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Health & Welfare Plans Newsletter

September 20, 2023

2 New Job Opportunities 2 New Job Opportunities


[Official Guidance]

Text of DOL Extension of Comment Period for Proposed MHPAEA Regs (PDF)

"This document extends the comment period for the proposed rules entitled 'Requirements Related to the Mental Health Parity and Addiction Equity Act' that were published in the August 3, 2023, issue of the Federal Register. The comment period for the proposed rules, which had been scheduled to close on October 2, 2023, is extended 15 days to October 17, 2023."  MORE >>

Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

[Guidance Overview]

Upcoming Deadline icon Gag Clause Attestations Due December 31, 2023

"Under the Consolidated Appropriations Act of 2021 (CAA), group health plans and health insurance issuers are prohibited from entering into agreements with service providers restricting certain information that the plan may make available to another party. This information includes [1] provider-specific cost or quality information sharing with plan members or [2] claims data (including individual claims pricing) sharing with plan sponsors (and their service providers)"  MORE >>

Bricker Graydon

[Guidance Overview]

When You Send Your Employees to Work Abroad, Do They Lose the Right to Take FMLA Leave?

"[As] long as the employee still remains employed within the United States, the employee has the right to take FMLA leave to travel abroad and care for a family member (child, spouse, parent).... A plain reading of the regulation ... tells us that an employee loses FMLA protection when they are employed 'outside' the United States.... But what about the employee who is assigned to work abroad on a short-term basis and reports at all times back to the United States?"  MORE >>

FMLA Insights

[Guidance Overview]

New York City Amends the Earned Safe and Sick Time Act's Rules

"The amendments include [1] clarification on how to calculate employer size in order to determine leave requirements, [2] what constitutes a New York-based employee for the purposes of the act and [3] when it is permissible to ask employees to document the need for safe and sick leave."  MORE >>

Fox Rothschild LLP

Comparison of Costs for Health Care Services Suggests That Self-Insured Employers Lack Leverage to Negotiate Lower Prices

"[U]nadjusted prices were higher in self-insured plans for most of the services [studied], with the largest differences found for endoscopies (approximately 8 percent higher in self-insured plans), colonoscopies (approximately 7 percent), laboratory tests (approximately 5 percent), and moderate-severity emergency department visits (4 percent). When patient characteristics, plan type, and geography were adjusted for, differences were generally smaller but were consistent with these findings."  MORE >>

Health Affairs Forefront

Risk Scores Impact Employee Benefit Costs

"After exhausting the supply side of healthcare through decreased benefits, spousal carve-outs, etc., employers seem to be running out of options. One current strategy is to look at the demand side of healthcare -- lowering employer and employee risks using wellness programs and improved population management. A company that can decrease claims through better benefits plan utilization can realize more favorable pricing through increased marketability and a larger number of interested carriers."  MORE >>

Assured Partners

2023 ICHRA Annual Report (PDF)

17 pages. "ICHRA adoption among U.S. employers grew by 64% between 2022 and 2023.... This year's report details how thousands of businesses from across the U.S. used their ICHRA benefit from midyear 2022 to midyear 2023. This report includes the average allowances organizations offered to employees, how employers designed their benefits, and more."  MORE >>


Open Enrollment Tips for Employers: Steps to Success

"[1] Decide on deliverables ... [2] Create a calendar ... [3] Use carrier resources ... [4] Wrap things up post enrollment ... [5] Plan for next year."  MORE >>

Woodruff Sawyer

Student Loan Repayments to Resume in October: Employers, Be Prepared

"Employees will likely seek help in the months ahead due to the re-emergence of student debt servicing. Employers should be prepared to provide resources to help employees grapple with financial stress and the new pressures the resumption of federal student loans may trigger.... Student loan assistance programs ... can provide support and guidance for employees, helping them navigate their options and reduce their debt as much as possible."  MORE >>

Brown & Brown, Inc.

