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Health & Welfare Plans Newsletter

January 11, 2024

2 New Job Opportunities 2 New Job Opportunities

 

[Guidance Overview]

California Mandates Leave for Reproductive Loss

"Senate Bill 848 ... requires employers with 5 or more employees to provide reproductive-related loss leave of absence. This leave allows employees to take up to 5 days of leave following a reproductive loss event. This law went into effect on January 1, 2024."  MORE >>

Sequoia

Key Factors Impacting Health Plan Cost Trends (PDF)

"Medical trend was favorable in 2022 primarily because there were fewer claims related to COVID-19 ... Treatment of mental health ... was still a major cost driver in 2022, increasing at more than twice the rate of general medical trend.... [By] 2022, cancer trend was almost four times higher than general medical trend.... Double-digit prescription drug trend in 2022 was mainly attributable to high utilization of [GLP-1] drugs used to treat diabetes and for weight loss."  MORE >>

Segal

House HELP Subcommittee Hearing: Lowering Costs and Increasing Access to Health Care with Employer-Driven Innovation

Video of Jan. 11 hearing, including testimony by [1] Michele Beehler, Schweitzer Engineering Laboratories; [2] Laura Josh, California Schools VEBA; [3] Andrea Ducas, Center for American Progress; and [4] Dr. Christopher Whaley, RAND Corporation.  MORE >>

Subcommittee on Health, Employment, Labor, and Pensions [HELP], Committee on Education and the Workforce, U.S. House of Representatives

[Opinion]

NCPA Applauds Class Action Lawsuit Alleging Collusion Between Express Scripts and Other PBMs

"The lawsuit ... claims that Express Scripts used its dominant market position to push rival PBMs to impose excessive back-end fees on pharmacies and then share the revenue with Express Scripts." [Osterhaus Pharmacy, Inc. v. Express Scripts Inc., No. 24-0039 (W.D. Wash. complaint filed Jan. 9, 2024)]  MORE >>

National Community Pharmacists Association [NCPA]

[Opinion]

Weight Loss Drugs Are Not the Only Answer: Why Employers Must Help Redefine the Obesity Journey

"While glucagon-like peptide 1 agonists (GLP-1) have been identified as an effective weight-loss drug, they should only be part of the solution.... Employers should take a longitudinal approach, shifting the focus from the one-off, high-cost weight-loss solutions to a sustained, affordable, comprehensive health and care strategy."  MORE >>

The European Sting

[Opinion]

Congress is Threatening Businesses' Health Coverage

"[I]nstead of addressing the need to improve employers' and employees' access to essential coverage, Congress is contemplating policies that could severely disrupt small businesses' ability to offer reasonably priced health care benefits to employees. The proposed policies would eliminate market-based incentives for pharmacy benefit companies ... Research ... revealed that such 'delinking' policies would likely cost patients and payers billions of dollars annually and drive up premiums in the Medicare Part D program alone by $4 billion to $13 billion."  MORE >>

Jim Chaston, via Ahwatukee Foothills News

Benefits in General

[Guidance Overview]

DOL Increases Civil Money Penalties for 2024

"[T]he final regulations' higher penalty amounts apply for penalties assessed after January 15, 2024, whose associated violations occurred after November 2, 2015.... [A] table reflects the DOL's 2024 annual inflation adjustments to the civil money penalties for violations of certain requirements under ERISA, effective January 15, 2024."  MORE >>

Thomson Reuters Practical Law

[Guidance Overview]

DOL Fact Sheet 13: Employment Relationship Under the Fair Labor Standards Act (FLSA)

Rev. Jan. 2024. "This fact sheet provides general information on how to determine if a worker is an employee or independent contractor under the FLSA.... What Is the Economic Reality Test? ... Economic Reality Test Factors: [1] Opportunity for profit or loss depending on managerial skill.... [2] Investments by the worker and the employer.... [3] Degree of permanence of the work relationship.... [4] Nature and degree of control.... [5] Extent to which the work performed is an integral part of the employer's business.... [6] Skill and initiative."  MORE >>

Wage and Hour Division [WHD], U.S. Department of Labor [DOL]

[Guidance Overview]

New Rule on Independent Contractor Classification Will Have Profound Impact on Businesses

"[T]he rule fails to provide a realistic solution for the frequent scenario where workers who desire to be independent contractors choose themselves to be 'economically dependent' on work made available to them by one company, such as an ongoing business relationship between a vendor and its customer. As such, the rule is likely to create more uncertainty for companies that utilize legitimate independent contractor relationships to carry out their business functions."  MORE >>

Holland & Knight

Trends to Watch in Benefits and Compensation in 2024

"[1] GLP-1 drug coverage decisions ... [2] More financial health offerings ... [3] Pay increases will meet or exceed inflation ... [4] Mental health focus ... [5] Controlling health care costs ... [6] More pay transparency ... [7] Pensions may make a comeback."  MORE >>

Society for Human Resource Management [SHRM]; membership may be required to view article

Dispelling Cybersecurity Myths for Benefit Plans

"As plans face potential vulnerabilities and threats, their strategies around data protection will vary based on factors such as size, scope and unique risks at play, but here are nine myths and misconceptions surrounding cybersecurity that every plan stakeholder should be aware of to ensure a more accurate understanding of a plan's risk posture."  MORE >>

International Foundation of Employee Benefit Plans [IFEBP]

Employee Benefits Jobs

View job as DB Plan Consulting Assistant for EGPS

DB Plan Consulting Assistant

EGPS

Remote / Franklin Square NY

View job as DB Plan Consulting Assistant for EGPS

View job as Operations Analyst II for EGPS

Operations Analyst II

EGPS

Remote / Franklin Square NY

View job as Operations Analyst II for EGPS

Selected New Discussions

HSA Eligibility Where One Spouse Has HDHP Plan, the Other Has Individual ACA Plan

"My wife and I are in an HDHP through my work, but due to some less-than-optimal coverage she is looking at enrolling in an individual ACA plan this week to start 2/1. I may stay on my work's plan (not calendar year). If so, does that affect my use of the HSA associated with it? I'd presume only my expenses would be eligible to be paid from it. Or does anything conflict such that I lose my eligibility? And the annual maximum contributions would be what, the individual limit times 1.083333? I don't know if her plan choice will qualify as an HDHP -- if it does, is that fine? We'd be in two separate plans that qualify, so perhaps we could continue with the HSA (although my work wouldn't care about her plan's benefits or fund anything on her behalf) with the full 8300 limit?"

BenefitsLink Message Boards

Press Releases

Strive Announces New 401(k) PEP Retirement Plan for Small-to-Mid-Sized Businesses

Strive

Hint Announces Partnership with E Powered Benefits to Enable Better Access to Direct Primary Care Through Performance Health Plans

Hint Health

Webcasts and Conferences
(Health & Welfare Plans)

ERISA Arbitration and Class Action Waivers: Drafting Arbitration Provisions, Minimizing Risks and Class Actions

February 20, 2024 WEBINAR

Strafford

Last Issue's Most Popular Items

Health Plan Issues in 2024: A Look Ahead

Arthur J. Gallagher & Co.

DOL Announces Final Rule on Determining Independent Contractor Status

Ogletree Deakins

Fiduciary Liability: 2023 in Review and a Look Ahead to 2024

Willis Towers Watson

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BenefitsLink® Health & Welfare Plans Newsletter, ISSN no. 1536-9595.

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