"Wellness indemnity payments under an employer-funded, fixed-indemnity insurance policy (including where the premium for the coverage is paid by employee salary reduction through a cafeteria plan under section 125 of the Internal Revenue Code ) are includible in the gross income of the employee if the employee has no unreimbursed medical expenses related to the payment. The exclusion under Section 105(b) is limited to amounts paid solely to reimburse expenses incurred for medical care and does not apply to amounts which the taxpayer would be entitled to receive irrespective of whether expenses for medical care are incurred. The exclusion from income in Section 105(b) does not apply to payments when the employee has no unreimbursed medical expense either because the activity that triggers the payment does not cost the employee anything or because the cost of the activity is reimbursed by other coverage."  MORE >>

"[E]mployers that have outsourced their FSAs' administration to third-party service providers should consult such provider to confirm that reimbursements and payments of FSA Expenses are being administered in compliance with the plan documents and the Regulations as reinforced by [Chief Counsel Advice Memorandum 202317020]."  MORE >>

"[E]mployers are permitted to use the federal poverty guidelines in effect six months prior to the beginning of the plan year to calculate affordability under the [federal poverty level (FPL)] safe harbor ... While the 2022 FPL can be used to determine the FPL safe harbor for plan years that begin before July 1, 2023, the 2023 FPL must be used for plans that begin on or after July 1, 2023.... Rate of Pay and W-2 safe harbors are calculated the same regardless of plan year start."  MORE >>

"Payroll tax withholding under the Washington Long Term Care Act will begin on July 1, 2023, for companies with employees in Washington State, unless an employee qualifies for an exemption.... [E]mployers need to not only prepare themselves to withhold that tax, but also identify those employees who are exempt from the withholding."  MORE >>

"The court explained that the provision relied on in Hall does not implicate jurisdiction. Instead, Section 1132(e) expressly references jurisdiction and provides no jurisdictional limitation on who can be sued under Section 1132. That a participant might not be able to enforce a money judgment against a former TPA does not mean that he lacks standing to sue that TPA." [Shafer v. Zimmerman Transfer, Inc., No. 22-2275 (8th Cir. June 7, 2023)]  MORE >>

"71% of all stop-loss claims came from the top 10 conditions. While cancer continues to be the largest driver of high-cost claims, cardiovascular disease rose ... to the #2 claim condition in 2022... 11 of the top 20 high-cost injectable drugs are related to the treatment of cancer.... Approximately one in nine employers (11%) experienced a birth-related stop- loss claim in the four-year benefit period of 2018 through 2021. Newborn/ infant care ... has one of the highest average costs at $371.8K. 20% of employers had at least one member with over $1M in claims during the four-year benefit period from 2018 through 2021."  MORE >>

"Two key House committees voted this week to send a series of health care bills to the House floor, including legislation to make permanent the ability of health savings account-qualifying high-deductible health plans (HSA-qualifying HDHPs) to cover telehealth and other remote care services on a predeductible basis."  MORE >>

"[B]etween 2000 and 2021, the premium payments employees must make for their workplace-sponsored health insurance plans grew by 295%, more than three times as much as the 88% increase in household income and 60% general inflation.... Analysts counted more than $3 billion in commercial 'excessive spending' in 2021 on seven categories: prescription drugs, labs, specialty services, imaging, endoscopies and colonoscopies, inpatient stays, and clinician-administered drugs."  MORE >>

"[Coalition members] are exceedingly concerned about states' efforts to enact legislation that erode the ability of self-insured employers to offer uniform benefits nationwide under the authority of the ERISA's pre-emptive provisions.... Employers are in the best position to design benefits in the way that best meets the needs of employees and their families. Protecting ERISA preemption, and by extension the ability of multi-state employers to offer uniform benefits is key to maintaining the system of employer-provided benefits; this system and coverage is contingent on preserving nearly fifty years of ERISA preemption."  MORE >>

"Streamline employer reporting requirements under the [ACA] ... Promulgate regulations updating electronic delivery rules and other guidance for providing applicable notices and making participant elections ... Matching contributions for student loan payments ... Catch-up contributions ... Emergency savings for working Americans ... Clarify the automatic enrollment mandate exemption for existing plans ... Overpayments and self-correction ... Optional Roth match ... Notice and disclosure ... Missing participants, including guidance on uncashed checks ... Remote witnessing ... In-service distributions ... Paid leave."  MORE >>