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Health & Welfare Plans Newsletter

February 2, 2024

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[Official Guidance]

Text of 2023 IRS Form 7206: Self-Employed Health Insurance Deduction (PDF)

"Use a separate Form 7206 for each trade or business under which an insurance plan is established."  MORE >>

Internal Revenue Service [IRS]

[Guidance Overview]

Health and Welfare Benefits Monthly Update, February 2024 (PDF)

24 presentation slides. Topics: [1] 2023 Short-term limited duration and fixed indemnity proposed regulations -- impact on abusive wellness program arrangements; [2] Specialty drug and copay assistance program compliance issues; [3] Service provider agreement compliance issues; and [4] Grab bag report and reminders.  MORE >>

Alston & Bird

[Guidance Overview]

EBSA Steps Up Mental Health Parity Enforcement

"While it is clear that regulators will not close investigations until they are satisfied no MHPAEA violations exist, they are also currently allowing significant opportunity for plans to cure deficiencies before issuing final determinations.... Plans should be prepared to document the actions they have taken and to demonstrate why any disparities are attributable to provider shortages in the geographic area rather than their NQTLs related to network composition."  MORE >>

Kutak Rock LLP

[Guidance Overview]

Annual ACA Information Reporting: Corrections and Replacements (PDF)

17 pages. "This employer resource guide provides an overview of several types of corrective opportunities available to reporting employers to the extent they discover, or are otherwise alerted to, errors in their ACA information reporting forms, failed electronic transmissions, inadvertently excluded information, or undelivered participant statements."  MORE >>

Baldwin Risk Partners

[Guidance Overview]

ACA Information Reporting: Requirements, Deadlines and Extensions (PDF)

12 pages. "The remaining sections of this employer resource guide detail the administrative steps underlying the employer information reporting process and incorporate a summarized table of important annual reporting related deadlines. Additionally, the following sections identify and explain different types of reporting related deadline extensions that are available to reporting employers through various IRS approved deadline extension programs."  MORE >>

Baldwin Risk Partners

[Guidance Overview]

New York City ESSTA Gives Employees New Private Right of Action

"The new law becomes effective March 20, 2024... New York City employers [should] ensure they are in compliance with the ESSTA, especially in light of rule changes that went into effect on October 15, 2023... Employees will have two years from the date they first knew (or should have known) about the alleged violation to file a lawsuit.... [P]revailing employees may recover other injunctive and declaratory relief, attorneys' fees and costs, and any other relief as the court deems appropriate."  MORE >>

Epstein Becker Green

[Guidance Overview]

2024 State Paid Family and Medical Leave Contributions and Benefits (PDF)

34 pages. "As of January 2024, California, Colorado, Connecticut, Delaware, Hawaii, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oregon, Puerto Rico, Rhode Island, Washington, and Washington, DC, mandate paid leave for an employee's own serious health condition or disability. Except for Hawaii and Puerto Rico, these jurisdictions also require paid family leave to bond with a new child, care for a seriously ill or injured family member, and handle certain other matters. Despite some common elements, differences in these laws make compliance and administration particularly challenging for multistate employers."  MORE >>


ERISA Litigation Highlights, February 2024

"[This article] explores decisions regarding [1] the transfer of an ERISA action that was filed in a state where an insurer did not maintain sufficient minimum contacts, [2] an award of attorneys' fees, costs, and prejudgment interest, [3] deference to an insurer's interpretation of a plan's provisions and ability to recoup overpaid money, and [4] an insurer's wrongful denial of benefits in light of powerful and compelling evidence submitted by a plaintiff-participant employed as an attorney."  MORE >>

Saul Ewing LLP


The MHPAEA Proposed Rule: Standards of Care and Medical Necessity

"The Legal Action Center claims that plans sometimes develop their own criteria for determining medical necessity for MH/SUD treatment or use criteria developed by nonprofit clinical specialty associations or industry entities ... [and] asks the Departments to revise the definition of 'strategies' to include a definition of 'generally accepted standards of care' that is tied to criteria and guidelines from the nonprofit clinical association for the relevant specialty.... It is possible for the Departments to rely on the proposed regulations' rules governing parity of outcomes to address [these concerns], although [the] proposed fix seems far more efficient."  MORE >>

McDermott Will & Emery

Benefits in General

Student Loan Benefits for Employees

"Given the impact of student loan debt on a large portion of the workforce, employers may find that tax-advantaged student loan programs are significant recruiting and retention tools. [This article covers] two potential benefits that an employer may adopt: [1] student loan assistance through Educational Assistance Programs (or EAPs), and [2] the new qualified student loan matching provision in certain retirement plans."  MORE >>

Kilpatrick Townsend

Employee Benefits Jobs

View job as Installation Specialist for Benefit Plans Plus, LLC

Installation Specialist

Benefit Plans Plus, LLC

Remote / Saint Louis MO

View job as Installation Specialist for Benefit Plans Plus, LLC

Last Issue's Most Popular Items

ACA Information Reporting Code Sets and Coding Flowcharts (PDF)

Baldwin Risk Partners

Correcting Mistaken HSA Distributions


New FAQs Address Contraception Coverage Under the ACA

Miller & Chevalier

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

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