"[P]lans must provide participants and beneficiaries with out-of-pocket cost estimates via a user-friendly online self-service tool (and by paper upon request).... [T]he first phase of the price comparison tool required the first 500 items and services to be published ... effective for plan years beginning on or after January 1, 2023, and the second phase will require all other services covered by the plan to be included ... effective for plan years beginning on or after January 1, 2024."  MORE >>

"The initial attestation will require reviewing contracts in effect on or after December 27, 2020, for any offensive gag clause language. Amending existing contracts may be necessary to ensure ongoing compliance. The entities that are required to submit an attestation include both self-insured and fully insured group health plans."  MORE >>

"The penalty amounts are adjusted annually ... These updated amounts for 2023 apply for penalties assessed on or after October 6, 2023 for violations that occurred on or after November 2, 2015.... [T]he HIPAA penalty amounts vary based on the penalized entity's level of care, while other penalties apply based on the violation itself, without regard to intent."  MORE >>

"Several states, including Florida, New Jersey, New York, South Dakota, and Wisconsin have ... enacted measures allowing beneficiaries to stay on their parent's health insurance plans well past the age of 26.... Most of the states that extend additional coverage require the dependents to be unmarried, have no dependents, be a resident of the state, or be enrolled as a full-time college student."  MORE >>

"Illinois' Paid Leave for All Workers Act ... effective January 1, 2024, applies to nearly all Illinois employers ... [P]aid leave can be used for any reason, and does not have to be for sick leave for the employee or their family member.... Effective December 31, 2023, Chicago has also amended its Paid Leave and Paid Sick and Safe Leave Ordinance to require eligible employees to accrue up to 40 hours of sick leave as well as 40 hours of paid leave that can be used for any reason. Chicago law also has different accrual rates than Illinois law[.]"  MORE >>

"This Part 2 describes annual cost-of-living increases and includes a summary table of penalties, percentages, and premiums under the employer shared responsibility requirements of Code Section 4980H."  MORE >>

"[1] Gag clause prohibition compliance attestation (GCPCA): Due December 31, 2023 ... [2] Expanded participant-level Transparency in Coverage (TiC): Starting January 1, 2024 ... [3] Prescription drug data collection (RxDC) report due June 3, 2024 ... [4] Electronic filing required for ACA reporting in 2024 ... [5] Deadlines for ACA reporting in 2024 ... [6] Year-end Section 125 cafeteria plan action items ... [7 Year-end state law action items."  MORE >>

"A seven-week period between employee engagement in protected activity and an adverse employment action may not be considered sufficient temporal proximity that is unusually suggestive of discrimination or retaliation. An employee's use of FMLA leave and administrative leave do not constitute an exercise of their rights under the ADA.." [Coleman v. Children's Hospital of Philadelphia, No. 22-1445 (E.D. Penn. Nov. 8, 2023)]  MORE >>

"Group captive-funded medical stop-loss insurance offers a way for smaller employers ... to obtain the full benefit of self-funding.... This Special Report explains what group medical stop-loss captives are and how they are structured and regulated.... [It] includes a discussion of the criteria that an employer might apply to determine whether a group captive solution is appropriate. Then, it offers an overview of the applicable laws, regulations and other considerations ... [and] concludes with some practical recommendations for employers that either currently participate in, or are considering signing on to, a group captive arrangement."  MORE >>

"[A]reas where AI could become transformative for healthcare [include] [1] Operational and administrative efficiencies ... [2] Improvements in employee experience: ... [3] Clinical enhancements ... [4] Empower true transparency ... There are numerous ethical and privacy concerns to consider ... Employers should be proactive and understand how the vendors in their ecosystems use AI today or if they plan to in the future."  MORE >>