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Health & Welfare Plans Newsletter

September 7, 2023

3 New Job Opportunities 3 New Job Opportunities


[Guidance Overview]

Health & Welfare Benefits Monthly Update, September 2023 (PDF)

50 presentation slides. Topics: [1] Washington update; [2] 2023 Short-term limited duration and fixed indemnity proposed regulations; [3] 2023 Mental health parity proposed regulations; [4] Case developments: Mulready and others; [5] Grab bag report and reminders.  MORE >>

Alston & Bird

[Guidance Overview]

The 'Data Evaluation Requirement' for NQTLs Under the Newly Proposed MHPAEA Regs

"This new requirement would provide that the plan or issuer designing and applying an NQTL collect and evaluate relevant data to assess the impact of the NQTL on access to MH/SUD and M/S benefits.... The proposed regulations would make compliance depend on outcomes. This position represents a significant shift in, if not an outright reversal of, existing law."  MORE >>

McDermott Will & Emery

[Guidance Overview]

Upcoming Compliance Deadlines for Group Health Plans

"[This] Compliance Timeline explains key compliance deadlines for employer-sponsored group health plans for the months of September through December 2023."  MORE >>

Burnham Benefits

[Guidance Overview]

Things to Know About IRS Form 5500 for Health and Welfare Benefit Plans

"[1] Filing exceptions ... [2] Self-funded plans.... [3] IRS Form 5500 and Schedule A information.... [4] One or multiple 5500s? ... [5] What if I haven't filed 5500s when I should have? ... [6] Who prepares the IRS Form 5500?.... [7] When is the IRS Form 5500 due?"  MORE >>

Kushner & Company

[Guidance Overview]

What Do Employers Need to Know about School-Activity Leave Laws?

"Although there is no federal law covering school activity leave, eight states -- California, Illinois, Massachusetts, Minnesota, Nevada, North Carolina, Rhode Island, and Vermont -- and the District of Columbia require covered private employers to provide leave for parents to attend school or day care activities; Louisiana, Oregon, and Tennessee encourage, but do not require, employers to provide leave for school activities.... This article provides] a summary of state laws requiring school-activity leave, some of which have recently been updated."  MORE >>



Register for the 2023 CCA Annual Meeting before Sept. 18 and Save

This three-day meeting includes 15 healthcare sessions covering the ever-changing state of the healthcare market. Topics include the role of AI in healthcare, prescription drugs and data transparency. 18.5 CPD credits available.

Sponsored by Conference of Consulting Actuaries [CCA]

Court OKs Two-Part COBRA Election Notice, but Dismisses Most Claims in Class Action

"[T]he court held that, even though the COBRA regulations refer to 'notice' in the singular, nothing prohibits an employer from providing multiple notices that together meet the notice content requirements. The court further held that the employees had not adequately explained how the combined notices failed to meet those requirements.... The court dismissed all but one claim -- an allegation that the notices provided an inaccurate election deadline for one employee whose qualifying event occurred during the COVID-19 outbreak period." [Bryant v. Walgreen Co., No. 23-1294 (N.D. Ill. Aug. 29, 2023)]   MORE >>

Thomson Reuters / EBIA

Plan's Comparable (but Not Identical) Medical Necessity Guidelines Comply with MHPAEA (PDF)

"Although the plan used two different sets of guidelines to review the two types of claims, the court found the guidelines comparable in that [1] the plan applied an identical definition of 'medically necessary' to both types of benefits; [2] the guidelines used for applying the medical necessity limitation were developed using similar processes; and [3] the differences between the guidelines were insufficient to show disparity." [L.D. v. United Healthcare Insurance, No. 21-00121 (D. Utah Jul. 28, 2023)]  MORE >>

Thomson Reuters / EBIA

Providers Score Yet Another Victory as Texas Court Again Vacates Provisions of Surprise Billing Regs

