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Health & Welfare Plans Newsletter

February 26, 2024

5 New Job Opportunities 5 New Job Opportunities

 

[Guidance Overview]

Federal Regulators Unveil Revised Final Guidance for Healthcare Cybersecurity and HIPAA Compliance

"HHS and NIST issued new guidance to provide information and serve as a resource for HIPAA-regulated entities to improve cybersecurity and compliance with the HIPAA Security Rule. The guidance comes after HHS announced a new carrots-and-sticks strategy to improve cybersecurity in the healthcare industry with additional resources and a proposal to increase civil penalties for data breaches to incentivize security measures."  MORE >>

Ogletree Deakins

[Guidance Overview]

March 1 Is Deadline for Calendar Year Health Plans to Submit Prescription Drug Coverage Disclosure to CMS

"Disclosure to CMS involves certifying that your plan's prescription drug coverage is at least as good, actuarially speaking, as the standard coverage offered by Medicare. While this may seem difficult to quantify (and it is!), CMS provides a general basis against which you can measure your plan's coverage to determine whether it is creditable."  MORE >>

Reid and Riege, P.C.

[Guidance Overview]

Correcting Mistaken Elections in Cafeteria Plans

"For erroneous elections, the IRS only allows an employer and employee to correct a mistaken election if there is 'clear and convincing evidence' that a mistake has occurred.... Examples may be wrong salary reductions, benefit elections entered into the HRIS/payroll system, or a delay in changing a salary reduction when a change in status occurs."  MORE >>

TRI-AD

[Guidance Overview]

Reporting Prescription Drug and Health Care Spending

"[A diagram provides] a visual overview of how the RxDC reporting fits into the larger scheme of health care transparency legislation.... Chief among [the] necessary compliance steps is communicating with carriers and TPAs about how they will assist with detailed reporting requirements, as most, if not all, group health plans will not possess the requisite information on their own."  MORE >>

McGriff

[Guidance Overview]

The Summary of Benefits and Coverage (PDF)

"While the information contained in an SBC is only a summary and can change, the standardized format makes it easier for people to compare health plans. This resource provides an overview of the layout and key terms used in the Summary of Benefits and Coverage."  MORE >>

Center on Budget and Policy Priorities

[Guidance Overview]

Easy Pricing Plans (Standardized Plans) (PDF)

"Beginning in the 2023 coverage year, HealthCare.gov reintroduced standardized plan design options, which are labeled 'easy pricing'. These plans are intended to simplify and streamline plan comparison within each metal level ... Every health insurance company offering plans on HealthCare.gov must provide a standardized plan for each metal level, plan type, and service area where they offer non-standardized plans."  MORE >>

Center on Budget and Policy Priorities

[Guidance Overview]

San Francisco Contractor-Lessee Health Plan Rules

"San Francisco contractors and lessees (and their subcontractors and subtenants) may have to provide covered employees health coverage meeting minimum standards or make an alternative payment under the Health Care Accountability Ordinance (HCAO). The Department of Public Health (DPH) has clarified how these standards apply to covered employers. Minimum standards and alternative payments also apply for covered employees at the San Francisco International Airport (SFO) under the Healthy Airport Ordinance (HAO) ... Finally, covered service contractors and airport tenants are subject to minimum compensation rates and time-off requirements under the city’s Minimum Compensation Ordinance (MCO)."  MORE >>

Mercer

District Court Deems Administrative Remedies to be Exhausted When Plan Failed to Strictly Adhere to Procedural Deadlines

"[T]he Court found that by a simple calendar count, [the claims administrator's] extension request was not timely.  ... The fact that [the administrator] waited 29 days before requesting the independent physician review, and then claimed the need to provide Plaintiff with time to rebut the review were unpersuasive reasons when [the administrator's] own actions caused the need for additional time." [Witt v. Intel Corporation Long-Term Disability Plan, No. 23-01087 (D. Ore. Feb. 16, 2024)]  MORE >>

