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Health & Welfare Plans Newsletter

April 16, 2024


[Official Guidance]

Text of EEOC Final Regs: Implementation of the Pregnant Workers Fairness Act

408 pages. "The Equal Employment Opportunity Commission is issuing this final rule and interpretive guidance to implement the Pregnant Workers Fairness Act, which requires a covered entity to provide reasonable accommodations to a qualified employee's or applicant's known limitations related to, affected by, or arising out of pregnancy, childbirth, or related medical conditions, unless the accommodation will cause an undue hardship on the operation of the business of the covered entity."  MORE >>

Equal Employment Opportunity Commission.


Register Now: ERISA at 50 -- Where Employee Benefits Law is Headed

Join WEB Network's webinar on June 20: panelists who have been involved with ERISA since its early days will discuss why and how ERISA was adopted, the growth of employee protections over the years, and how ERISA might be further expanded.

Sponsored by WEB Network

[Guidance Overview]

EEOC Issues Final Regulations to Implement the Pregnant Workers Fairness Act

"Like the proposed regulations, the final regulations cover a wide range of conditions related to pregnancy ... The final regulations significantly maintained the list of reasonable accommodation requests that will almost never impose an undue hardship ... The final regulations further restrict the documentation and information an employer may require to support a request."  MORE >>

Jackson Lewis P.C.

[Guidance Overview]

IRS Fact Sheet FS-2024-13: Frequently Asked Questions About Work-Life Referral Services

"This fact sheet provides answers to frequently asked questions (FAQs) addressing the tax treatment of work-life referral services (sometimes also called caregiver or caretaker navigation services) provided by an employer to an employee. Under certain circumstances, the value of such referral services can be excluded from gross income and employment taxes as a de minimis fringe benefit."  MORE >>

Internal Revenue Service [IRS]

[Guidance Overview]

CMS Issues Guidance on Medicare Part D Drug Program, Creditable Coverage Calculation

"The final guidance provides some relief for plan sponsors with active plans and helpful clarification for those who take advantage of the [Retiree Drug Subsidy (RDS)] program.... Plans that test for creditable coverage for active employees will be able to continue to use the current testing methodology for 2025, which means it is less likely that plans would be found to not be creditable coverage."  MORE >>


[Guidance Overview]

CMS Final Key Dates for Calendar Year 2024: Qualified Health Plan Data Submission and Certification, Rate Review, and Risk Adjustment (PDF)

6-page chart summarizes key dates for calendar year 2024 regarding activities and policies that are outlined in other documents.  MORE >>

Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

Maryland Adopts Family and Medical Leave Insurance Requirements

"Maryland has prepared to join D.C., Delaware, and New Jersey in launching the Family and Medical Leave Insurance program [FAMLI], which promises to provide employees in the State with paid leave under certain circumstances. The FAMLI provides wage replacement to workers who need to take qualified leave for up to 12 weeks."  MORE >>

Carr Maloney P.C.

Ninth Circuit Revives Putative Class Action Claims Against UnitedHealth Group for Violation of MHPAEA and ERISA

"The Ninth Circuit held that, as a matter of first impression, Plaintiff sufficiently alleged that Defendants applied an internal process that violates the Parity Act.... [T]he court noted that there is no clear law on how to state a claim for a Parity Act violation, which can occur in a few forms.... Here, Plaintiff alleged an internal process violation. He did not need to allege a 'categorical' practice or the uniform denial of his benefits." [Ryan S. v. UnitedHealth Group, Inc., No. 22-55761 (9th Cir. Apr. 11, 2024)]  MORE >>

Roberts Disability Law

House Committee Leaders Request Information from UnitedHealth Group about Change Healthcare Cyberattack (PDF)

"The health care system is rapidly consolidating at virtually every level, creating fewer redundancies and more vulnerability to the entire system if an entity with significant market share at any level of the system is compromised. It is important for policymakers to understand the events leading up to, during, and after the Change Healthcare cyberattack. In order to understand better the steps UnitedHealth has taken to address this situation, we request information about the impact of the cyberattack, the actions the company is taking to secure its systems, and the outreach to the health care community in the aftermath."  MORE >>

Energy & Commerce Committee, U.S. House of Representatives

Change Healthcare Stolen Patient Data Leaked by Ransomware Gang

"[A] new ransomware and extortion gang that calls itself RansomHub published several files on its dark web leak site containing personal information about patients across different documents, including billing files, insurance records and medical information. Some of the files ... also contain contracts and agreements between Change Healthcare and its partners."  MORE >>


What is a Spousal Incentive Health Reimbursement Arrangement?

"[D]ependents can drive total health plan costs up as much as 60%. A SIHRA aims to reduce these plan costs by encouraging working spouses to elect coverage on their own employer's sponsored health plan. A SIHRA's objective is to offer an employee's spouse the opportunity for full coverage on eligible health expenses with limited out of pocket exposure."  MORE >>

Corporate Synergies

Leveraging Healthcare Analytics to Revolutionize Your Benefits

"While the fine detail can help employers support individual employees, the overarching benefits to having insight to healthcare analytics is that employers are able to identify common chronic conditions that may be impacting a large number of employees such as hypertension or diabetes and begin to promote condition-specific programming for their organization."  MORE >>


Benefits in General

House HELP Subcommittee Hearing: ERISA’s 50th Anniversary: the Path to Higher Quality, Lower Cost Health Care

Video of Apr. 16 hearing. Opening statement, Rep. Bob Good (R-VA); testimony from [1] Mr. Russell DuBose, Phifer Inc.; [2] Ms. Mairin Mancino, Peterson Center on Healthcare; [3] Ms. Karen L. Handorf, Berger Montague; and [4] Mr. Scott Behrens, Lockton Companies.  MORE >>

Subcommittee on Health, Employment, Labor, and Pensions, Committee on Education and the Workforce, U.S. House of Representatives

How Employers Can Help Employees with Student Loan Debt

"For qualified retirement programs ... SECURE 2.0 enabled employers to optionally count Qualified Student Loan Payments (QSLPs) as if they were a regular elective contribution to those plans, and therefore provide an employer matching contribution.... In addition, employers were also given a temporary tool through December 31, 2025 to provide a nontaxable benefit of up to $5,250 ... for not just the usual items of tuition, fees, books, and certain other expenses but also for the repayment of qualified student loans."  MORE >>

Kushner & Company


AI for Benefits Administration: What Can We Expect?

"[W]hile many vendors have spoken at length about how they're 'using AI,' it's often unclear exactly how. More importantly, it's unclear what advantages employers and benefits administrators can expect from AI in the coming years.... [Here are] three predictions for how AI will improve benefits administration: [1] Removing friction from incentives ... [2] Boosting employee engagement ... [3] Enhancing employee experience."  MORE >>


Press Releases

Ophelia Designated as Pennsylvania's First Virtual-Oriented Center of Excellence for Opioid Use Disorder Treatment


Webcasts and Conferences
(Health & Welfare Plans)

Employee Benefits Spring Update 2024

April 17, 2024 WEBINAR

American Bar Association Joint Committee on Employee Benefits [JCEB]

Last Issue's Most Popular Items

DOL Plans to Issue Rules Requiring All Prescription Drugs to Count Towards Out-of-Pocket Limits

Haynes and Boone, LLP

Why Establish a Fiduciary Committee for Welfare Benefit Plans?

Dickinson Wright

What Is the Future of Monetary Relief under ERISA Section 502(a)(3)?

Ogletree Deakins, for DRI [Defense Research Institute], via JDSupra

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

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