"[Notice 2023-37] puts a deadline on the relief described in Notice 2020-15, issued in March 2020, by saying it applies only to plan years ending on or before Dec. 31, 2024."  MORE >>

"The 2022 MHPAEA Report Io Congress reflects [the agencies'] most recent enforcement efforts ... [The EBSA] autism working group ... reviewed autism coverage quantitative treatment limitations and NQTLs to determine subjects for the investigations ... and to identify the insurers and plans that might include limits that violate MHPAEA. Exclusions of ABA therapy (or other services used to treat autism) were the primary NQTLs found to be noncompliant in the audited plans. "  MORE >>

"[CCA 202323006] generally provides that if an employee receives a wellness indemnity payment under a fixed indemnity health insurance policy and the employee paid the premiums by a pre-tax salary reduction through a cafeteria plan, the payment will be included in the employee's gross income as wages subject to FICA, FUTA, and Federal income tax withholding to the extent the employee does not have any unreimbursed out-of-pocket medical expenses related to the payment. This is the fourth CCA the IRS has released on this topic."  MORE >>

"Plaintiff, who resides in San Francisco, is the successor trustee of Mr. Morrison's trust and the co-conservator of his estate.... Plaintiff was not the plan participant, and instead only administered the plan benefits via a Connecticut special-needs trust.... [T]he alleged underpayment of plan benefits harmed the plan participant in Connecticut. As such, the overall factual context shows that the operative facts occurred in Connecticut and that state has a far greater local interest in the controversy." [Hammer v. JP Morgan Chase Long-Term Disability Benefit Plan, No. 22-6886 (N.D. Cal. June 16, 2023)]  MORE >>

"[In] aggregate, A and B-rated services account for only 2.4 percent of total employer spending on health care. If employers were allowed and chose to impose 20 percent cost-sharing on all the A and B-rated services and medications that are measurable in claims data for individuals under age 65, employer spending would fall by 0.48 percent.... [As] enrollees reduce use of A and B-rated preventive services, other health care costs may increase."  MORE >>

"Six months into the 118th Congress ... PBM reform has, as expected, risen to the top of the list of topics in the conversation about reducing runaway drug prices.... [This alert] will highlight the major topics of the debate in Congress and provide a summary of committee efforts. [The authors] also address recent agency action and [offer] predictions for the remainder of this Congress."  MORE >>

"While state PBM laws may intend to lower prescription drug costs and protect consumer pharmacy choices, increasing state regulatory authority potentially erodes ERISA's protection of employer-sponsored health plans. These laws often result in increased costs to plan sponsors, which may ultimately lead to higher premiums for plan participants."  MORE >>

"[1] Get buy-in and assess the need ... [2] Determine the type of program to offer based on employee need and demographics ... [3] Educate your employees and communicate to launch the program ... [4] Consider the administrative and compliance burden of implementation ... [5] Partner with experts."  MORE >>

"If you were to make a 'pros and cons' list ... you might see that numerically, there are more cons that pros. But ... the quality of the overall benefit should be evaluated. Overall, when a participant is aware of the requirements and limitations, evaluates their individual situation, and carefully plans for the use of the DCFSA, the tax savings on a necessary expense makes it all worthwhile."  MORE >>

"According to the latest numbers gathered by Pew Charitable Trusts, states collectively reported $749 billion in OPEB liabilities with only about $69 billion in assets to pay for them, resulting in a funding ratio of under 10%.... Pew developed a metric ... to measure whether a state's contributions are sufficient to keep the gap between OPEB assets and OPEB liabilities from growing on an annual basis.... [S]tates collectively fell short of the benchmark by $30 billion in 2019, with just 10 states meeting the benchmark."  MORE >>