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Health & Welfare Plans Newsletter

February 8, 2024


[Official Guidance]

Text of IRS Publication 969: Health Savings Accounts and Other Tax-Favored Health Plans (PDF)

23 pages; Rev. Jan. 5, 2024. "For use in preparing 2023 returns.... What's New: ... Notice 2023-37 addresses the announced end of the COVID-19 public health emergency and the National Emergency Concerning the Novel Coronavirus Disease 2019 Pandemic ... Notice 2023-37 also clarifies whether certain items and services are treated as preventive care under section 223(c)(2)(C)."  MORE >>

Internal Revenue Service [IRS]

[Guidance Overview]

IRS Web Page Helps Businesses Determine Eligibility for Up to $150,000 Employer-Provided Childcare Tax Credit

"The [IRS] announced the launch of a new page ... explaining the Employer-Provided Childcare Tax Credit, an incentive for businesses to provide child care services to their employees.... This tax credit is designed to help employers cover some of the qualified child care facility and resource and referral expenditures associated with providing child care services to their employees."  MORE >>

Internal Revenue Service [IRS]

[Guidance Overview]

Tri-Agencies Issue FAQs on Contraceptive Coverage

"For plans and issuers that seek to impose cost-sharing or medical management techniques on certain contraceptives without a therapeutic equivalent, [the authors] anticipate greater scrutiny of the plan/issuer's exceptions process, both in terms of how it is communicated to participants and providers, as well as the scope of deference given to the treating provider regarding the medical appropriateness of the particular contraceptive."  MORE >>

Groom Law Group

[Guidance Overview]

Paid Family and Medical Leave: Snapshots Across the U.S. (PDF)

22 slides recap 2024 laws in 14 states, Puerto Rico and Washington, DC, that require paid leave for an employee's serious health condition or disability and, in most cases, for certain family reasons. The slides include information on voluntary paid leave programs and a 2024 contribution and maximum benefit summary slide for all jurisdictions.  MORE >>


J&J Suit Adds to Growing Wave of Health Plan Litigation Over Costs and Fees

"The plaintiff claims defendants should have used their bargaining power to demand better contract terms and prices, should have considered contracting with an alternative 'pass-through' PBM that passes on discounts and rebates to plans, and should have considered carving out their specialty drug program from their broader Express Scripts contract. The complaint lists a host of companies that the plaintiff claims have taken steps to prudently manage their prescription drug benefits, in contrast to J&J's alleged failures to do so. This case is almost certain to spur copycat filings alleging similar violations[.]" [Lewandowski v. Johnson & Johnson, No. 23-0671 (D.N.J. complaint filed Feb. 5, 2024)]  MORE >>

Miller & Chevalier

Small Business Health Insurance Insights, February 2024 (PDF)

12 pages. "Offering group health coverage is important to small businesses: 92% say it's important, with 69% call it 'extremely important.' ... 90% of those offering health coverage say it helps them hire and retain the best workers.... Among those offering coverage, 44% are 'very worried' while 37% are 'somewhat worried.' ... 47% say an increase of 15% would make offering coverage unaffordable."  MORE >>


One Company Cut Health Spending by Nearly Half: A Case Study

"A midsized Montana-based company managed to nearly halve its per-person health spending in just five years, without dropping benefits.... Pacific Steel & Recycling's success in wrestling down its health spending provides a case study of how employers can cut costs, but CEO Jeff Millhollin said the effort also demonstrates why it's harder than needed for most companies and workers."  MORE >>


The Balancing Act with Covering Psychedelics

"When employers think about providing coverage for ketamine treatment, they must navigate various considerations and guardrails to ensure a balanced and responsible approach.... [1] Provide educational resources about mental health, treatment options and the effects of treatments like ketamine.... [2] Consult with medical providers and health plan carriers on the clinical appropriateness and/or the medical necessity of ketamine treatment.... [3] Evaluate the financial aspects of providing ketamine coverage.... [4] Seek legal advice  ... [5] If an employee's job involves safety-sensitive tasks, consider performing evaluations to assess safety risks for those thinking about treatment."  MORE >>

Brown & Brown, Inc.

