"For use in preparing 2023 returns.... What's New: ... Notice 2023-37 addresses the announced end of the COVID-19 public health emergency and the National Emergency Concerning the Novel Coronavirus Disease 2019 Pandemic ... Notice 2023-37 also clarifies whether certain items and services are treated as preventive care under section 223(c)(2)(C). S"  MORE >>

"TPAs and PBMs hold virtually all of the information necessary to complete the analyses, but much of the details are kept as closely guarded secrets until the DOL requests the information. Accordingly, self-funded plan sponsors must be more assertive with their TPAs and PBMs to ensure [1] the analyses are completed, [2] the analyses are made available as required, and [3] that the analyses include all of the required detail, data, and elements[.]"  MORE >>

15 pages. "The year 2023 ... peaked over the summer with the release of the long-anticipated proposed rules for non-quantitative treatment limitations under the [MHPAEA]. Regulators also issued ... proposed rules for fixed indemnity excepted benefits coverage and short-term, limited-duration insurance; privacy of reproductive health information; and investment fiduciaries.... [A] new proposed regulation was issued this fall after several court opinions disrupted the federal IDR process. The IRS quietly released a chief counsel memorandum confirming that the substantiation rules for account-based plans really do mean what they say they mean.... Congress introduced several bills this year aimed at regulating PBMs."  MORE >>

"Beginning in 2022, New Mexico became the first state to eliminate cost-sharing for MH/SUD treatment in private insurance plans subject to state regulation.... [T]his study recounts the law's passage and intended impact."  MORE >>

22 pages. "In 2022, average cost of a biological product, $174 per prescription, was 3.7 times greater than average cost of a small molecule drug, $48 per prescription. Among the 1,838 small molecule drugs in 2022, 43 percent (796 drugs) had only one manufacturer ... Between 2017 and 2022, for small molecule drugs, the proportion of drugs with 6+ manufacturers rose while those with a single manufacturer declined over time."  MORE >>

"[The DOL] must take action to prevent group health plans and their plan sponsors from subjecting themselves to liability for either [1] failing to submit an attestation or [2] submitting an incorrect attestation. The DOL can do this by issuing guidance delaying the December 31 attestation submission date. Alternatively, the DOL can announce a one-year non-enforcement period for those plans and their sponsors that believe -- in good faith -- that prohibited gag clauses are still present in their agreements."  MORE >>

Changes to benefits-related items from EBSA and from the Wage and Hour Division (WHD) from the Spring 2023 DOL Regulatory Agenda:

Added to Prerule Stage:

• [1210-AC23] SECURE 2.0 Reporting and Disclosure

Moved from Prerule to Proposed Rule stage:

• [1210-AC20] Worker Ownership, Readiness, and Knowledge
• [1210-AC21] Exemption for Certain Automatic Portability Transactions

Added to Proposed Rule Stage:

• [1210-AC24] Federal Independent Dispute Resolution Process Fees

Update to Proposed Rule: 

• [1210-AC02] "Conflict of Interest in Investment Advice" changed to "Retirement Security Rule: Definition of an Investment Advice Fiduciary"

Moved from Proposed to Final Rule stage: 

• [1210-AC13] Coverage of Certain Preventive Services under the Affordable Care Act
• [1210-AB64] Adoption of Amended and Restated Voluntary Fiduciary Correction Program

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Changes from the Spring 2023 IRS Regulatory Agenda:

Added to Proposed Rule stage:

• [1545-BQ87] Guidance Under Section 162(m)

Moved from Proposed to Final Rule stage:

• [1545-BQ28] Short-Term, Limited-Duration Insurance; Independent, Non coordinated Excepted Benefits Coverage; Level-Funded Plan Arrangements; and Tax Treatment of Certain Accident and Health Insurance
• [1545-BQ29] Mental Health Parity and Addiction Equity Act and the Consolidated Appropriations Act, 2021
• [1545-BQ57] Requirements in Connection With Coverage of Certain Preventive Services

Added to Final Rule stage:

• [1545-BQ94] Federal Independent Dispute Resolution Fees

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"Most service providers carefully maintain and continuously upgrade their cybersecurity practices and technology, but employers cannot afford to take this for granted. It must be on the employer's checklist to regularly seek satisfactory documentation, from all outside vendors, that plan data is secured as much as possible."  MORE >>