"The [ACA] benchmark for determining the affordability of employer-sponsored health coverage will drop significantly to 8.39% of an employee's household income for the 2024 plan year -- down from the 2023 plan-year level of 9.12% ... [E]mployers that use the exact safe harbor dollar amount to set employee contributions will need to reduce the current employee contribution for the lowest-cost, self-only option for the 2024 plan year."  MORE >>

"In order to avoid a potential section 4980H(b) penalty an employer must make sure one of its plans provides minimum value and is offered at an affordable price. An actuary will determine whether the minimum value threshold has been satisfied and this is generally not an issue for employers. However, an employer is in control as to whether the plan it is offering meets the affordability threshold."  MORE >>

"The [Section 4980H(a)] penalty for 2024 is $247.50 per full-time employee (less the first 30 employees) for each month they had no offer of minimum essential coverage.... The [Section 4980H(b)] penalty for 2024 is $371.66 per full-time employee for each month they had no offer of minimum essential coverage."  MORE >>

"What remains unclear ... is how Health Plans can demonstrate MHPAEA compliance.... Reading between the lines, it's clear that the Departments recognize the difficulties many plan sponsors have faced in obtaining the information required to demonstrate MHPAEA compliance. And, pending issuance of the final regulations, this inherent tension between plan sponsors' MHPAEA compliance obligations and their ability to comply remains."  MORE >>

"With the fall college semester quickly approaching, the [IRS] today reminded employers and employees that under federal law, employers who have educational assistance programs can use them to help pay student loan obligations for their employees.... Though educational assistance programs have been available for many years, the option to use them to pay student loans has been available only for payments made after March 27, 2020, and, under current law, will continue to be available until Dec. 31, 2025."  MORE >>

"By clearly allowing for reprocessing of claims as a remedy, in appropriate circumstances, for claims brought under ERISA section 502(a)(1)(B), the court's latest opinion eliminates some confusion created by its January 2023 analysis. That said, the court again concluded that the district court erred in holding that reprocessing of claims is 'appropriate equitable relief' for fiduciary breach claims under section 502(a)(3), because it was not relief typically available in equity under analogous circumstances." [Wit v. United Behavioral Health, Nos. 20-17363 and 21-15193 (9th Cir. Aug. 22, 2023)]  MORE >>

"States will no doubt continue to attempt to rein in the power of PBMs -- the court noted that PBMs administer prescription drug benefits for approximately 270 million people -- and courts will continue to examine ERISA's preemptive effect on various state PBM laws. Ultimately, the court suggested, states may have to approach Congress to seek redress for their displeasure with PBMs." [PCMA v. Mulready, No. 19-0977 (10th Cir. Aug. 15, 2023)]  MORE >>

"The most important thing you can do is educate your employees on proper security and privacy practices.... If you're not using it already, you need to seriously consider using multi-factor authentication (MFA) to protect your data and systems.... Encryption is another technology that is not new, not very expensive, and provides great protection when laptops, disks, mobile phones, or thumb-drives are lost or stolen, as they inevitably will be."  MORE >>

"Blue Shield of California has announced its intentions to stop using most of CVS Health's PBM services by early 2025 and open their doors to others including Amazon.com's struggling pharmacy dispensing service and entrepreneur Mark Cuban's firm Cost Plus Drugs."  MORE >>

"A quality health plan should provide easy, direct access and understanding of pricing and advanced explanation of benefit information so participants can make informed and cost-effective decisions. Cost-management strategies include effectively designed acquisition cost-based pharmacy pricing, HSA-capable coverage, reference-based pricing and adequate participant protections against balance billing."  MORE >>

37 pages. Employee Benefits items begin on page 4.  MORE >>