"The change in residence becomes a qualifying event when that change affects the employee's or dependent's eligibility for coverage. Unless the relocation makes the moving individual ineligible or newly eligible under the plan, the move would not be considered a change in status qualifying event.... [T]here would likely be a qualifying event if the relocation resulted in the employee or dependent moving outside of a network that would provide service."  MORE >>

27 pages. Topics: [1] Washington update; [2] MHPAEA drill down; [3] Account based plan issues; [4] Other health & welfare plan updates.  MORE >>

"Proposed regulations include a broad exemption for existing policies that provide 40 hours of paid leave to be used for any reason. Updates to accrual and carryover include fractional accrual calculation and 80-hour carryover cap. New reporting requirements for employers include a customized statement, frontloading notice, and paid leave balance reporting on paystubs."  MORE >>

"Ohio's budget bill ... included provisions amending dependent coverage under dental and vision policies issued in the state ... The bill extends coverage for unmarried dependents up to age 26 under certain conditions.... The amendment applies to fully insured dental or vision plans delivered, issued, renewed, or amended in Ohio beginning January 1, 2024."  MORE >>

"[T]he 2024 WA PFML total premium rate will be 0.74% of wages up to the 2024 Social Security cap of $168,600. The new rate is a decrease [from] the current rate of 0.8% and will become effective on January 1, 2024. The total contribution of 0.74% is split between employers and employees, depending on the size of the employer."  MORE >>

11 pages. "[1] Verify your data is accurate and up-to-date ... [2] Calculate codes and validate Forms 1094-C and 1095-C ... [3] Stay on top of IRS filing rules, deadlines, and penalties ... [4] Identify and adhere to state laws and deadlines ... [5] Follow a consistent and repeatable process."  MORE >>

"Weight loss prescriptions Wegovy, Rybelsus and Saxenda -- along with Ozempic -- are driving health costs for employers up by more than $300 per insured worker this year ... These GLP-1 drug costs are expected to boost healthcare spending through 2025, increasing from $324 per insured member this year up to $500 per insured health plan member in two years ... By comparison, annual spending on such prescriptions in 2021 was $96 per member[.]"  MORE >>

"As employers have seen their spending on claims return to or even exceed pre-pandemic levels, they will need to ... focus on new and evolving cost drivers. These include more acute price inflation brought on by provider losses sustained during the pandemic, a robust drug pipeline, emerging therapies for cancers and other complex diseases and the increasing number of large claimants."  MORE >>

12 pages. "Estimating the impact of cost-sharing changes on the federal actuarial values (AVs) for ACA individual and small group plans is often a guessing game. As HHS limits the number of non-standardized plan options, this paper serves as a convenient reference to better estimate AV impacts driven by cost-sharing changes and to optimize issuers' product portfolio strategies."  MORE >>

"If the final rule looks anything like the proposal, there will be a challenge, the particulars of which will likely include one central question: Is the final rule consistent with Congress' intent in the matter? Dueling comments by the majority and minority members of the House of Representatives Committee on Education and the Workforce and (in the case of the minority) the Subcommittee on Health, Employment, Labor, and Pensions frame the question[.]"  MORE >>