GAO Report on Medicare Part D: CMS Should Monitor Effects of Rebates on Drug Coverage and Spending

"GAO found plan sponsors -- private companies that provide voluntary Medicare Part D prescription drug coverage -- received $48.6 billion in rebates from drug manufacturers in 2021.... GAO found that rebates may influence formulary design in ways that could affect beneficiary access for certain drugs.... [M]onitoring rebate and expenditure data would not require CMS to interfere with negotiations between plan sponsors and manufacturers, and it could provide CMS and Congress insight on the extent to which rebates' influence on formularies could discourage enrollment of certain beneficiaries." [GAO-23-107056]  MORE >>

U.S. Government Accountability Office [GAO]

Estate Planning Benefits Gain Momentum

"The growth of estate planning benefits is driven by a number of factors, notably the COVID-19 pandemic, which has put matters of life and death front and center for many employees.... Through estate planning benefits or services through a legal benefit, employees can receive relevant advice and coordination services so they can prepare and coordinate their will and other planning documents. The benefits can be both employer- and employee-paid."  MORE >>

Society for Human Resource Management [SHRM]; membership may be required to view article

Benefits in General

2023 Benefits Strategy and Benchmarking Survey of Healthcare Organizations

"[T]op HR priorities for healthcare employers include: [1] A well-thought-out total rewards strategy is imperative for employee retention and engagement.... [2] Employers are looking for ways to expand mental health services and acceptability.... [3] Concerns about burnout are prompting employers to enhance career wellbeing resources ... [4] Financial wellbeing is increasingly important to employees, with 49% of healthcare organizations opting to auto-enroll their employees in a 401(k) or 403(b) plan."  MORE >>



Social Inflation Is Coming for Employment Verdicts, Too

"Section 510 of ERISA bars retaliation or similar employment actions against employees who exercise their rights under ERISA. For years, such claims.... lacked legs.... Recent decisions ... suggest that this dynamic is well on its way to changing, and that recovery under Section 510 is a risk that plan sponsors and their lawyers now have to take seriously at all times." [Kairys v. S. Pines Trucking, Inc., No. 22-1783 (3d Cir. July 25, 2023)]  MORE >>

Stephen Rosenberg, The Wagner Law Group

Employee Benefits Jobs

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Financial Planner


Greensboro NC

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Wealth Planning Specialist


Allentown PA

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Selected New Discussions

Gag Clause Attestation Questions

"The CAA requires, among other things, that a group health plan attest, by December 31, 2023, that it 'will not enter into an agreement, and has not, subsequent to December 27, 2020, entered into an agreement' with a service provider that contains a gag clause. A covered health plan entered into a master services agreement with a carrier (say, Blue Cross) in 2010 that contains an offending gag clause. The master agreement has not been amended since originally executed, except that the financial terms of the agreement change each year (including in 2021, 2022, and 2023), subject to the parties' agreement on such revised terms. The parties have agreed each year to the subsequently changed financial terms Two questions: [1] Do the revised financial terms mean that the services agreement has been amended such that the plan has entered into an agreement after December 27, 2020, so that the plan cannot make the attestation? Or can the plan make the attestation because the original agreement predates the effective date of the gag rule requirement? [2] If the answer to the first question is that the plan cannot make the attestation due to the changes in financial terms, can an amendment retroactively removing the offending clause even fix the situation? (Because the plan has, in effect, 'entered in an agreement' that contains a gag clause and amending the agreement, even retroactively, doesn't really change that.)"

BenefitsLink Message Boards

Press Releases

The Retirement Advantage (TRA) Strengthens Distribution Team in the Southwest

TRA [The Retirement Advantage]

Risk Strategies Acquires orchestrateHR Inc. and Affiliate eBen Benefits

Risk Strategies

Webcasts and Conferences
(Health & Welfare Plans)

Law and Policy Washington Update

October 12, 2023 WEBINAR


Last Issue's Most Popular Items

Massachusetts Sets 2024 Individual-Mandate Coverage Dollar Limits


District Court Ruling Provides a Win for Patients and Payers and a Huge Loss for Air Ambulance Companies


One Year Later, Where Are the 'Transparency in Coverage' Compliance Studies?

Health Affairs Forefront

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

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