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Health & Welfare Plans Newsletter

October 25, 2023

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[Guidance Overview]

The Cost of Not Complying with HIPAA Is High and Rising

"Penalties for violating the privacy, security, and breach notification requirements under HIPAA use a four-tier scheme based on the level of culpability. The new penalty amounts are approximately 14% higher than last year and are shown [in a chart]."  MORE >>

Arthur J. Gallagher & Co.

[Guidance Overview]

Amended Massachusetts Paid Family and Medical Leave Allows 'Topping Off' Benefits with Accrued Sick, Vacation Pay

"An employer cannot require an employee to use accrued sick, vacation, or other paid leave benefits to top off the PFMLA benefit; the employee must be allowed to choose to use the benefit."  MORE >>

Jackson Lewis P.C.

[Guidance Overview]

Changes to California Paid Sick Leave Obligations Are Coming January 1

"[E]mployers will now be required to provide employees a minimum of five (5) days (or 40 hours) of paid sick leave by the employees' 200th calendar day of employment.... [T]he new law extends the procedural protections that were previously only available to employees who were not covered by an MOU or CBA to those that are covered by such a contractual agreement."  MORE >>

Liebert Cassidy Whitmore

District Court Vacates HHS Guidance on Copay Accumulator Programs

"The now-vacated provision followed an earlier [HHS] announcement that manufacturer assistance need not be counted toward a plan's annual cost-sharing limit when a medically appropriate generic equivalent is available.... The preamble to the 2021 regulations explained that this change was necessary to avoid a potential conflict with the HDHP rules, under which only amounts actually paid by the individual may be counted toward the HDHP deductible. This case appears to revive that conflict (and adds confusion to compliance)." [HIV and Hepatitis Policy Inst. v. HHS, No. 22-2604 (D.D.C. Sep. 29, 2023)]  MORE >>

Willis Towers Watson

Firing a High-Cost Claimant Can Be Even More Costly

"[T]he Third Circuit Federal Court of Appeals has upheld an award of front pay and attorneys' fees to an employee who claimed he was fired as a result of his medical expenses. Among other claims, the employee alleged his employer violated ERISA Section 510 when it terminated his employment. The case represents a warning signal to employers who might take adverse action against employees who incur high-cost medical claims." [Kairys v. S. Pines Trucking, Inc., Nos. 22-1783, 22-2055 (3d Cir. Jul. 25, 2023)]  MORE >>

HUB International

Who's Driving the Craze for Ozempic, Other Weight Loss Drugs?

"Extensive media coverage and high obesity rates are fueling interest in prescription weight loss drugs ... 28% of U.S. adults said they are interested in taking prescription GLP-1 drugs like Ozempic, Mounjaro or Wegovy for weight loss ... Consumers who have heard 'a lot' about the drugs, have weight-related health conditions or have higher incomes are most likely to be interested in taking the medications."  MORE >>

Morning Consult

Open Enrollment: Common Employee Mistakes

"[1] Failing to review all options ... [2] Overlooking plan changes ... [3] Forgetting to consider how your life has changed ... [4] Selecting the wrong type of health insurance coverage ... [5] Missing out on employer matching contributions ... [6] Overlooking the benefits of flexible spending accounts (FSAs) and health savings accounts (HSAs) ... [7] Failing to update beneficiaries ... [8] Procrastinating "  MORE >>

Memphis Flyer

UPS Expands Emergency Day Care Program for Employees

"The pilot program offered emergency day care services onsite at the Northern California facility, 'where parents would have the lowest possible barrier to using the new service,' UPS said. Eight in 10 eligible employees participated and took advantage of the service more than once, avoiding more than 120 unplanned absences. Employee turnover among the pilot group dropped significantly, from 31 percent to 4 percent."  MORE >>

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

Benefits in General

Clearing the Blind Spot Between Employer Perceptions and Employee Preferences

"Total rewards preferences among the workforce have always differed somewhat from employers' perceptions.... Regular feedback, whether gathered formally or in real time, allows closer alignment of resource investments with employee preferences ... Data access and analysis provide the clearest window into strategic applications for optimizing the employee experience.... Assessing current employee experience data at regular intervals helps ensure that employers stay tuned to quickly evolving preferences."  MORE >>


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Press Releases

July Business Services is First to Earn a CEFEX Certification for Operational Fiduciaries in Pooled Plans

JULY Business Services

Cerulli Associates

Webcasts and Conferences
(Health & Welfare Plans)

Practically Speaking with Compliance: Gag Clause Attestation Submissions



Hospital & Health Plan Price Transparency

October 30, 2023 WEBINAR

Society of Actuaries

The Latest on Healthcare Price Transparency

November 8, 2023 WEBINAR

HFMA [Healthcare Financial Management Association]

Medicare: Understanding and Navigating the Planning Process

November 29, 2023 WEBINAR

TRA [The Retirement Advantage]

Financial Reporting in Healthcare

December 6, 2023 WEBINAR

Conference of Consulting Actuaries

Last Issue's Most Popular Items

Text of DOL Fact Sheet 66E: The Davis-Bacon and Related Acts – Compliance with Fringe Benefit Requirements

Wage and Hour Division [WHD], U.S. Department of Labor [DOL]

Machine-Readable File Requirements: More Transparency-in-Coverage Work for Health Plans


IRS Releases Final Forms and Instructions for 2023 ACA Reporting (PDF)

Cowden Associates, Inc.

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

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