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Health & Welfare Plans Newsletter

November 27, 2023

7 New Job Opportunities 7 New Job Opportunities

 

[Official Guidance]

Text of CMS Corrections to Final Regs: Medicare Secondary Payer and Certain Civil Money Penalties

"This correcting document identifies and corrects errors in [final regs] of October 11, 2023.... [T]he corrections are effective December 11, 2023.... [CMS] made technical errors in the amendatory instructions as well as the headings, entries, and table notes in the civil monetary penalty adjustment table[.]"  MORE >>

Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

Proposed Rules to Implement the Illinois Paid Leave for All Workers Act

"[T]he proposed rules will not be finalized until after the PLAWA takes effect on January 1, 2024 ... Covered employees ... Independent contractor test ... Frontloading paid leave ... Mixed-earning policies ... 'Qualifying pre-existing paid leave policy' ... Denial of PLAWA leave ... Carry over of PLAWA leave ... Payment of paid leave upon separation from employment ... Reinstatement of leave upon rehire ... Notice and accounting ... Local paid leave ordinances."  MORE >>

Jackson Lewis P.C.

[Guidance Overview]

City of Chicago Amends Paid Leave and Paid Sick and Safe Leave Ordinance

"The amendment provides that covered employees are entitled to take up to 40 hours of paid sick leave per year and another 40 hours of paid leave to use for any reason. The Department of Business Affairs and Consumer Protection may impose fines for violations and aggrieved employees may bring a private action."  MORE >>

Jackson Lewis P.C.

District Court Allows Participant's Gender Dysphoria Claims Involving Facial Feminization Surgery to Proceed

"In litigation under Section 1557 of the [ACA], a Pennsylvania district court concluded that a health plan participant plausibly alleged that the plan insurer's coverage denial for facial feminization surgery and related procedures was intentionally discriminatory based on sex in violation of Title IX of the Education Amendments of 1972." [Doe v. Indep. Blue Cross, No. 23-1530 (E.D. Penn. Nov. 21, 2023)]  MORE >>

Thomson Reuters Practical Law

Tenth Circuit Affirms Denial of Residential Treatment Benefits But Reverses Dismissal of Parity Act Claim

"The court rejected Health Net's argument that Plaintiffs fail to state a claim because applying the InterQual Criteria was ostensibly consistent with MHPAEA regulations. Even if a court were to find that the InterQual Criteria qualify as generally accepted standards, no such finding follows from Plaintiffs' allegations and Plaintiffs have stated a claim under MHPAEA." [E.W. v. Health Net Life Ins. Co., No. 21-4110 (10th Cir. Nov. 21, 2023)]  MORE >>

Roberts Disability Law

When the Payor Is Also the Decisionmaker in ERISA Benefits Lawsuits

"Over the last several years, courts have provided administrators and their attorneys with guidance on how to limit the impact of this common structural conflict of interest. When defending against denial of benefits claims ... defendant plan administrators should be aware of whether the conflict of interest exists and address it proactively to avoid negative inferences."  MORE >>

Husch Blackwell

Walmart Expands Doula Coverage for Employees

"The benefit, which kicked off Nov. 1 for most Walmart workers nationwide, covers up to $1,000 for doula services during pregnancy and is part of a suite of benefits offered through the company's 'Life with Baby' program, which is available to associates on most employee medical plans."  MORE >>

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

Is the High Price of Health Care Killing Americans?

"High healthcare costs lead many Americans to delay or forgo necessary medical treatment. A 2020 Gallup poll found that one in four Americans have delayed treatment for serious medical conditions due to the cost."  MORE >>

MSN News

ERISA and Health Insurance: A Comprehensive Overview for Employees

"For employees navigating the complex landscape of healthcare coverage provided by their employers, understanding ERISA is crucial. This article aims to provide a comprehensive overview of ERISA's impact on employer-sponsored health insurance plans and the rights bestowed upon employees within this framework."  MORE >>

Onrec

Benefits in General

[Official Guidance]

IRS Disaster Relief Announcement IL-2023-07, for Taxpayers Impacted by Severe Storms and Flooding in Parts of Illinois

"[I]ndividuals and businesses affected by severe storms and flooding in parts of Illinois ... now have until Feb. 15, 2024, to file various individual and business tax returns and make tax payments ... [I]ndividuals and households affected by severe storms and flooding that reside or have a business in Cook County qualify for tax relief."  MORE >>

Internal Revenue Service [IRS]

[Official Guidance]

IRS Disaster Relieve Announcement Vi-2023-01, for Taxpayers Impacted by Elevated Levels of Lead and Copper in Water Supply in Saint Croix, U.S. Virgin Islands

"[I]ndividuals and businesses affected by elevated levels of lead and copper in the water supply in the Island of St. Croix ... now have until Feb. 29, 2024, to file various individual and business tax returns and make tax payments."  MORE >>

Internal Revenue Service [IRS]

Employee Benefits Jobs

View job as ESOP Administrator
for Blue Ridge ESOP Associates

ESOP Administrator

Blue Ridge ESOP Associates

Remote

View job as ESOP Administrator for Blue Ridge ESOP Associates

View job as Defined Contribution Account Manager
for Nova 401(k) Associates

Defined Contribution Account Manager

Nova 401(k) Associates

Remote

View job as Defined Contribution Account Manager for Nova 401(k) Associates

View job as DB/DC Consultant
for Nova 401(k) Associates

DB/DC Consultant

Nova 401(k) Associates

Remote

View job as DB/DC Consultant for Nova 401(k) Associates

View job as Director of Sales
for Ubiquity Retirement + Savings

Director of Sales

Ubiquity Retirement + Savings

Remote

View job as Director of Sales for Ubiquity Retirement + Savings

View job as Vice President of Partner Ecosystem
for Ubiquity Retirement + Savings

Vice President of Partner Ecosystem

Ubiquity Retirement + Savings

Remote

View job as Vice President of Partner Ecosystem for Ubiquity Retirement + Savings

View job as Retirement Account Administrator
for Alerus

Retirement Account Administrator

Alerus

Remote / MN / ND

View job as Retirement Account Administrator for Alerus

View job as Senior Retirement Analyst
for Dunbar, Bender & Zapf, Inc.

Senior Retirement Analyst

Dunbar, Bender & Zapf, Inc.

Remote / Pittsburgh PA

View job as Senior Retirement Analyst for Dunbar, Bender & Zapf, Inc.

Last Issue's Most Popular Items

HHS Announces Adjusted Annual Limitation on Cost-Sharing for 2025 Benefit Year, Issues Proposed 2025 Benefit and Payment Parameters (PDF)

Thomson Reuters / EBIA

Are You Making Benefit Determinations? Be Sure to Check the Plan Documents

Haynes and Boone, LLP

More Americans Could Get Dental Coverage Under CMS Proposed 2025 Benefit and Payment Parameters

Axios

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

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