"What's New: [1] Notice 2023-37 ...modified Notice 2020-15 and clarified the definition of preventive care ... [2]Telehealth and other remote care extended.... [3] Insulin products ... [4] Q&As on certain qualified medical expenses."  MORE >>

"[1] Mental Health Parity and Addiction Equity Act (MHPAEA) non-quantitative treatment limit (NQTL) comparative analysis ... [2] Prescription drug data collection ... [3] Gag clause attestation ... [4] Broker and consultant compensation disclosures ... [5] ACA form distribution ... [6] Telehealth HSA relief ... [7] Updated 2024 benefit limits ... [8] Overview of significant health and welfare benefit plan compliance tasks."  MORE >>

"The FAQs confirm that the regulations do not alter the reporting requirements in any way. According to the FAQs, the regulations will apply beginning October 11, 2024, meaning that the earliest a penalty may be imposed is October 2025. "  MORE >>

"Beginning January 1, 2024, employers will be required to grant a broadly defined group of eligible employees up to five days of reproductive loss leave, potentially without documentation verifying an employee's eligibility for leave."  MORE >>

"While acknowledging that intentional discrimination may be hard to prove, the court concluded that the participant had adequately alleged that the policy discriminated against certain participants based only on their sexual orientation.... In a footnote, the court acknowledged, but declined to follow, another court's conclusion that Section 1557 does not prohibit discrimination on the basis of sexual orientation." [Murphy v. Health Care Serv. Corp., No. 22-2656 (N.D. Ill. Oct. 17, 2023)]  MORE >>

"DOL and plaintiffs' counsel representing participants and beneficiaries who have brought ERISA class action lawsuits related to the practice of cross-plan offsetting have yet to put forth in public complaints or otherwise data indicating that participants and beneficiaries have, in fact, suffered financial harm from the practice of cross-plan offsetting ... The outreach to participants and beneficiaries and the reporting required under this settlement with Emblem may answer this question once and for all, and that answer will impact how attractive these cases will be for both DOL and the plaintiffs' bar."  MORE >>

"[The] Better Mental Health Care, Lower-Cost Drugs and Extenders Act, when included with provisions from the Modernizing and Ensuring PBM Accountability (MEPA) Act from earlier this year, would introduce more transparency and regulation surrounding PBMs."  MORE >>

"Recently, discrepancies have been identified between TiC data and the actual commercial claims for several small self-insured employers. However, it remains unclear whether prices disclosed in TiC data sets are comparable to prices disclosed in other national data sets"  MORE >>

"Pet ownership comes with its own set of expenses, and by providing pet insurance, employers can help prepare their employees for the unexpected, reducing the likelihood that they'll face financial stress due to unexpected vet bills.... Forty-five percent of pet owners will spend the same amount or even more on their animal's health care than on their own ... 50% of dog owners express concerns about their ability to cover unforeseen veterinary expenses."  MORE >>

"The unbalanced process created by Department rulemaking has fueled an astronomical amount of claims being sent to IDR. If the policy is implemented in line with the law and Congressional intent of the No Surprises Act, health insurers will be encouraged to expand their provider networks, increasing access to care for patients, and the 'open negotiation' period will allow medical providers and health insurers to confidently resolve disputes and only require IDR as a last resort."  MORE >>

"Nearly 90 percent of eligible employees had an HSA in 2022 with 80 percent making contributions to it, up from 72.8 percent in 2021.... Three-quarters of employers make contributions to the HSA. Most provide a set amount per coverage level.... Sixty percent of responding organizations offer investment options for HSA contributions, though most participants choose not to use this option -- 70 percent of all HSA assets remain in cash."  MORE >>

"Courts continue to disagree over the enforceability of mandatory arbitration provisions containing class action waivers set forth in benefit plans governed by [ERISA]. In the absence of U.S. Supreme Court resolution, uncertainty will persist ... Plan sponsors should expect to see more litigation over the arbitrability of ERISA Section 502(a)(2) claims in the near term, and thoughtfully drafted arbitration provisions are key to minimizing the risk of potential class action litigation.'

[Harrison v. Envision Mgmt. Holding, Inc. Bd. of Directors, No. 22-1098 (10th Cir. Feb. 9, 2023; Argent Trust Co. v. Harrison, No. 23-30, cert. denied Oct. 4, 2023); Henry v. Wilmington Trust NA, No. 21-2801 (3d Cir. Jun. 30, 2023; cert. denied Oct. 16, 2023); Merrow v. Horizon Bank, No. 22-123 (E.D. Ky. Oct. 24, 2023)]  MORE >>