21 pages; Nov. 30, 2023. "What's New: The temporary special rules for dependent care flexible spending arrangements (FSAs) have expired."  MORE >>

"Two FAQs address IDR batching, while a third addresses the [ACA] requirement to provide certain notices in a culturally and linguistically appropriate manner."  MORE >>

"[To] state a claim under MHPAEA, [the court said] a plaintiff must: [1] Plausibly allege that the relevant group health plan is subject to MHPAEA. [2] Identify a specific treatment limitation applied to MH/SUD benefits covered by the plan. [3] Identify M/S benefits covered by the plan that are analogous to the MH/SUD care for which the plaintiff seeks benefits. [4] Plausibly allege a disparity between the treatment limitation on the MH/SUD benefits as compared to those placed upon the analogous M/S benefits." [E.W. v. Health Net Life Ins. Co., No. 21-04110 (Nov. 21, 2023)]  MORE >>

"Employers ... see ultra-pricey drugs as key factors pushing up costs overall.... [F]ewer than half of large employers (42% of those with 500 or more employees) currently cover GLP-1 medications for treatment of obesity, although another 19% say they are considering it.... Employers and health plans also are looking at putting systems in place, such as prior authorization, that can better manage the cost around these drugs."  MORE >>

"Among users of primary care, 95-97 percent utilized it in an office setting prior to 2020, but only 86 percent did so from 2020-2021 as employees began using telemedicine (7-8 percent) and urgent care clinics (3-4 percent) with greater frequency due to the COVID-19 pandemic.... There has been a consistent downward trend in the share of employees whose primary care office visits are at a general/family practice, falling from 42 percent in 2013 to 37 percent in 2021."  MORE >>

"Additional claims information should be disclosed to employers to facilitate supplementation of paid leave benefits ... Further guidance is needed on the definition of 'family member' for employee understanding and employer administration ... Job protection standards should not arbitrarily limit the equivalent positions available to employees returning from paid leave."  MORE >>