77 pages. "This document sets forth proposed rules related to the fees established by the No Surprises Act for the Federal independent dispute resolution (IDR) process ... These proposed rules would amend existing regulations to provide that the administrative fee amount charged ... to participate in the Federal IDR process, and the ranges for certified IDR entity fees for single and batched determinations will be set by the Departments through notice and comment rulemaking. These proposed rules would also set forth the methodology used to calculate the administrative fee and the considerations used to develop the certified IDR entity fee ranges. This document also proposes the amount of the administrative fee ... [and] the certified IDR entity fee ranges for disputes initiated on or after the later of the effective date of these rules or January 1, 2024"  MORE >>

"Internal Revenue Code Section 4980D generally imposes a nondeductible excise tax of $100 per day per affected individual for failure to comply with Code Chapter 100, group health plan requirements. Noncompliant plans must self-report the Section 4980D excise tax on Form 8928. MHPAEA amends the Code.... in Section 9812, which is in Chapter 100. Thus, Code Section 4980D applies to violations of MHPAEA, including the requirement to prepare and provide NQTL analyses upon request."  MORE >>

"The Departments have consistently highlighted certain types of plan exclusions or limitations as problematic or out of compliance and addressed these areas again in both the 2023 MHPAEA Report to Congress and the Proposed Rules.... Plan sponsors should review their plans carefully for these red flags ... [and] should also consider performing a more general MHPAEA compliance review of their group health plans, with an emphasis on the Department's six areas of focus."  MORE >>

"Beginning on January 1, 2024, Covered Employers must offer Covered Employees the pre-tax transportation program benefit beginning on the first full pay period that falls 120 days after the start of employment. Employers can also meet this requirement by participating in programs offered by the Chicago Transit Authority or the Regional Transportation Authority."  MORE >>

"In a divided-panel opinion ... the Fourth Circuit narrowed the scope of remedies available to plaintiffs in ERISA breach of fiduciary duty claims in this circuit.... [T]he Fourth Circuit held that 'surcharge' is not an available remedy. Instead, monetary recovery under 502(a)(3) is only available when a plaintiff points to specific funds that the plaintiff rightfully owned but that the defendant possesses as a result of unjust enrichment. This is a reversal of prior Fourth Circuit decisions[.]" [Rose v. PSA Airlines, Inc., No. 21-2207 (4th Cir. Sep. 11, 2023)]  MORE >>

"[D]espite the sheer volume of COBRA notice cases, courts have issued relatively little guidance on the merits of the plaintiffs' claims ... Based on the decisions and proceedings to date, [this article describes] some trends indicating that, although COBRA notice litigation may present a risk for plan sponsors, there are also multiple potential merits and class-based defenses available to defendants."  MORE >>

"[The Florida Office of Insurance Regulation (OIR) has published] rules to allow implementation of provisions from SB 1550, wide-ranging legislation passed earlier this year addressing PBMs and drug pricing. The [OIR] has created a web page with resources related to the new statutory requirements for PBMs, as well as information about how providers can lodge complaints."  MORE >>

"[This annual survey] measures the ongoing expense and coverage of medical stop-loss amongst employer-sponsored, self-funded health plans. Recent pricing and renewal requests are further detailed with annualized increases ranging from 6.9% at a $100,000 deductible to higher, more leveraged increases of 15.9% at $500,000. The primary focus of the survey remains current premium rates ... Stop-loss premium reflecting nearly 850,000 covered employees for a total of $727 million in annual premium expense is measured."  MORE >>

"As of 2023, 24 states have passed laws that require physicians to perform urine drug testing of chronic pain patients undergoing opioid therapy. Despite the potential health and financial benefits of testing for employees and employers, there is no evidence to date regarding compliance with these state policies or their second-order effects.... This research provides key insights for plan sponsors and employers considering cost-effective health benefits designs to support employees with chronic pain."  MORE >>

"During the first half of 2023, HSA investment assets grew 20%, totaling $40 billion at the end of June (up 30% from the year prior).... Account holders contributed $29 billion to their accounts in the first half of 2023 (up 11% from the year prior) and withdrew $21 billion from their accounts during the first half of 2023 (up 16% from year prior)."  MORE >>