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Health & Welfare Plans Newsletter

January 23, 2024

 

[Guidance Overview]

Departments Announce Therapeutic Equivalence Approach to ACA Contraceptives Compliance

"[DOL], [HHS], and Treasury have issued additional FAQ guidance addressing first-dollar coverage of contraceptives under the [ACA's] preventive health services rules. The FAQs include a therapeutic equivalence approach ... as an alternative to complying with the contraceptives mandate using the Departments' current implementing guidance."  MORE >>

Thomson Reuters Practical Law

[Guidance Overview]

Florida PBM Law Limits Mail-Order Prescription Drug Programs, Requires State Filings by Employer Plans

"Employers that cover Florida employees under their prescription drug plans are now prohibited from imposing mandatory mail-order requirements and are required to provide a sixty-day continuity of care period following midyear formulary changes under a recently enacted Florida law regulating pharmacy benefit managers (PBMs)."  MORE >>

Ogletree Deakins

[Guidance Overview]

Correcting Missed HSA Contributions

"Employers should act in a timely manner to correct missed HSA contributions in the manner best suited for the specific facts and circumstances. Fortunately, employers discovering missed contributions after the close of the year can still correct by the tax filing deadline -- and without the need to correct the prior year Form W-2."  MORE >>

Newfront

House Committee Seeks Input on Reforms to Employer-Provided Health Insurance (PDF)

9 pages."As the 50th anniversary of ERISA approaches, the Committee is seeking feedback on ways to build upon and strengthen ERISA, the foundation of employer-sponsored health care.... Examining ways to increase affordability of coverage and increase quality and access to care, the Committee seeks feedback on the topics outlined [in this letter]. Please submit any responses ... by March 15, 2024." [Committee letter to Members of the Employee Health Benefits Community, Jan. 22, 2024]  MORE >>

Committee on Education and the Workforce, U.S. House of Representatives

Majority of Employers Expect to Change Their Leave Programs in the Next Two Years

"[S]upporting attraction and retention strategies [is] the number one driver for making changes to paid leave, time off or disability programs, cited by almost three-quarters (73%) of employers that have made or plan to make changes to their leave programs. Nearly as many (72%) cited enhancing the employee experience as a top reason. These reasons for making changes are consistent, with just small variations, across all employer sizes, from 100 employees to more than 25,000 or more employees."  MORE >>

Willis Towers Watson

Using Interpretable Machine Learning Methods: An Application to Health Insurance Fraud Detection (PDF)

48 pages. "Machine learning algorithms excel at constructing intricate models by discerning patterns in data, yet the risk of overfitting to training data necessitates rigorous testing by modelers and users.... This report endeavors to enhance transparency and understanding in the realm of health insurance fraud detection through interpretable machine learning."  MORE >>

Society of Actuaries

CRS In Focus: Prescription Drug Importation

"In the context of rising drug prices, the possibility of importing prescription drugs from other countries at lower prices is again being debated. Generally, the importation or reimportation of a prescription drug that does not meet Food and Drug Administration (FDA) requirements is prohibited. The policy debate has centered on creating a legal option for the import of lower-cost prescription drugs into the United States." [IF11056 Jan. 22, 2024]  MORE >>

Congressional Research Service [CRS]

[Opinion]

Data Sharing, PBM Reforms and Transparency: Where We Stand in Early 2024

"We don't know if the Senate will take steps to approve the House's Lower Costs, More Transparency Act [HR 5378]. That means we do not know if the amendments to the Gag Clause Prohibition ... will ever make their way into the law.... We also don't know whether PBM reforms -- particularly S 1339 -- will be included in legislation to keep the government funded and/or other supplemental spending bills.... [We] don't know whether the requirement to share claims data for 'audit' purposes and/or any other Transparency provisions will find their way into the law during these upcoming legislative exercises."  MORE >>

Benefitfocus

Benefits in General

[Official Guidance]

IRS News Release IR-2024-17: Connecticut Taxpayers Impacted by Storms Qualify for Tax Relief

"[I]ndividuals and businesses in parts of Connecticut affected by severe storms, flooding and a potential dam breach that began on Jan. 10 ... now have until June 17, 2024, to file various federal individual and business tax returns and make tax payments.  ... Currently, this includes New London County, including the Mohegan Tribal Nation and Mashantucket Pequot Tribal Nation."  MORE >>

Internal Revenue Service [IRS]

DOL's Employee Benefits Audit Quality Study: Key Takeaways

"[This DOL report] covers the last year before auditors were required to comply with the new Statement on Auditing Standards (SAS) No. 136 ... Of the 307 plan audits reviewed, 30% contained major deficiencies ... The audit areas with the most deficiencies were participant data (15.6%), contributions received and receivable (15.3%), and benefit payments (9.4%)."  MORE >>

Berry, Dunn, McNeil & Parker, LLC

Press Releases

New Survey Reveals 86 Percent of Benefits Leaders Recognize Need for Heart Health Strategy in 2024

Hello Heart

Encore Fiduciary (Formerly Euclid Fiduciary) Releases Authoritative Benchmark Survey on Recordkeeping Fees for Large Defined Contribution Plans

Encore Fiduciary

Financial Accounting Foundation Launches Redesigned Website for the Financial Accounting Standards Board; Additional Sites Premiere Soon

Financial Accounting Foundation

NCPERS Recognizes Industry Leaders with Inaugural Public Pension Communicator of the Year Award

National Conference on Public Employee Retirement Systems [NCPERS]

Webcasts and Conferences
(Health & Welfare Plans)

The Year Ahead 2024: Employee Benefits

January 23, 2024 PODCAST

Jackson Lewis LLP

2024 Employment & Employee Benefits Seminar

February 7, 2024 in NC

Poyner Spruill

Massachusetts Paid Family and Medical Leave (PFML)

February 8, 2024 WEBINAR

Littler

Last Issue's Most Popular Items

Employee Benefits Plan Transition and Integration Decisions Continue After M&A Transactions Close

Morgan Lewis

Text of Agency FAQs, Part 64: Coverage of Preventive Services (PDF)

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

District Court Finds Insurer Owed No Duty to Inform Plan Participant of Life Insurance Conversion Rights Upon Resignation

Roberts Disability Law

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

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