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Health & Welfare Plans Newsletter

October 9, 2023

4 New Job Opportunities 4 New Job Opportunities


[Guidance Overview]

Nondiscrimination Testing and Form 5500 Filing Obligations for Welfare Benefit Plans

"[H]ere's a refresher course on compliance requirements of Internal Revenue Code (IRC) Section 125 cafeteria plans and IRC Section 105.... [1] Definition of nondiscrimination testing; [2] Contributions for highly paid employees and non-highly compensated employees; [3] Applicability to cafeteria plans, including healthcare Flexible Spending Accounts (FSA), Dependent Care Flexible Spending Accounts (DCFSA), Health Reimbursement Arrangements (HRA), and Health Savings Accounts (HSA); [3] Examples of nondiscrimination testing rules; [5] Form 5500 obligations and welfare benefit plans[.]"  MORE >>


[Guidance Overview]

HHS Increases Civil Money Penalties for HIPAA Noncompliance, Effective October 6, 2023

"To calculate the 2023 annual adjustment, HHS multiplied the most recent penalty amount for each applicable penalty by the multiplier, 1.07745, and rounded to the nearest dollar.... [A] table reflects certain of HHS's annual inflation adjustments to the civil money penalties for HHS-administered provisions, which are generally effective October 6, 2023."  MORE >>

Thomson Reuters Practical Law

[Guidance Overview]

California Mandatory Paid Sick Leave Increases in 2024

"Effective January 1, 2024, employers must provide qualifying employees (working in California) with up to five [5] days/40 hours of Paid Sick Leave (PSL) for use per year, an increase of the current law requiring three (3) days/24 hours of PSL. Like the current law, non-exempt employees must be paid PSL at their regular rate of pay."  MORE >>

Davis Wright Tremaine LLP

District Court Ruling Calls Into Question Whether Plans and Issuers Can Count Drug Coupons Towards ACA Out-of-Pocket Limit

"[T]he 2021 Notice of Benefit and Payment Parameters (2021 NBPP) ... permitted (but did not require) plans and issuers to count direct support offered by drug manufacturers for prescription drugs toward the [ACA's] annual cost-sharing limit (MOOP).... [T]he court concluded that the 2021 NBPP interpretation of 'cost sharing' conflicts with the statutory and regulation definition of 'cost sharing' under the ACA [and] remanded the amendments ... back to [HHS] for further consideration." [HIV and Hepatitis Policy Inst. v. HHS, No. 22-2604 (D.D.C. Sep. 29, 2023)]  MORE >>

Groom Law Group

District Court Finds State Law Restricting Contractual Limitations Clause Is Not Preempted by ERISA

"[The court] denied MetLife's motion to dismiss Plaintiff's lawsuit stemming from MetLife's denial of disability and waiver of premium benefits finding that ... a Michigan state law requiring a six-year limitations period for breach of contract actions was not preempted by ERISA, and precluded application of a three-year contractual limitations clause in the Plans." [Marshall v. Metropolitan Life Ins. Co., No. 22-12218 (E.D. Mich. Sept. 22, 2023)]  MORE >>

Roberts Disability Law

Hawai'i Attorney General Sues PBMs Alleging They Deceptively Represent That They Lower Drugs Costs

"The complaint alleges that the PBMs' business practices have driven skyrocketing prices for brand-name prescription medications over the past decade. These practices include charging drug manufacturers 'rebates,' which are payable directly to the PBMs, in exchange for the favorable placement of drugs on the PBMs' formularies ... The number of medications excluded from the PBM defendants' formularies increased by 961% from 2014 to 2022." [Hawai'i v. CaremarkPCS Health, L.L.C.; Express Scripts, Inc.; and OptumRx, No. 23-1181 (1st Cir. Haw. complaint filed Oct. 4, 2023)]  MORE >>

Office of the Governor, State of Hawai'i

Changes in the List Prices of Prescription Drugs, 2017-2023

"Drug manufacturers may change the list prices of their drugs at any time after launch. Over the period from January 2022 to January 2023, more than 4,200 drug products had price increases, of which 46 percent were larger than the rate of inflation. The average drug price increase over the course of the period was 15.2 percent, which translates to $590 per drug product."  MORE >>

Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS]

Employee Benefits Jobs

View job as Client Service Manager
            for July Business Services

Client Service Manager

July Business Services


View job as Client Service Manager for July Business Services

View job as Enrolled Actuary
            for Pension Associates Retirement Planning LLC

Enrolled Actuary

Pension Associates Retirement Planning LLC

Stamford CT

View job as Retirement Plan Onboarding Coordinator
            for The Finway Group

Retirement Plan Onboarding Coordinator

The Finway Group

Remote / West Des Moines IA

View job as Retirement Plan Onboarding Coordinator for The Finway Group

View job as Regional Plan Consultant (Sales) Pacific Northwest US Territory
            for The Retirement Advantage, Inc.

Regional Plan Consultant (Sales) Pacific Northwest US Territory

The Retirement Advantage, Inc.


View job as Regional Plan Consultant (Sales) Pacific Northwest US Territory for The Retirement Advantage, Inc.

Webcasts and Conferences
(Health & Welfare Plans)

ERISA: Defense Strategies to DOL Litigation and Investigations

October 18, 2023 WEBINAR

The Knowledge Group

Last Issue's Most Popular Items

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

Alston & Bird

ERISA Litigation Is a Hot Mess: Challenges and Potential Reforms

DeBofsky Law

Text of Agency FAQs, Part 62: Implementation of No Surprises Act in Light of the Recent Court Decision in Texas Medical Association v. HHS (PDF)

Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

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

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