"[A letter from CMS, the Treasury Department, and the DOL] to employers, plan sponsors, and insurance issuers ... indicates that there are no legal impediments that would prevent a group health plan from allowing for a longer special enrollment period beyond the 60-day minimum period.... [E]mployers and plan sponsors should consider how their Code Section 125 (a/k/a cafeteria plans, flex plans, flexible benefit plans, or premium only plans) may include a limit on elections and if an interim amendment is necessary."  MORE >>

"In addition to the Proposed Rules, the agencies released the second report to Congress on the MHPAEA comparative analysis for nonquantitative treatment limitations. This report for the first time ... names specific plans that were found by the agencies to not be compliant with the comparative analysis requirement.... If finalized as proposed, the new requirements would be generally effective starting the first plan year starting on or after January 1, 2025. However, certain clarifications of existing rules are currently effective."  MORE >>

"As proposed, a plan will need to assess the expected dollar amount of all plan payments for medical/surgical benefits in the classification to determine whether the NQTL applies to 'substantially all' medical/surgical benefits, and then identify the most common or frequent variation of the NQTL for purposes of determining whether it is 'predominant.' ... The processes, strategies, evidentiary standards, or other factors used in designing and applying the NQTL to MH/SUD benefits in the classification must be comparable to, and applied no more stringently, than those used for designing and applying the NQTL to medical/surgical benefits in the same classification."  MORE >>

"[The proposed regulations] require plans or issuers to collect, evaluate, and consider the impact of data on access to mental health and substance abuse benefits before imposing an NQTL in a care classification. Obtaining data has been one of the greatest challenges of the NQTL comparative analysis requirement. The Departments recognize this and specifically request comments on how best to ensure plans and issuers can obtain the information they need from all the entities involved in designing and administrating the plan in support of their MHPAEA compliance efforts."  MORE >>

"Employers are not required to contribute to employee premiums or to the WA Cares Fund but are tasked with withholding and remitting the full amount of premiums when due. An employer that fails to withhold premiums from employee wages may not deduct premiums retroactively and must pay the missed premiums during regular quarterly reporting. The first reporting quarter will begin on October 1, 2023."  MORE >>

"[T]he Eighth Circuit's ruling upholding the application of a deferential standard of review conflicts with rulings issued by other federal circuit courts that have found the issuance of a tardy decision requires application of the de novo standard of court review, irrespective of the benefit plan's discretion-granting language. [The] ruling is also in conflict with views expressed by other courts as to the meaning of what constitutes substantial evidence." [McIntyre v. Reliance Standard Life Ins. Co., No. 21-3063 (8th Cir. Jul. 21, 2023)]  MORE >>

"The legal fight over the [ACA's] requirement that insurers and employers cover preventive services without cost-sharing is now before the federal Court of Appeals for the Fifth Circuit.... A diverse set of advocates, academics, organizations, and participants in the health care system filed amicus briefs in support of the government and urged the Fifth Circuit to reverse the lower court's decision. Brief overviews of the amicus briefs are provided [in this article] ." [Braidwood Management, Inc. v. Becerra, No. 20-0283 (N.D. Tex. Mar. 30, 2023; on appeal to 5th Cir. No. 23-10326)]  MORE >>

"[HHS and CMS] have responded to a May 2023 data breach in Progress Software's MOVEit Transfer software on the corporate network of Maximus Federal Services, Inc., a contractor to the Medicare program, that involved Medicare beneficiaries' personally identifiable information (PII) and/or protected health information (PHI). No HHS or CMS systems were impacted."  MORE >>

"California will release draft regulations July 31 on how the state will implement notice-and-review requirements for mergers and acquisitions under a health-care affordability bill enacted last year. A similar law in New York to review material transactions in health-care is slated to take effect Aug. 1. Minnesota, Rhode Island, Nevada, Massachusetts, Oregon, Connecticut, and Washington also have comparable laws[.]"  MORE >>

For plan years beginning in 2023 and later:

• Form for Summary Annual Report relating to Pension Plans [DOCX]
• Form for Summary Annual Report relating to Welfare Plans [DOCX]

For plan years beginning in 2022 and earlier:

• Form for Summary Annual Report Relating to Pension Plans [DOCX]
• Form for Summary Annual Report Relating to Welfare Plans [DOCX]

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"Most employees expect their employers to provide medical insurance, while paid family leave, dental, vision and life insurance are also highly valued benefits.... [B]enefits that promote wellbeing, including offerings focused on mental, physical and financial health, have become even more important to younger employees. Younger generations were much more likely to express interest in mental health treatment and physical wellness benefits, tuition and student loan assistance, and caregiving benefits."  MORE >>