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Health & Welfare Plans Newsletter

November 7, 2023

2 New Job Opportunities 2 New Job Opportunities


[Guidance Overview]

State Actions Expand Health Coverage and Protect Consumers, Even as Costs Rise

"States enacted over 206 bills this year affecting health care costs, coverage and delivery in commercial markets. Here is a look at the issues addressed in those bills, including health care coverage and network adequacy, individual and small-group marketplaces, surprise billing, medical debt and more."  MORE >>

National Conference of State Legislatures [NCSL]

[Guidance Overview]

Employers with Massachusetts Employees: December 15 Deadline for 2023 HIRD Form

"The Annual Health Insurance Responsibility Disclosure (HIRD) form is due no later than December 15, 2023.... If you are an in-state or out-of-state employer who had six or more employees who were employed within the state of Massachusetts during the past 12 months, you are required to complete the HIRD form.... The HIRD form consists of questions related to each medical plan that you offer."  MORE >>

Assured Partners

[Guidance Overview]

Answers to Common Employer Questions About California Paid Sick Leave

"[1] If we front load 40 PSL hours every January 1st, are we subject to any other accrual or carry-over requirements per year? ... [2] What rate of pay do we use to pay employees' PSL if their wages include commissions and a base hourly rate? ... [3] If we use the front load method, and an employee is rehired within the current year, do we have to reset and give the employee the full amount of leave for the current year? ... [4] Our employees have an alternative work schedule of four 10-hour days each week. Are they entitled to 40 or 50 hours of PSL per year?"  MORE >>

Shaw Law Group

District Court Addresses Interaction of Surprise Billing Rules and the Federal Arbitration Act

"In a case of first impression, a Florida district court dismissed claims by out-of-network air ambulance services providers to challenge an arbitrator's reimbursement decisions under the No Surprises Act's (NSA's) independent dispute resolution (IDR) process. Although the court allowed the providers to amend their complaints, it noted that the providers faced an 'uphill battle' in challenging the NSA/IDR payment determinations." [Med-Trans Corp. v. Capital Health Plan, Inc., No. 22-1153 (M.D. Fla. Nov. 1, 2023)]  MORE >>

Thomson Reuters Practical Law

Are Family-Building Benefits Raising COBRA Coordination Issues?

"If an employer decides to create an HRA to reimburse infertility treatment expenses, the COBRA treatment is more complex.... For purposes of assessing the employer's COBRA obligation in connection with [long-term fertility preservation ], the key question is whether the reimbursement of such expenses constitutes the provision of 'health care.' ... In general, reimbursement of costs related to adoption or surrogacy shouldn't give rise to a program that provides medical benefits -- meaning neither program should be subject to COBRA."  MORE >>

HR Daily Advisor

Transparency in Coverage Data and Variation in Prices for Common Health Care Services

"The private market lacked meaningful price transparency for patients and purchasers until the recent implementation of Hospital Price Transparency and Transparency in Coverage (TiC) rules. Lack of transparency limits the ability of regulators to monitor prices and of employers, patients, and purchasers to impose market discipline on prices. [The authors] examined TiC price data for common services from Humana, a large national insurer, and highlighted use cases of such novel data for future research."  MORE >>

RAND Corporation

Leave to Care for a Friend Who's Like Family: Pandora's Box or Chance to Empathize?

"More employers are granting employees leave to look after ill friends with a 'familial affinity,' as a growing number of states are requiring them to do.... With more people relying on chosen rather than nuclear families, the number of [requests for such leave] is likely to rise."  MORE >>

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

Maryland Department of Labor Seeks Input from Employers About Paid Leave Regulations

"The Maryland [DOL's] FAMLI Division -- the State agency that implements and guides the statewide Family and Medical Leave Insurance (FAMLI) law -- is conducting a research study to better understand businesses' unique needs and the potential challenges the forthcoming paid leave system presents."  MORE >>

Maryland Association of Counties

Long-Term Care Insurance Coverage: State-to-State 2023 (PDF)

57 pages. "This report catalogues what long-term care insurers contribute in terms of: [1] Number of individuals covered; [2] Number of individuals who have received benefits from their coverage; [3] Dollar amount of benefits received; [4] Estimated length of time long-term care insurance coverage will pay for various forms of long-term services and supports."  MORE >>

America's Health Insurance Plans [AHIP]

Benefits in General

[Official Guidance]

Text of EBSA Meeting Notice for ERISA Advisory Council

"[T]he 220th open meeting of the [ERISA Advisory Council] will be held via a teleconference on December 11-12, 2023.... The purpose of the open meeting is for Advisory Council members to finalize their observations and recommendations on the issues they studied in 2023, present their observations and recommendations to the [DOL], and receive an update from leadership of [EBSA]. The issues studied by the ERISA Advisory Council in 2023 are: [1] Long-Term Disability Benefits and Mental Health Disparity, and [2] Recordkeeping in the Electronic Age. Descriptions of [these] topics are available on the ERISA Advisory Council's web page[.]"  MORE >>

Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

Building Benefits Technology Into Long-Term Benefits Strategy

"Whether it's a fully integrated HRIS platform or a robust standalone benefits administration technology platform, you want a solution that can help you fully execute upon your benefits strategy while increasing employee understanding and connection to their benefits."  MORE >>

Corporate Synergies

Employee Benefits Jobs

View job as Onboarding Specialist
            for Compass Retirement Consulting Group, Inc./Compass 360, LLC

Onboarding Specialist

Compass Retirement Consulting Group, Inc./Compass 360, LLC


View job as Onboarding Specialist for Compass Retirement Consulting Group, Inc./Compass 360, LLC

View job as ESOP Administrator
            for Blue Ridge ESOP Associates

ESOP Administrator

Blue Ridge ESOP Associates


View job as ESOP Administrator for Blue Ridge ESOP Associates

Press Releases

Cohen & Buckmann Recognized in 2024 Best Law FirmsĀ®

Cohen & Buckmann P.C.

OneDigital Creates Access to Retirement Plan Solutions for Small Business Clients through Simply Retirement by PrincipalĀ®


Webcasts and Conferences
(Health & Welfare Plans)

2023 Compliance Issues for Employer Health and Welfare Plans: Fees, Services, Plan Contracts, Reporting, Audits

November 30, 2023 WEBINAR


Last Issue's Most Popular Items

HHS Rescinds Enforcement Safe Harbor for Prescription Drug Machine-Readable File Requirement

Burnham Benefits

Price Comparison Transparency Tool Expanded for 2024

Burnham Benefits

Health Plan Fiduciary Governance: Participant Claims and Appeals, and Provider Disputes

Nixon Peabody LLP

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BenefitsLink® Health & Welfare Plans Newsletter, ISSN no. 1536-9595.

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