Employer-Provided Pet Insurance: Tax and ERISA Issues (PDF)

"If your company pays or contributes to the cost of the pet insurance, the value of the benefit would be fully taxable to employees under federal law because there is currently no federal income tax exclusion for pet insurance.... While ERISA's welfare benefit plan definition does cover medical, surgical, or hospital care or benefits, or benefits in the event of sickness, it seems doubtful that those terms encompass veterinary benefits. In any event, it appears that a pet could not be an ERISA beneficiary, as a pet would not be considered a 'person' under ERISA."  MORE >>

Thomson Reuters / EBIA

HHS Settles HIPAA Cybersecurity Investigation Involving 'Malicious Insider' for $4.75 Million

"HHS announced this settlement as part of its broader cybersecurity strategy for the health sector. However, other HIPAA CEs -- including group health plans -- could also fall prey to an employee-turned-bad-actor who takes advantage of employment-related access to individuals' PHI. As a result, HHS has encouraged all CEs to take steps ... to prevent (or at least reduce the likelihood of) cyber threat."  MORE >>

Thomson Reuters Practical Law

Medicare Part D’s New Prescription Payment Plan May Not Reduce Costs For All

"Under the redesigned benefit, beneficiaries will no longer have to navigate multiple coverage phases when filling their prescriptions. Instead, they will have a single benefit phase (after meeting a deductible if their plan has one) until they reach their annual out-of-pocket spending limit of $2,000.... Although the policy goal is well-intentioned to help minimize the burden of high out-of-pocket prices, it may have the unintended consequence of perpetuating the problem of patients not knowing their medication costs month to month while accruing a large 'surprise' bill at the end of the year."  MORE >>

Health Affairs Forefront


Flipping the Script on the New Excess Health Plan Fee Case Against Johnson and Johnson

"The highly detailed and lengthy complaint represents a groundbreaking attempt to turn plan sponsors into guarantors of the lowest possible fees for every drug or medical service offered by the plan.... If there is any victim of excess fees in health plans, the victim is the plan sponsor. If there is an culprit in health plan excess fees, it is the PBM or other service provider. Consequently, if there is any liability for excess fees, the liability should be borne by health care providers. And any liability damage recoveries should be returned to plan sponsors -- not to plaintiff lawyers or even participants." [Lewandowski v. Johnson & Johnson, No. 23-0671 (D.N.J. complaint filed Feb. 5, 2024)]  MORE >>

Encore Fiduciary

Benefits in General

[Official Guidance]

IRS Disaster Relief Announcement WV-2024-01, for West Virginia Taxpayers Impacted by Severe Storms, Flooding, Landslides and Mudslides

"[I]ndividuals and businesses in parts of West Virginia affected by severe storms, flooding, landslides and mudslides that began on Aug. 28, 2023 ... now have until June 17, 2024, to file various federal individual and business tax returns and make tax payments.... [I]ndividuals and households that reside or have a business in Boone, Calhoun, Clay, Harrison, and Kanawha counties, qualify for tax relief."  MORE >>

Internal Revenue Service [IRS]

Press Releases

Tax Season 2024: Updated Resources Offer Crucial Guidance on Tax Returns and Reporting

Vitality Appoints Distinguished Health Plan Executive Steve Margolis as President


Payroll Integrations Automates Admin Hassles of 401(k) Compliance Testing

Payroll Integrations

Voya Evolves Suite of Advice and Guidance Solutions with Launch of New Dual QDIA

Voya Financial

The ESOP Association Prepares to Release Proposed Regulatory Framework

ESOP Association

Webcasts and Conferences
(Health & Welfare Plans)

2024 Employee Benefits Webinar: Public Sector Employers


Hanson Bridgett

2024 Employee Benefits Webinar: Private Sector Employers


Hanson Bridgett

Last Issue's Most Popular Items

Correcting Improper Health FSA Payments


Draft IRS Publication 969: Health Savings Accounts and Other Tax-Favored Health Plans (PDF)

Internal Revenue Service [IRS]

Roundup of Selected State Health Developments, Fourth-Quarter 2023 (PDF)


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

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