|
New Job Opportunity Today
|
|
[Guidance Overview]
New York State Proposes Network Adequacy Regs for Health Insurers
"If adopted, this regulation would establish network adequacy standards for behavioral health services ... The regulation specifies that an
adequate network of health care providers includes residential facilities that provide sub-acute care, assertive community treatment providers, critical time intervention services providers, and mobile crisis intervention services providers." MORE >>
ArentFox Schiff LLP
|
[Guidance Overview]
Summary of Draft CY 2025 Medicare Part D Redesign Program Instructions (PDF)
14 pages. "[CMS] released draft instructions on the CY2025 Part D Redesign. These draft instructions touch on many of the
outstanding Part D benefit adjudication questions that the industry has been asking.... in addition to reinsurance, medical loss ratio, risk corridor, and Out-of-pocket cost (OOPC)/meaningful difference methodologies. Some guidance on Employer Group Waiver Plans (EGWPs) was also provided." MORE >>
Wakely Consulting Group
|
J&J Lawsuit Shines Spotlight on Welfare Plan Fiduciary Duties
"[P]lan sponsors should take a proactive and critical look at their welfare plan governance and administration to ensure that fiduciary duties are being satisfied ... [1] Establish and maintain a health and welfare plan committee.... [2] Review and update committee
documents and committee composition.... [3] Conduct regular fiduciary training ... [4] Monitor service providers; review and pay reasonable fees.... [5] Follow plan documents.... [6] Fiduciary liability insurance.... [7] Consider cybersecurity obligations.... [8] Highlight your wins." MORE >>
Morris, Manning & Martin, LLP
|
IVF Uncertainty in Alabama: What Can Employers Do?
"Employers may want to identify employees and covered plan members residing in Alabama and consider the potential implications this ruling may have on their family building journey. Ask the health plan or fertility benefit vendor what IVF treatment and embryo transport access in
Alabama looks like today -- whether in-network clinics are continuing to provide IVF treatment or have paused it -- and request regular updates.... This may also be a good time to review the plan's reproductive and medical travel benefits and the organization's leave policies." MORE >>
Mercer
|
Ransomware Hack Hits Prescription Drug Market, Inconveniencing Millions
"Insurance giant UnitedHealthcare Group said the hackers struck its Change Health business unit, which routes prescription claims from pharmacies to companies that determine whether patients are covered by insurance and what they should pay. The hackers stole data about patients,
encrypted company files and demanded money to unlock them, prompting the company to shut down most of its network as it worked to recover.... U.S. pharmacies reported a wide range of impacts, with independent stores experiencing some of the worst problems." MORE >>
The Washington Post; subscription may be required
|
Cross-Plan Offsetting in Group Health Plans: The DOL Makes Its Position Clear
"In October of 2023, the DOL entered into a settlement agreement with EmblemHealth Inc. ... resolving claims that Emblem breached its fiduciary duties under ERISA by engaging in the practice of cross-plan offsetting.... Based on the potential ERISA violations and the
practical problems that may result, employers that maintain health plans (particularly self-insured health plans) should determine whether their TPAs are engaging in cross-plan offsetting." MORE >>
Verrill Dana LLP
|
What We Get Wrong About Predicting Mental Health Outcomes
"Health plans understand that mental health affects outcomes, but the theory often has not translated to improved delivery of health care to individual patients. The new role of incorporating mental health into predicting outcomes, in contrast, is one that focuses on
well-executed intervention, not merely identification and awareness. It unifies predictive endeavors with the patient in a timely, relevant manner to address the influence that men- tal health has on all health care experiences." MORE >>
Segal, via Benefits Quarterly
|
2023-2024 Voluntary Benefits Benchmarking Overview (PDF)
"[K]ey findings suggest many employers view offering or expanding their voluntary benefits programs as an effective strategy to address attraction and retention challenges in 2024." MORE >>
Bolton
|
