"This document proposes to rescind the [DOL's] 2018 rule entitled 'Definition of Employer -- Association Health Plans'.... The 2018 AHP Rule's alternative criteria were set aside in large part by the U.S. District Court for the District of Columbia in [2019].... The Department ... now proposes to rescind in full the 2018 AHP Rule in order to resolve and mitigate any uncertainty regarding the status of the standards that were set under the 2018 AHP Rule, allow for a reexamination of the criteria for a group or association of employers to be able to sponsor an AHP, and ensure that guidance being provided to the regulated community is in alignment with ERISA's text, purposes, and policies." [New York v. DOL, No. 18-1747 (D.D.C. Mar. 28, 2019)]  MORE >>

"[T]he percentage increase [in the CPI-U] from 2023 to 2024 is 1.0543149339.... [P]lans and issuers may round any resulting QPAs to the nearest dollar.To calculate the adjusted QPA, the prior year's adjusted QPA is multiplied by the percentage increase for the most recent year. To simplify this calculation, this notice provides cumulative percentage increases. "  MORE >>

"Based on the methodology described in the preamble to the final rule, the Departments are finalizing an administrative fee amount of $115 per party for disputes initiated on or after the effective date of this rule.... For disputes initiated on or after the effective date of this rule, the Departments are finalizing a certified IDR entity fee range of $200-$840 for single determinations and $268-$1,173 for batched determinations."  MORE >>

12 pages. "The new version features a vast change in the underlying data and several methodological tweaks ... On top of the Federal AVC changes, the maximum out of pocket was reduced from 2024 to 2025, and several benefit increases were proposed for standardized plan designs in the 2025 Notice of Benefit and Payment Parameters. All these updates contribute to potentially sizable changes in plan design and premium impacts, in particular likely premium increases to silver metal level plans."  MORE >>

"Unlike the [Illinois Paid Leave for All Workers Act (PLAW)], the [Cook County Paid Leave Ordinance (CCPLO)] allows employees to file civil suits against employers ... in addition to letting employees file complaints with Commission.... The CCPLO will be enforced starting on February 1, 2024."  MORE >>

"Under the Ordinance, employers may not: [1] Set a minimum increment for the use of paid leave that exceeds two hours; [2] Require an employee to provide a reason for requesting or using paid leave; [3] Require an employee to provide any documentation or certification in support of the paid leave ... Cook County intentionally included an effective date of December 31, 2023, to ensure the new Ordinance is not preempted by the Illinois PLAWA, which goes into effect on January 1, 2024."  MORE >>

"The 2018 rule's alternative criteria were set aside by the U.S. District Court for the District of Columbia in a 2019 decision. The district court found the bona fide association and working owner provisions in the rule to be an unreasonable interpretation of ERISA, inconsistent with congressional intent that ERISA applies to employee benefits arising out of employment relationships. The 2018 rule was never fully implemented, and the department is not aware of any existing AHP formed based on the rule."  MORE >>

"The Oklahoma Attorney General's office is likely to appeal to the Supreme Court. ... [T]he Eighth Circuit had previously ruled that ERISA did not preempt regulation of pharmacy benefit managers (PBMs) ... while the Tenth Circuit [has] ruled that similar regulation is preempted by ERISA.... As things now stand, PBMs, insurers, etc., operating in Kansas City, Missouri, and Kansas City, Kansas, may be subject to different legal standards as ERISA preempts state regulation of PBMs in Kansas but not in Missouri." [PCMA v. Mulready, No. 22-6074 (10th Cir. Aug. 15, 2023; pet. for en banc hearing denied Dec. 12, 2023)]  MORE >>

"As part of their efforts to implement health care cost growth targets, several states now require payers to provide aggregate data on pharmaceutical rebates they receive. In Connecticut, Rhode Island, and Oregon, these new data show that even after accounting for rebates, spending on prescription drugs has continued to grow at an unaffordable rate."  MORE >>

"The IRS issued final regulations ... that provide a de minimis safe harbor from the penalties for failure to file correct information returns under Sec. 6721 and failure to furnish correct payee statements under Sec. 6722[.]"  MORE >>

"[K]ey items to consider at this time: [1] Health Plans: Gag-clause attestation due December 31, 2023 ... [2] Retirement Plans: Increased cash-out limit option January 1.... [3] Health Plans: Mental health parity comparative analysis required now.... [4] Retirement Plans: Student loan matching contributions allowed January 1.... [5] Health Plans: PBM legislation increasing costs on employers and employees.... [6] Health Plans: Prescription drug reporting due June 1.... [7] Health Plans: Online shopping tool required for all covered items and services effective January 1.... [8] Health Plans: Prescription drug machine-readable files."  MORE >>