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Health & Welfare Plans Newsletter

January 31, 2024

3 New Job Opportunities 3 New Job Opportunities


[Guidance Overview]

Departments Issue ACA FAQs on Coverage of Contraceptives

"The FAQs state that despite past attempts by the departments to clarify medical management techniques they have considered reasonable ... potentially unreasonable techniques and other problematic practices have nevertheless proliferated ... In response, the FAQs provide for an alternative 'therapeutic equivalence approach' to compliance for contraceptive drugs and drug-led devices."  MORE >>


[Guidance Overview]

Exceptional Usefulness and Quality icon ACA Information Reporting: Hypothetical Scenarios (PDF)

26 pages. "Think of this document as your worksheet for evaluating and creating successful, accurate ACA information reporting code sets for Lines 14-16 of IRS Form 1095-C. Designed to provide [ALEs] with a means by which to certify performance of certain obligations contained within the ACA's Employer Shared Responsibility Provisions, [these] hypothetical information reporting scenarios ... demonstrate proposed ACA information reporting responses reflective of the affordability, minimum value, and minimum essential coverage standards."  MORE >>

Baldwin Risk Partners

[Guidance Overview]

2024 Federal Poverty Level Announced: Impact on ACA Affordability

"[T]he 2024 federal poverty level (FPL) was announced as $15,060 (up from $14,580 in 2023).... Under the FPL safe harbor, coverage will be affordable if the cost to employees for self-only coverage on the lowest-cost plan offered is less than 8.39% of the federal poverty level."  MORE >>


Administration Drops Appeal of Prescription Drug Copay Accumulator Program Lawsuit

"[By] not pursuing an appeal, the Biden Administration will not seek to reinstate a rule that explicitly allowed group health plans to exclude prescription drug manufacturer copay assistance from participants' out-of-pocket maximums (a practice known as a 'copay accumulator program').... While the D.C. federal district court vacated the 2021 [Notice of Benefit and Payment Parameters], the court did not rule on whether manufacturer copay assistance must be included in the out-of-pocket maximum calculation under the ACA." [HIV and Hepatitis Policy Inst. v. HHS, No. 22-2604 (D.D.C. Sep. 29, 2023)]  MORE >>

Miller Johnson

Enrollment Trends in Self-Funded Employer-Sponsored Insurance, 2015 and 2021

"The share of employer-sponsored health insurance enrollment in self-funded plans grew from 55 percent in 2015 to 60 percent in 2021. Growth was concentrated in states with an initially low share but was widespread across most states (88.0 percent saw growth) and counties (78.2 percent saw growth). There were substantial differences in plan types in the self-funded and fully insured markets."  MORE >>

Health Affairs Forefront

Using Journey Mapping to Support Employees with Cancer: An Employer's Guide (PDF)

20 pages. "A journey map is one tool employers can use to foster empathy. It can help an employer understand the challenges their employees face when managing a cancer diagnosis. It can identify gaps in benefits and coverage as well as other points of friction. It can also help generate communication materials that provide guidance and answer the questions your employees will have as they navigate the phases of their cancer experience."  MORE >>


Few Americans Know How Much Their Healthcare Costs

"Seventeen percent of U.S. adults report they know how much their healthcare products or services will cost before receiving them. Results are similar across key demographic groups, including by race/ethnicity, gender, age, education level, geographic region and health insurance coverage status, suggesting a societywide lack of awareness about one's healthcare costs, regardless of personal background."  MORE >>



American Benefit Council Response to Congressional Working Group RFI on Paid Leave

24 pages. "[M]ulti-state companies face the significant challenge of navigating a maze of increasingly complex and inconsistent state paid leave mandates that undermines their ability to offer valuable paid leave benefits to their employees on a consistent basis nationwide.... To support and leverage employer-provided paid leave benefits, it is critical that federal legislation promote the harmonization of existing and potential forthcoming state paid leave programs so that multi-state employers can treat their employees equitably across the country."  MORE >>

American Benefits Council

Employee Benefits Jobs

View job as Retirement Plan Administrator for Burke & Schindler CPA

Retirement Plan Administrator

Burke & Schindler CPA

Cincinnati OH / Hybrid

View job as Retirement Plan Administrator for Burke & Schindler CPA

View job as Employee Benefits Account Manager for U.S. Retirement & Benefits Partners

Employee Benefits Account Manager

U.S. Retirement & Benefits Partners

New Braunfels TX

View job as Employee Benefits Account Manager for U.S. Retirement & Benefits Partners

View job as Actuary/Director - Retirement Plan Consulting for Eisner Advisory Group LLC

Actuary/Director - Retirement Plan Consulting

Eisner Advisory Group LLC

Remote / Minneapolis MN / FL / IL / LA / NJ / PA / TX / Hybrid

View job as Actuary/Director - Retirement Plan Consulting for Eisner Advisory Group LLC

Selected New Discussions

Owners of S-Corp Transfer Ownership to Children: Effect on Cafeteria Plan?

"On 1/1/2023, ownership of A corp was transferred from Mr. & Mrs. A to the A's 3 children. As of 1/1/2024, can Mr. & Mrs. A have deductions through our Section 125 Cafeteria Plan for their insurance premiums? Not quite sure on the family attribution rules as it relates to IRC 125 plans."

BenefitsLink Message Boards

Press Releases

Federal Court Orders Coal Producer Retirement Plan Trustees to Pay $637K in Restitution for Unremitted Contributions, Unlawfully Diverted Funds

Employee Benefits Security Administration [EBSA], U.S. Department of Labor

Kantor and Kantor, LLP Launches Their Podcast, 'Talking Insurance with Kantor and Kantor'

Kantor & Kantor LLP

Last Issue's Most Popular Items

ACA Information Reporting: Responding to IRS Letter 226-J (PDF)

Baldwin Risk Partners

Wellness Apps and Privacy


What Leave Benefits Are Employers Offering in 2024?

FMLA Insights

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

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