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Health & Welfare Plans Newsletter

January 18, 2024

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[Official Guidance]

Text of Tri-Agencies Notice Reopening Comment Period on Proposed Regs for Federal Independent Dispute Resolution Operations

"This document reopens the comment period for the proposed rules entitled 'Federal Independent Dispute Resolution Operations' ... The comment period for the proposed rules, which closed on January 2, 2024, is reopened from [the date of publication in the Federal Register, currently scheduled for January 22, 2024,] to [14 days after that publication date]."  MORE >>

U.S. Department of Health and Human Services [HHS]; U.S. Department of Labor [DOL]; and U.S. Treasury Department

[Guidance Overview]

2023 Year in Review Plus What to Expect in 2024 (PDF)

70 presentation slides. "[1] The ACA has survived a trilogy of U.S. Supreme Court challenges plus multiple repeal/replace efforts, and now (a dozen years in) we start to have some stability and can settle into a more regular routine. [2] The CAA ... is proving to be the most significant health care reform effort since ACA ... [3] The COVID relief provisions have all expired -- what that means moving forward ... [4] LSAs continue to be a widely popular new offering for employees, and [5] the most popular new questions for compliance!"  MORE >>


[Guidance Overview]

ACA Reporting Deadlines and Penalties Cheat Sheet

"Employers subject to [ACA] reporting under Internal Revenue Code Sections 6055 or 6056 should prepare to comply with reporting deadlines in early 2024."  MORE >>


[Guidance Overview]

DOL Increases 2024 Penalty Amounts for Health and Welfare Benefit Plan Violations

"[1] Failure to timely file annual report Form 5500 subjects a plan sponsor to a penalty of $2,670 per day ... EBSA offers an amnesty program ... for late filers that voluntarily submit tardy Forms 5500.... [2] Failure to file annual report Form M-1 on a timely basis subjects a plan sponsor to a penalty of $1,942 per day ... There is no formal amnesty program for late M-1 filers ... [3] Failure to timely provide a compliant Summary of Benefits and Coverage (SBC) per the [ACA] requirements subjects a plan sponsor to a penalty of $1,406 per failure."  MORE >>


[Guidance Overview]

Administration Cracks Down on Prior Authorization -- But There Are Limits

"More than a year after it was initially proposed, [CMS] announced a final rule ... that will change how insurers in federal programs such as Medicare Advantage use prior authorization ... Beginning in 2027, [CMS] will require some insurers to adopt an electronic process for prior authorization. They'll have to respond to expedited prior authorization requests within 72 hours and to standard requests within seven days."  MORE >>

KFF Health News

[Guidance Overview]

Employers Take Note: New Employee Paid Leave Laws for 2024

"This article provides a summary of some of the key employee paid leave laws, including paid sick leave and paid family leave laws, that went into effect at the start of 2024.... [1] Minnesota ... [2] Illinois ... [3] Colorado ... [4] California ... [5] New York."  MORE >>

Venable LLP

[Guidance Overview]

Massachusetts Updates Paid Family and Medical Leave Poster, Notice, Contribution and Benefit Amounts

"The 2024 poster requires employers with a private plan to specifically list the name, address, phone number, and website of their private plan provider and indicate if the private plan covers family benefits, medical benefits, or both. The Department also updated the employee notice for 2024 to address legislation providing employees the ability to 'top off' PFMLA benefits by using other available paid leaves, such as vacation, or sick time."  MORE >>

Jackson Lewis P.C.

When to Distribute an Updated Wrap SPD

"Employers often are under the impression that they need to distribute a new wrap SPD annually and the updated underlying carrier documents within 90 days of the start of the plan year. However, by relying on open enrollment communications as a summary of material modifications (SMM), ERISA generally requires only that employers distribute a new wrap SPD once every five years."  MORE >>


Health Benefits Trends: New Solutions for Employers

"[1] Smarter plan design to help people manage their health.... [2] Employee fatigue from point solutions and wellness programs.... [3] Health benefits embracing consumer-centric ideas from other industries.... [4] Greater focus on pharmacy coverage.... [5] ICHRAs growing in popularity."  MORE >>

Employers Are Struggling to Figure Out If They're Overpaying for Health Care

"Employers are facing stronger legal requirements to ensure they aren't wasting their workers' money on overpriced health insurance, at the growing risk of financial consequences. But employers say secrecy around negotiated health care prices too often prevents them from accessing data that would help them figure out if they're getting a good deal."  MORE >>

MSN News


The Two Health Care Cost Crises

"One reason efforts to take on health care costs are fragmented may be that there are currently no national goals for health care costs and no requirement for a national strategy mandated by Congress ... The end result is that we have two larger health cost crises -- an acute one, affordability, and a chronic one, spending -- several other serious health cost problems, and no national strategy on health care costs[.]"  MORE >>

Henry J. Kaiser Family Foundation

Benefits in General

Supreme Court Appears Ready to End Deference to Federal Agency Expertise

"The Supreme Court appears poised to strip away at least some of the discretion federal agencies enjoy in interpreting and implementing federal law after hearing challenges to a decades-old doctrine that the judicial branch should defer to the executive when provisions of law are unclear.... Chevron has long been considered one of the most significant precedents in administrative law and its reversal, even if only partial, could cause major disruptions in how agencies operate." [Loper Bright Enterprises, Inc. v. Raimondo, Sec. of Comm., No. 22-451 (S.Ct. transcript of oral argument Jan. 17, 2024); Relentless, Inc. v. Dept. of Commerce, No. 22-1219 (S. Ct. transcript of oral argument Jan. 17, 2024)]  MORE >>

Government Executive

Employee Benefits Jobs

View job as Lead Transition Consultant - Retirement Plans for Ameritas

Lead Transition Consultant - Retirement Plans


Remote / Lincoln NE

View job as Lead Transition Consultant - Retirement Plans for Ameritas

Press Releases

Jordan Mamorsky Appointed Partner at The Wagner Law Group

The Wagner Law Group P.C.

Trucker Huss Director Joseph Faucher Selected to 2024 Southern California Super Lawyers List

Trucker Huss

DOL Recovers $47K in Back Wages, Damages for 2 Workers Illegally Fired by Tennessee Healthcare Employer for Taking Protected Leave

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

Webcasts and Conferences
(Health & Welfare Plans)

Risks May Be Bigger Than They Appear: A Rearview Look at 2023 Labor and Employment Law Changes and a Guide to Potential 2024 Obstacles

February 6, 2024 WEBINAR

Davis & Gilbert LLP

Understanding & Administering the Employer’s USERRA Obligations

February 28, 2024 WEBINAR

Baldwin Risk Partners

Last Issue's Most Popular Items

Employers Should Pay More Attention to USERRA


DOL Sues Blue Cross Blue Shield Minnesota for Collecting $66.8m in Provider Tax

PLANSPONSOR; free registration may be required

District Court Decision Provides Reminder that Benefit Claim Denial Letters Must Comply with ERISA

Haynes and Boone, LLP

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

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