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Health & Welfare Plans Newsletter

March 27, 2024

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[Guidance Overview]

Puerto Rico Special Paid Leave Activated for Dengue Fever State of Emergency

"[E]mployers are required to provide eligible non-exempt employees who have or are suspected of having dengue fever the five-day special paid leave due to emergencies declared by the Government of Puerto Rico ... [To] be eligible for the special paid leave, covered employees who are sick -- or suspected of being sick -- as a result of an illness that triggers a state of emergency ... must first use any other available paid leave, including accrued sick leave."  MORE >>

Jackson Lewis P.C.

[Guidance Overview]

CDC Issues New COVID-Related Guidance: What This Means for Employers

"While the new guidance provides some clarity on when employees with COVID and other respiratory viruses can return to work, employers will continue to grapple with ... COVID-related issues ... [such as] managing employees' requests for time off when experiencing active symptoms of a respiratory virus ... Employers must also be aware of other federal and state-specific guidance related to COVID-19.... In New York State, the COVID-19 Sick Leave Law that went into effect in 2020, [has yet] to be rolled back or modified."  MORE >>


A New Lawsuit Against the NFL Disability Plan Survives Its First Challenge

"[T]he court refused to dismiss the players' benefit claims for failure to exhaust administrative remedies [concluding] that plaintiffs' argument that it would be futile to do so could not be resolved at this stage given the 'robust backdrop of alleged malfeasance and nonfeasance' spelled out in the complaint. This backdrop included an alleged 'systematic pattern that the more the Defendants compensate their hired physicians, the higher the likelihood that those physicians will render flawed, inadequate, result-oriented opinions adverse to benefits applicants,' as well as a practice of providing 'inaccurate, misleading, and deceptive information about the Plan to Plaintiffs and absent Class members.' " [Alford v. The NFL Player Disability & Survivor Benefit Plan, No. 23-0358 (D. Md. Mar. 20, 2024)]  MORE >>

Kantor & Kantor

Is Your Data Secure? HHS Opens Investigation into Change Healthcare Cyberattack

"Although the OCR stated it is not prioritizing investigations of health care providers, health plans or business associates that were impacted by this cyberattack, the OCR did remind entities that have partnered with Change Healthcare and UHG of their regulatory obligations and responsibilities, including ensuring that up-to-date business associate agreements are in effect, and that timely breach notifications to HHS and the affected individuals are provided."  MORE >>

Haynes and Boone, LLP

A First Look at Outcomes Under the No Surprises Act Arbitration Process

"[T]he median IDR decision is at least 3.7 times what Medicare would pay. For the two categories of services where we have estimates of historical mean in-network commercial prices relative to Medicare, the median decision is at least 50% higher than these past prices. Decisions appear closer to the amounts insurers historically paid for out-of-network care. These outcomes reflect the fact that providers are submitting relatively high offers and that IDR entities are selecting the provider's offer more than three-quarters of the time."  MORE >>

The Brookings Institution

Health Reimbursement Arrangements: An Option for Small Employers

"Under current law, subject to a few limited exceptions, employers generally may not offer 'stand-alone' HRAs -- i.e., HRAs that are not integrated with major medical coverage -- to current employees. One exception to this rule, which may be an attractive option for some small employers, is a qualified small employer HRA (QSEHRA)."  MORE >>

Holland & Knight

Maximizing Your Wellness Incentive Dollar Investment

"Employers should be rethinking how wellness incentives can drive health outcomes rather than simple participation. Creating this bond require a skillful translation of health behavior theory to application and a defined wellness strategy."  MORE >>

Corporate Synergies

Yes, No or Maybe: Will New Rules Lower Your Medical Costs (PDF)

"Health Reform was not designed to reduce the cost of employer-sponsored coverage for employers or employees. Surveys confirm that 160+ million Americans with employer-sponsored coverage saw their average premium increase 50+% over the past 12 years despite a tripling in the percentage of plans with deductibles in excess of $2,000."  MORE >>

Jack Towarnicky, via Employee Benefit Plan Review

Employee Benefits Jobs

View job as Defined Benefit Combo Cash Balance Compliance Consultant for Loren D.  Stark Company (LDSCO)

Defined Benefit Combo Cash Balance Compliance Consultant

Loren D. Stark Company (LDSCO)


View job as Defined Benefit Combo Cash Balance Compliance Consultant for Loren D.  Stark Company (LDSCO)

Selected New Discussions

Spouse Has Individual Coverage and FSA Through Her Employer. I Have Individual and HSA Through Mine. Bank of America Says That Is Fine?!?

"I started a new job in 2023. I have never had an HSA before and that was all that my employer offered. My wife has always had an FSA. Later in 2023, I realized there was an issue with me having HSA and her FSA. I spoke with the custodian (Bank of America) and they keep telling me that since we are on individual plans, then our current arrangement is not an issue. However, everything I see says that her FSA is allowed to be used for a spouse even if they are not on the health care plan. This, by default, means I am not allowed to have an HSA. Is Bank of America just not understanding the situation? I would think they should know, but I am nervous to leave things as is if that means I am stuck with a penalty at tax time."

BenefitsLink Message Boards

Press Releases

OneAmerica Financialâ„  and Broadridge Retirement and Workplace Team Up to Provide Female Advisors with Fiduciary Training


MissionSquare Retirement Strengthens Commitment to Public Service Employees in California and Texas Through Renewed Partnerships

MissionSquare Retirement

Empower Readies New Digital Solution to Help Small Employers Create 401(k) Plans


Webcasts and Conferences
(Health & Welfare Plans)

ERISA at 50: How We Got Here and Where Employee Benefits Law is Headed

June 20, 2024 in NY

Worldwide Employee Benefits Network [WEB] - New York Chapter

ERISA at 50: How We Got Here and Where Employee Benefits Law is Headed

June 20, 2024 WEBINAR

Worldwide Employee Benefits Network [WEB]

Last Issue's Most Popular Items

Penalties for Certain Employee Benefits Failures

KLB Benefits Law Group

Mutual Mistake Under ERISA (PDF)

The Wagner Law Group, via Benefits Law Journal

New Litigation Brings Attention to Potential Fiduciary Risk for Group Health Plan Sponsors

Krieg DeVault

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

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