"[FAQs Part 62] specifically addresses the provisions of the TiC final rules requiring plans and carriers to post machine-readable files for in-network negotiated rates and historical net prices for all covered prescription drugs by plan or issuer at the pharmacy location level. It also covers the status of a previously announced enforcement safe harbor applicable to in-network provider rates for covered items and services which allowed plans with percentage-of-billed-amount contracts or other alternative reimbursement arrangements to report this information differently if the dollar amount could not be determined in advance."  MORE >>

"Effective Nov. 1, 2023, the Massachusetts Paid Family Medical Leave (PFML) law will ... allow employees to use accrued paid leave ... to supplement PFML benefits at any time during leave.... [E]mployees will be able to use accrued PTO and other employer-provided paid leave to 'true up' their PFML benefit payments, rather than forfeiting those payments. The Department of Family and Medical Leave has also announced the new contribution and benefit amounts for 2024."  MORE >>

"SB 616 increases the number of paid sick leave days an employer must provide eligible employees each year from three days/24 hours to five days/40 hours.... Accrued paid sick leave requirements, including the annual usage cap, will increase.... The carry over accrual cap will also increase but can be capped for employees who receive their sick leave in the beginning of the year.... SB 616 preempts local ordinances.... SB 616 maintains the CBA exemption, with a twist."  MORE >>

"[E]mployers and their associations have been stopped by Ninth Circuit courts when they attempted to argue state and local benefits laws are preempted by ERISA and other federal laws due to the market-participant exception to preemption. The Ninth Circuit has now rejected the market-participant exception  ... at least based on the penalty provisions of the San Francisco law.... [T]he case may provide a roadmap for employers who want to challenge state and local benefits laws in the future." [Airlines for America v. City and County of San Francisco, No. 22-15677 (9th Cir. Aug. 29, 2023)]  MORE >>

"PBMs are under increased scrutiny from policymakers due to the perceived opaqueness of their operations and their perceived role in increasing drug costs. As part of this scrutiny, Congress and other stakeholders are raising questions about PBMs' impact on drug prices and out-of-pocket costs for patients. In the 118th Congress, several key committees have advanced legislation that would increase PBM transparency and reporting obligations and modify other business practices." [Chart provides side-by-side comparison of three House and three Senate proposals.]  MORE >>

"What has been particularly notable about COVID-19, in contrast with recent influenza pandemics, is the development of persistent adverse health effects in a portion of infected individuals, ranging from disparate symptoms, such as cough and fatigue, to new onset disease and premature mortality. This white paper investigates the emergence of excess mortality and new-onset disease resulting in insurance underwriting significance beyond 30 days from the time of infection."  MORE >>

"[M]ost individuals and businesses in California will now have until Nov. 16 to file their 2022 returns and pay any tax due. Fifty-five of California's 58 counties -- all except Lassen, Modoc and Shasta counties -- qualify. IRS relief is based on three different FEMA disaster declarations covering severe winter storms, flooding, landslides, and mudslides over a period of several months."  MORE >>