"Following the decision, the Departments froze the bulk of the arbitration process. Currently, parties may only continue with negotiations and respond to requests for information from IDREs entity. IDREs may only proceed with eligibility determinations for single and bundled disputes submitted on or before August 3, 2023; all other steps of the process involving IDREs are on hold, and it is unclear how the Departments will respond to this most recent setback." [Texas Medical Association v. HHS, No. 22-560 (E.D. Tex. Aug. 24, 2023)]  MORE >>

ArentFox Schiff LLP

CRS Legal Sidebar: Overview of Select No Surprises Act Litigation

"Litigation over the NSA highlights areas in which the law grants or potentially grants the tri-agencies with authority to implement a range of policy choices within the statutory parameters, as well as potential areas of statutory ambiguity.... To the extent Congress determines that the relevant range of policy choices should be limited or expanded, or that the law should be otherwise clarified, Congress may amend the NSA to alter its scope or method of implementation." [LSB11036 Sep.7, 2023]  MORE >>

Congressional Research Service [CRS]

Employee Curiosity Sometimes Overcomes HIPAA Training

"[E]ven those employees who are not given access to protected health information should be trained in HIPAA compliance ... The goal should be to find snooping employees as soon as possible before they continue with the habit out of curiosity or for criminal reasons. Even the best training program cannot prevent snooping."  MORE >>

Relias Media

CRS Report: Constitutional Challenges to the Medicare Drug Price Negotiation Program (PDF)

22 pages. "In summer 2023, several drug manufacturers and trade associations representing manufacturers challenged the law before federal district courts across the country.... This report explains and contextualizes the plaintiffs' constitutional claims by analyzing relevant U.S. Supreme Court jurisprudence.... The report concludes by identifying relevant considerations for the 118th Congress as the litigation proceeds. At least one drug manufacturer has filed a preliminary injunction, seeking to halt CMS's implementation of the program until the litigation is resolved." [R47682 Sep. 6, 2023]  MORE >>

Congressional Research Service [CRS]

How Workplaces Can Support Working Parents During the School Year

"Deliver adequate training and awareness to all managers and leaders around how to talk to employees about their specific work/life needs.... Provide flexibility in scheduling.... Ensure company policies around flexibility are inclusive of all employees."  MORE >>

HR Daily Advisor

Benefits in General

[Guidance Overview]

New System Will Affect E-Filings and E-Payments

"Beginning January 1, 2024, users of the DOL's EFAST filing system will be required to access EFAST using [E]xisting users will need to create an account on that can be linked to an existing EFAST account.... This year, the PBGC is expected to adopt the sign-on system for its e-Filing Portal. The PBGC will contact users who have existing e-Filing accounts about the change."  MORE >>


Employee Benefits Jobs

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            for Pentegra

Enterprise Sales Consultant


Remote / West Harrison NY

View job as Enterprise Sales Consultant for Pentegra

View job as Account Manager
            for Pentegra

Account Manager


Remote / West Harrison NY

View job as Account Manager for Pentegra

View job as ERISA Attorney
            for Definiti

ERISA Attorney



View job as ERISA Attorney for Definiti

Press Releases

First Dollar Partners with Health-E Commerce® to Create Frictionless Shopping Experience for FSA, HSA Users

First Dollar

Webcasts and Conferences
(Health & Welfare Plans)

Beyond an EAP: A New Approach to Workforce Mental Health



The No Surprises Act: Litigation Update and Recent Guidance

September 14, 2023 WEBINAR

Sheppard Mullin

Student Loan Repayment Benefits

September 20, 2023 WEBINAR


Proposed MHPAEA Rules and the Challenges They Would Create

September 20, 2023 WEBINAR


Last Issue's Most Popular Items

Employers May Need to Lower Employees' Premiums to Keep Health Plans Affordable Under the ACA

Bricker Graydon

District Court Dismisses All But One of Employees' COBRA Election Notice Claims

Thomson Reuters Practical Law

Medicare Part D Notices Are Due Before Oct. 15, 2023 (PDF)

Cowden Associates, Inc.

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BenefitsLink® Retirement Plans Newsletter, ISSN no. 1536-9587.

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