"The IRS appears to take the position that work-life referral service benefits are treated as de minimis fringe benefits because they are used infrequently by employees and only when an employee faces one of the challenges the programs are designed to address.... [T]he IRS will not rely on [these FAQs] to resolve a case, and also warns that if an FAQ provides an inaccurate statement of the law, the law will control."  MORE >>

"[T]he departments ... intend to propose rulemaking that would align the standards that apply to large and self-insured group health plans with those that apply to individual and small group market plans ... If all prescription drugs covered by a plan are eventually considered EHBs, then a large or self-insured group health plan could not impose annual or lifetime dollar limits on those drugs. This could be an issue for certain high-cost drugs ... [and] if there would no longer be a way to define a covered drug as a 'non-EHB,' then some copay accumulator or maximizer programs may no longer be available for employers to use."  MORE >>

"The final rules revise the consumer notice that is currently required for fixed indemnity excepted benefits coverage in the individual market and establish a new requirement to provide a consumer notice in the group market. Plans and issuers must prominently display the notice in marketing, application, enrollment, and reenrollment materials."  MORE >>

"[Paid Leave Oregon (PLO)] and [Oregon Family Leave Act (OLFA)] no longer run concurrently ... Employees must be permitted to use accrued leave ... New OFLA definition of 'one-year period."  MORE >>

"Employer contributions to Maine's Paid Family and Medical Leave Insurance Fund are set to begin on January 1, 2025. The Maine [DOL] is expected to begin the rulemaking process in spring 2024. The state has given itself a deadline of January 1, 2025, to adopt final rules implementing the program."  MORE >>

"The new amendment, effective immediately, postpones the implementation of the Ordinance for public school districts and park districts until January 1, 2025. The new rules clarify certain employee rights and employer responsibilities under the Ordinance. The County is also contemplating issuance of additional procedural rules governing park districts and school districts."  MORE >>

12 pages. "Consumers and employers will pay on average $50 more for single coverage and $175 more for family coverage in premiums in 2024 due to the markups charged by providers to supply specialty drugs that could have been supplied by a specialty pharmacy. The total value of health insurance premiums and premium equivalents that could have been saved if providers charged the same price for specialty drugs as those available from specialty pharmacies would be as much as $13.1 billion in 2024."  MORE >>

"A major impediment to long-term coverage of telemedicine has been concerns that it will increase spending or hurt quality.... [The authors] compared changes between 2019 and 2021-22 in utilization, spending, and quality for patients receiving care from health systems that used telemedicine at higher or lower rates."  MORE >>

"While still evolving, ICHRAs and QSEHRAs hold significant potential to impact the individual and small group market, warranting consideration by health plan actuaries involved in product development and pricing strategies."  MORE >>

"Collect data to understand needs within the population... Evaluate and enhance benefit design to prevent inequities... Communicate, educate and lead with a health equity lens."  MORE >>

"The FDA is prioritizing listening to patients by approving treatments quickly -- and in spite of the insurer backlash against accelerated approvals.... The major issue for insurers is cost. Insurers resent that drug companies can charge full price for a treatment that may or may not work.... Instead of refusing to cover a new drug, CMS and other insurers could condition the price they pay for a certain drug on its ability to achieve specific outcomes, including outcomes that are important to patients."  MORE >>