement Plan Consultant
            for ADP

Retirement Plan Consultant


KY / NJ / TX / Hybrid

View job as Retirement Plan Consultant for ADP

View job as Senior Health Benefits Consultant
            for Segal

Senior Health Benefits Consultant


CT / DC / GA / MA

View job as Senior Health Benefits Consultant for Segal

Press Releases

NFP to Acquire Virginia-based Actuarial Consulting Group and ACG Advisory Services, Expanding its Retirement and Wealth Management Capabilities and Scale

NFP Corp.

Hub International Expands Commercial Insurance, Employee Benefits and Retirement Capabilities with Acquisition of Seven Firms in Michigan

HUB International

Last Issue's Most Popular Items

Text of CMS Standard Form: 'Good Faith Estimate for Health Care Items and Services' Under the No Surprises Act (PDF)

Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

When Do Severance Payment Practices Create a Plan Subject to ERISA?

Dorsey & Whitney LLP

Dependent Care FSA Debit Card Substantiation


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

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