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Health & Welfare Plans Newsletter

November 1, 2023

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[Guidance Overview]

Reminder: Gag Clause Attestations Due by Year-End

"[1] Review applicable contracts to ensure that they do not contain prohibited gag clauses. [2] If the group health plan is fully insured, confirm that the insurer will make the Attestation on behalf of the plan.... [3] If the group health plan is self-insured, it may be possible to delegate the responsibility for completing the Attestation to the plan's TPA.... [4] Review existing agreements with insurers/TPAs to ensure that the agreement includes a 'compliance with applicable law' provision[.]"  MORE >>

Faegre Drinker

Smaller Employers Weigh a Big-Company Fix for Scarce Primary Care: Their Own Clinics

"Nationwide, a modest number of small- and medium-size employers have set up their own health clinics at or near their workplaces ... Improving employee health and lowering health costs are among the main advantages employers cite for running clinics. But some companies also say they're helping to blunt the nation's shortage of primary care doctors and eliminate the hassle of finding and getting care."  MORE >>

MM&M [Medical Marketing and Media]

Options for Menopause Benefits for Employees

"As the U.S. workforce ages and includes more women than ever before, more employers are considering benefits and other workplace changes specific to menopause.... Menopause benefits can range from simple employer policy changes to workplace accommodations, to medical benefits that are a part of, or integrated with, the employer's major medical plan."  MORE >>

Ogletree Deakins

Since 2014, Worker Eligibility for Employment-Based Health Coverage Has Increased

"Despite predictions to the contrary, employers did not drop health benefits in large numbers after the ACA took effect.... The increase in employer offer rates combined with structural changes in the labor force resulted in a 5% increase in the percentage of workers eligible for health benefits between 2014-2022."  MORE >>

Employee Benefit Research Institute [EBRI]

The Self-Funded Plan's Guide to Gender-Affirming Coverage

"Whether or how a [group health plan (GHP)] should cover gender-affirming care is a complex and evolving legal issue. This is especially true of self-funded GHPs, which are generally not subject to the nondiscrimination provisions of the [ACA] Both state and federal law are still unsettled ... [S]elf-funded GHP sponsors must carefully consider numerous legal factors."  MORE >>

Hall Benefits Law


New IRS Letters Call Into Question Accuracy of ACA Penalties

"[Section 1411] notices were required to be sent by the Exchanges prior to the IRS being able to assess a penalty under IRC section 4980H. These notices were supposed to serve as a useful tool for employers as it alerts them to the possibility of an employee triggering an IRC section 4980H penalty. By bundling the sham 1411 notice up with the IRS proposed penalties, this employer protection was lost and the clear language of the ACA was not followed."  MORE >>


Employee Benefits Jobs

View job as Legislative Affairs Specialist
            for Pension Benefit Guaranty Corporation

Legislative Affairs Specialist

Pension Benefit Guaranty Corporation

Washington DC

View job as Legislative Affairs Specialist for Pension Benefit Guaranty Corporation

Press Releases

Judy Hensley Joins Eide Bailly as Leader of Compensation and Benefits Tax Services Team

Eide Bailly LLP

National Alliance Names Health Policy Expert Shawn Gremminger as New President and CEO

National Alliance of Healthcare Purchaser Coalitions

Webcasts and Conferences
(Health & Welfare Plans)

A Deep Dive Into Oregon's Leave Laws

November 16, 2023 WEBINAR


Education: Comparing Coverdell ESAs, 529 Plans, UTMAs and UGMAs

December 12, 2023 WEBINAR


Last Issue's Most Popular Items

Drug Copay Accumulator Programs: A Many-Sided Argument


Mandated Paid Leave and Other State Law Trends to Watch in 2024


Additional Guidance on Requirements of the Illinois Paid Leave for All Workers Act

Michael Best

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

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