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Health & Welfare Plans Newsletter

February 9, 2024

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[Guidance Overview]

Federal Poverty Level Announced for 2024: What This Mean for Employer Shared Responsibility Rules

"[t]he 2024 federal poverty level (FPL) was announced as $15,060. This is an increase from $14,580 in 2023.... [E]mployers whose plan years begin on or after July 1, 2024, and who expect to rely on the FPL safe harbor should review their single employees' lowest-cost coverage premiums/contributions for their medical coverage offerings and make any required adjustments to premiums/contributions in order to ensure compliance with the ACA's affordability requirements."  MORE >>

Winston & Strawn LLP

Johnson & Johnson Case Signals Employee Drug Price Suits to Come

"A novel lawsuit from an employee suing Johnson & Johnson Inc. for allegedly mismanaging drug benefits appears a harbinger of litigation to come against companies, especially those that rely on pharmaceutical industry middlemen to negotiate pricing and rebates.... Employers can mitigate their liability exposure to these types of cases by ensuring they are engaged in a prudent process in selecting and monitoring their service providers, according to benefits attorneys who represent companies." [Lewandowski v. Johnson & Johnson, No. 23-0671 (D.N.J. complaint filed Feb. 5, 2024)]  MORE >>

Bloomberg Law

Uses of Generative AI in Healthcare and Implications for Health Insurers

"If the routes to market for new medicines are made faster and easier using generative AI, then insurers will need to increase their horizon-scanning activities and be prepared to make rapid changes to benefits, medical policy, claim processing capabilities and policy terms and conditions where necessary. Agility in governance and systems will become even more important, given the potential of new and possibly expensive personalised treatments to drive up medical inflation."  MORE >>


Retail Workers Have Mental Resilience, But Don't Often Use Employer Mental Health Services

"New research ... revealed that while frontline workers in retail and service-related businesses have high levels of stress, anxiety and depression, they are more resilient to these conditions than non-frontline workers.... The research also suggests that many workers do not know their employers have mental health services to help them."  MORE >>

The Wrap, via Yahoo News

Protective Behavior and Life Insurance

"[The authors] study life insurance market responses to COVID-19 using unique national administrative data from Israel on purchases and cancellations of life insurance policies, and an internet survey of Americans' life insurance choices, risk attitudes, COVID-19 perceptions, and vaccination behavior. [They find] no evidence that life insurance purchases or cancellations were consistent with adverse selection during the pandemic, while [they] do find advantageous selection."  MORE >>

Pension Research Council, The Wharton School of The University of Pennsylvania

Is Unlimited PTO Right for Your Organization?

"Unlimited PTO has pros and cons for both the employer and employee, and there's no one-size-fits-all answer to whether unlimited PTO makes sense for your organization. Organizations must consider four points to answer that question.... [1] Eligibility for unlimited PTO ... [2] Interplay with other time-off policies ... [3] Impact on current balances (banked leave) ... [4] Value of tracking time with unlimited PTO."  MORE >>


Employee Benefits Jobs

View job as Junior Retirement Plan Administrator for WIA Consultants, Inc.

Junior Retirement Plan Administrator

WIA Consultants, Inc.

East Meadow NY / Hybrid

View job as Junior Retirement Plan Administrator for WIA Consultants, Inc.

Webcasts and Conferences
(Health & Welfare Plans)

Gender-Affirming Benefits: Best Practices for Group Health Plans

February 29, 2024 WEBINAR

McDermott Will & Emery LLP

Pharmacy Benefit Managers (PBMs): What ERISA Fiduciary Obligations and Duties Relate to Prescription Drug Plans?

March 5, 2024 WEBINAR

Trucker Huss

Last Issue's Most Popular Items

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

Miller & Chevalier

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


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


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

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