18 pages. "[CMS] is making available summary information on issuers' 2021 benefit year HHS-RADV results.... This memo contains an overview of the 2021 benefit year HHS-RADV error rate methodology, a summary of the 2021 benefit year HHS-RADV results, and information to assist issuers in understanding their results." [Also available: Appendix A: National Program Benchmarks -- 2021 Benefit Year HHS-RADV [XLSX]; Appendix B: 2021 Benefit Year RA State Market Risk Pool Weighted Average Error Rate [XLSX]; and Appendix C: 2021 Benefit Year HHS-RADV Failure Rate Group Definition [XLSX]]  MORE >>

"The new statute establishes a mandatory state-run insurance fund to help Washington residents pay for certain long-term care services, such as assisted living facilities, after retirement. The Act requires that employees to pay for the insurance through mandatory wage withholding premiums.... The deadline for an employee to apply for an exemption was June 1, 2023.... Employers must begin withholding employee premiums starting July [1] Covered workers will be eligible to use benefits starting July 1, 2026."  MORE >>

"The Seventh Circuit affirmed that the language in the plan made clear that severance benefits were contingent on the receipt of the 'memo,' which plaintiffs and other class members plainly did not receive. Plaintiffs argued that until October 2011, Northrop provided the 'memo' to every terminated employee who had worked a threshold number of hours -- they contended that the plan's change in course supported an estoppel theory. The Seventh Circuit rejected this argument[.]" [Carlson v. Northrop Grumman Severance Plan & Northrop Grumman Corp., No. 22-1764 (7th Cir. May 8, 2023)]  MORE >>

"The agreement, ... now finalized in a filing in the New Orleans-based 5th U.S. Circuit Court of Appeals, leaves the mandate in place nationwide while the administration appeals a court order striking it down." [Braidwood Management, Inc. v. Becerra, No. 20-0283 (N.D. Tex. Mar. 30, 2023); No. 23-10326 (5th Cir. joint stipulation and proposed order Jun. 12, 2023)]  MORE >>

"Regulation from CAA '21 is pushing employer-sponsored health care programs toward fiduciary rules that will look familiar to retirement plan advisers.... [These include] fiduciary responsibility to price shop for the best deal for employees; requirements to report drug pricing and pharmaceutical information to government regulators; and the monitoring of the direct and indirect compensation received by health industry broker/dealers.... As 2024 nears and CAA regulations hit key deadlines, the chances of lawsuits being filed against plan sponsors is going to rise[.]"  MORE >>

12 pages. "[This report documents] the prices of federally supported prescription drugs, focusing on treatments developed with the help of scientists from the U.S. National Institutes of Health (NIH). The average (median) price of new treatments that NIH scientists helped invent over the past twenty years is $111,000.... [For one drug,] NIH negotiated royalties of around 1% on sales, without any pricing constraints.... The average price of new treatments that NIH scientists helped invent over the past twenty years is now more than ten times the price that led NIH to first introduce a reasonable pricing clause in 1989."  MORE >>

"It is now possible to provide preimplantation genetic diagnostic (PGD) testing at the embryo stage of development.... With this technology, at-risk parents can combine PGD with in vitro fertilization (IVF) to select embryos for implantation that have been screened for the absence of the inherited disease.... Many commercial health plans exclude IVF as a benefit, and in 2017, only 26 percent of large employers offered an IVF benefit.... While there may be reluctance to add IVF as a benefit to address infertility, PGD-IVF potentially offers payers an intervention that could be cost-saving compared with the costs of care for patients with a single-gene defect."  MORE >>

37 pages. "A flexible work schedule is a particularly significant factor both in considering a move to another employer (49%) and in remaining with the current employer (38%). When considering benefits, young adults planning to change jobs in the next year cite paid time off (65%) and a flexible work schedule (58%) among the top four benefits influencing their choice of an employer. Young adults also seek flexibility in accessing benefits. Nearly three in four young adults (73%) indicate that they'd prefer to receive benefits that stay with them from job to job."  MORE >>