"[State] reporting requirements basically fall into three categories: individual health coverage mandate reporting, health plan covered-lives assessment/surcharge payment/reporting, and other health plan-related reporting. ERISA arguably preempts some, but not all, state reporting requirements for GHP sponsors, but there are no current legal challenges to these employer mandates."  MORE >>

"[T]he proposed rules establish that only hours actually worked within the City of Chicago count toward accrual of Paid Leave ... [D]ay laborers who perform at least two hours of work for an employer within the City of Chicago are covered employees under the Ordinance.... [E]mployers must maintain employee records containing specific information for a period of not less than five years, and such records must be made available for inspection upon request by the Department."  MORE >>

"[E]mployees will now receive 10 paid leave days divided into two categories: five days of general paid leave and five days of paid sick leave.... While both types of leave will accrue at a rate of one hour for every 35 hours worked, the two categories have their nuances [listed here in a side-by-side table]."  MORE >>

"Under the new ordinance, for every 35 hours worked, an employee earns one hour of paid sick leave and one hour of paid leave.... Employers who choose to frontload paid sick leave are still subject to the requirements of carryover.... Under the new ordinance, employees may use their paid sick leave in minimum increments of two hours per day (down from four hours) and paid leave may be used in minimum increments of four hours."  MORE >>

"[1] Gag clause prohibition compliance attestation (GCPCA): Due by December 31, 2023 ... [2] Expanded participant-level transparency in coverage (TiC): Starting January 1, 2024 ... [3] Prescription drug data collection (RxDC) report: Due by 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."  MORE >>

"The court determined that the participant had presented facts sufficient to show that the plan had applied its cosmetic procedure exclusion in a discriminatory manner. It explained that the facts alleged by the participant show that the plan's denial of coverage for the surgery was based, at least in part, on considerations of gender stereotypes and gender conformity or nonconformity." [Doe v. Indep. Blue Cross, No. 23-1530 (E.D. Penn. Nov. 21, 2023)]  MORE >>

"[T]he company said its more than 9,000 pharmacies will be reimbursed by contracted pharmacy benefit managers (PBMs) and payors using a formula built on the cost of the drug, a set markup, and a flat fee to cover pharmacy services. CVS said the new model, called CostVantage, aims to bring 'greater transparency and simplicity to the system.' It is expected to launch for commercial payors in 2025, CVS said."  MORE >>

"There is a great deal riding on, and more than a little controversy over, the scope of any independent professional medical or clinical standards/fraud, waste and abuse exceptions that might be adopted in a final regulation. If these exceptions are narrowly construed, a final rule might doom carve-out arrangements or at least make them far more challenging to maintain."  MORE >>

176 pages. "The OIG remains concerned about [EBSA's] ability to protect the integrity of pension, health, and other benefit plans of about 153 million workers, retirees, and their families under [ERISA]. In particular, the OIG is concerned about the statutory limitations on EBSA's oversight authority and inadequate resources to conduct compliance and enforcement.... EBSA has limited legal authority to compel the Federal Retirement Thrift Investment Board to implement its recommendations, which includes enforcing its recommendations to improve the Thrift Savings Plan's cybersecurity posture."  MORE >>