Roberts Disability Law

The Shifting Regulatory Landscape for Level-Funded Plans

"[L]evel-funded health plans are steadily gaining ground as a viable middle approach between fully insured health plan and self-funded health plans ... Their growing popularity, however, is now catching the attention of both lawmakers and regulators who are concerned about the lack of regulation that exists between fully insured and self-insured plans, particularly regarding the use of stop-loss insurance."  MORE >>

Fenwick & West LLP

In Its Second-Ever HIPAA Settlement on Ransomware, HHS Offers Best Practices for Avoiding Cyber-Attacks

"The CAP also requires the provider to develop (or update) its HIPAA policies and procedures. As revised, the policies and procedures must address -- at a minimum -- a lengthy set of issues under HIPAA's Privacy and Security Rules[.]"  MORE >>

Thomson Reuters Practical Law

Cyberattack on Change Healthcare Brings Turmoil to Healthcare Operations Nationwide

"On its incident page, Optum listed more than 100 Change Healthcare services that were affected. Among various other core functions being impacted are benefits verification, claims submission and status updates, remittance information transmittal and prior authorization. As of Feb. 25, Optum had not offered new information about the attack nor a timeline for when Change Healthcare's systems will be up and running."  MORE >>

Healthcare Financial Management Association [HFMA]; free registration required

Benefits in General

Measuring Employee Engagement with Benefits Communication

"Setting up a step-by-step method for measuring employee engagement with benefits communication helps you keep track of your progress and quickly bring other team members into the process as your team grows or changes. [1] Evaluate past performance ... [2] Benchmark key metrics ... [3] Identify opportunities for improvement ... [4] Act on key insights."  MORE >>

Benefitfocus

Employee Benefits Jobs

View job as Senior Client Service Specialist for EPIC RPS

Senior Client Service Specialist

EPIC RPS

Remote / AZ

View job as Senior Client Service Specialist for EPIC RPS

View job as Senior Internal Sales Consultant for EPIC RPS

Senior Internal Sales Consultant

EPIC RPS

Remote

View job as Senior Internal Sales Consultant for EPIC RPS

View job as Retirement Sales Consultant for Pension Financial Services

Retirement Sales Consultant

Pension Financial Services

Duluth GA / Hybrid

View job as Retirement Sales Consultant for Pension Financial Services

View job as Retirement Plan Administrator for TPA Admin, Inc.

Retirement Plan Administrator

TPA Admin, Inc.

Melbourne FL

View job as Retirement Plan Administrator for TPA Admin, Inc.

View job as Director Group Compliance for NRECA

Director Group Compliance

NRECA

Arlington VA / Hybrid

View job as Director Group Compliance for NRECA

Selected New Discussions

Employee Contributed to HSA and Also Inadvertently Contributed to a Traditional Medical FSA

"We have a client who had an employee contribute $6,750 to their HSA and $800 into the FSA in 2023. The FSA contribution was meant to go into a limited purpose account, but they just learned that there was no limited purpose account set up, and the funds were coming from the full-purpose FSA. Prior to this, they had a rule set up in their system, which prevented the enrollment. The only reason they allowed the election to pass was because they thought it was a limited purpose account. We are currently working with the carrier to set up the limited purpose account so this will be corrected going forward. The employer did instruct the employee at the time that the FSA was to be used for dental and vision only. How should we advise the client for what occurred in 2023?"

BenefitsLink Message Boards

Press Releases

Apex-MEC and the Health Benefits Alliance Announce a Partnership to Expand Employee Health Benefits Offerings

Apex-MEC

Kris Coffey Honored With 2024 Richard Ford Volunteer Service Award

National Tax-Deferred Savings Association [NTSA]

DOL Obtains Judgment Requiring Defunct Westmoreland County Company, President to Restore $40K to Its Health Plan

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

Webcasts and Conferences
(Health & Welfare Plans)

Back to Basics with Compliance: Plan Eligibility

RECORDED

Gallagher

Last Issue's Most Popular Items

Florida Now Regulates PBMs Operating in the State

HUB International

ERISA Fiduciary Duties, Part 2

Maynard Nexsen

Johnson & Johnson Case Highlights Fiduciary Duty Obligations of Employer-Sponsored Health Plans

Haynes and Boone, LLP

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

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