"Although in the past HHS announced the annual limitation on cost-sharing in the notice of benefit and payment parameters, the limitation (and certain other limits) is now published in guidance by January of the benefit year prior to the applicable benefit year, so long as no changes to the methodologies to calculate these amounts are proposed. For the 2025 benefit year, HHS is not proposing changes to the methodology, and thus has separately issued the 2025 limits rather than proposing them in regulations."  MORE >>

"In 2023, the IRS finalized regulations substantially expanding mandatory electronic filing of information returns. For returns required to be filed after December 31, 2023, the threshold for required electronic filing is ten returns."  MORE >>

"Employees who accrue leave time must be permitted to carry over up to 16 hours of unused general paid leave and 80 hours of unused sick and safe leave into the following year.... [A]ny unused general paid leave must be paid out upon separation or when an employee is transferred outside the city of Chicago, while unused sick and safe leave need not be paid out."  MORE >>

"CMS proposed ... allowing states to include adult dental services as an 'essential health benefit' (EHB) that ACA health plans must cover without imposing annual or lifetime limits on customers. While states wouldn't have to require the coverage, the proposal would reverse a ban on states from including adult dental services as an essential benefit."  MORE >>

"To consider the relative importance of a given drug in patient care, [CMS] will need to identify therapeutic alternatives, determine their comparative therapeutic advantage for patients, and incorporate that comparative information into its initial proposed price that will serve as the starting point for negotiation. This commentary discusses at a high level the issues CMS will need to consider in pursuing each of these three steps along with the necessary data sources to support each step."  MORE >>

"While the Settlement involved a health care providers, health plans and other HIPAA entities also are subject to the same HIPAA requirements to prevent unauthorized photography, videos, or other sharing or disclosure of participant or other PHI to media in interviews or other media interactions or by workforce members, business associates or other third parties.... [EBSA] now views HIPAA compliance and other prudent steps to protect PHI and other sensitive health information as part of fiduciaries and plan administrator's ERISA compliance obligations[.]"  MORE >>

"Only the person required to file electronically can sign Form 8508. A transmitter cannot sign Form 8508 for the issuer unless a power of attorney has been established. If you have a power of attorney, attach a copy to this form."  MORE >>

"A recent district court case highlights the importance of following the terms of the plan document in making determinations on benefit claims.... After reviewing minutes from the committee meeting at which the claim was decided, the court found the committee’s decision was based on an immaterial point and not the proper standards outlined by the terms of the plan." [Franke v. Fifth Amended & Restated Newfield Exploration Company Change of Control Severance Plan, No. 21-2234 (D. Colo. Oct. 20, 2023)]  MORE >>