The CARES Act Paid Leave Door May Be Open, But the Path to Recovery Remains Narrow and Uncertain for Most Government Contractors
"[M]ost federal contractors know that it can be challenging to recover increased costs for paid leave stemming from the COVID-19 pandemic under Section 3610 of the [CARES] Act.... A recent Armed Services Board of Contract Appeals (ASBCA) decision provides claimants with some
reason for hope by confirming that the ASBCA has Contract Disputes Act (CDA) jurisdiction over appeals from a contracting officer's denial of Section 3610 claims.... [E]stablishing jurisdiction is only the first step, and the path to recovering paid leave costs remains narrow and highly dependent on the facts of each case." MORE >>
Miller & Chevalier
|
With Medical Debt Burdening Millions, a Financial Regulator Steps in to Help
"In the past two years, the [Consumer Financial Protection Bureau (CFPB)] has penalized medical debt collectors, issued stern warnings to health care providers and lenders that target patients, and published reams of reports on how the health care system is undermining the
financial security of Americans. In its most ambitious move to date, the agency is developing rules to bar medical debt from consumer credit reports[.]" MORE >>
KFF Health News
|
Practice of Prior Authorization Draws Increased Scrutiny
"At the federal level, [CMS] issued a final rule in January that requires electronic processing known as Application Programming Interface for prior authorizations ... Starting in 2026, required prior-authorization turnaround times are reduced to 72 hours for urgent claims and
seven calendar days for non-urgent claims.... Elsewhere, states are looking at restrictions or outright bans on preauthorization for some services and procedures." MORE >>
Mercer
|
Benefits in General |
Employers Struggle to Meet Employee Demand for Higher Pay, Better Benefits
"{If] given the option for an enhanced benefit, employees expressed a clear preference for increased pay and increased 401(k) match, while employers assume employees would prefer improved health and dental insurance, health savings accounts and charitable contributions. Seven in
10 workers also reported experiencing challenges when it comes to understanding benefits offered by their employer." MORE >>
PLANSPONSOR; free registration may be required
|
Breaking Down Health Care Expenses in Retirement
"Health insurance premiums account for between 73% and 81% of retirees' annual health care expenses and, for the most part, are predictable and can be paid from monthly income. However, out‑of‑pocket expenses can vary and should be paid from savings. Traditional financial
planning principles and basic budgeting can help address many of the financial unknowns about health care costs in retirement." MORE >>
T. Rowe Price
|
Employee Benefits Jobs
|
|
|
Press Releases |
DOL Recovers $438K for Two Workers Illegally Terminated by Alabama Car Manufacturer After They Took Protected Leave
Wage and Hour Division [WHD], U.S. Department of Labor [DOL]
|
Vanguard Announces CEO Retirement and Appointment of President
Vanguard
|
Kodak Company Statement on U.S. Pension Plan
Kodak
|
The ERISA Industry Committee Appoints Tom Christina as Executive Director of ERIC Legal Center
ERIC [ERISA Industry Committee]
|
|
Webcasts and Conferences (Health & Welfare Plans) |
Are You Ready For It? Health Plan Fee Litigation
March 7, 2024 WEBINAR
ERIC [ERISA Industry Committee]
|
Employment and Benefit Plan Issues in M&A: Due Diligence Checklist, Transaction Strategies, Risk Mitigation
March 20, 2024 WEBINAR
Strafford
|
|
Last Issue's Most Popular Items |
When Are Disability Benefit Programs Exempt from ERISA?
Thomson Reuters / EBIA
|
District Court Finds Health Plan Not Required to Furnish Administrative Service Agreements in Response to ERISA Document Request
The Wagner Law Group
|
Hacking at UnitedHealth Unit Change Healthcare Cripples a Swath of the U.S. Health System
KFF Health News
|
Unsubscribe |
Change Email Address
Search Past Issues |
Privacy Policy
Submit an Article |
Contact Us |
Advertise Here
Copyright 2024 BenefitsLink.com, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.
BenefitsLink® Health & Welfare Plans Newsletter, ISSN no. 1536-9595.
Links to web sites other than BenefitsLink.com and EmployeeBenefitsJobs.com are offered as a service to our readers. We are not involved in their production and are not responsible for their content.
|