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Health & Welfare Plans Newsletter

May 6, 2024

3 New Job Opportunities 3 New Job Opportunities

 

[Official Guidance]

Text of OPM Final Regs: Establishment of the Postal Service Health Benefits Program

"This rule finalizes an interim final rule that established the Postal Service Health Benefits (PSHB) Program for Postal Service employees, Postal Service annuitants, and their eligible family members, pursuant to the Postal Service Reform Act of 2022. This Program will include health benefits plans available to United States Postal Service employees, Postal Service annuitants, and their eligible family members starting January 1, 2025."  MORE >>

U.S. Office of Personnel Management [OPM]

[Guidance Overview]

CRS Legal Sidebar: The Scope of ACA Section 1557: 'Health Program or Activity'

"This Legal Sidebar explores the potential scope of the 2024 Section 1557 rule with respect to HHS's definition of 'health program or activity,' which the statute does not define, and discusses how the new rule differs from previous interpretations of that term. In addition to the Department's position, federal courts have also begun interpreting Section 1557's scope; this Sidebar discusses a few of those cases. The Sidebar concludes by offering several considerations for the 118th Congress, especially given the possibility of continued litigation surrounding the rule and its potential to impact the availability of and coverage for health care services." [LBS11160 May 6, 2024]  MORE >>

Congressional Research Service [CRS]

[Guidance Overview]

Illinois Finalizes Regs Interpreting Paid Leave for All Workers Act

"The final regulations affirm a broad carveout for existing policies that provide 40 hours of paid leave (or a prorated equivalent) to be used for any reason. They also confirm that setting a carryover cap for the paid leave bank is permitted."  MORE >>

Littler

[Guidance Overview]

Chicago Finalizes Interpretive Rules in Advance of July 1, 2024, Effective Date of New Paid Leave and Paid Sick Leave Ordinance

"The final rules confirm that carryover of unused Paid Sick Leave is required, even when frontloading. They also address the circumstances under which employers can deny an employee's request for Paid Leave. The rules do not provide any direction to employers as to how to calculate the 90-day lookback rate of pay contemplated by the Ordinance for certain non-exempt employees."  MORE >>

Littler

Cyber Resilience After the Change Healthcare Breach

"In the aftermath of the Change Healthcare breach, healthcare entities should heed cybersecurity recommendations from regulatory bodies to prevent future attacks and mitigate post-attack enforcement actions.... Not only will alignment with agency recommendations prevent or deter future attacks, but it could likely mitigate the severity of enforcement actions imposed by such agencies in the aftermath of an attack."  MORE >>

Fenwick & West LLP

50-State Survey of Telehealth Insurance Laws

"More organizations are implementing and expanding robust virtual care programs to supplement their traditional in-person offerings.... More states changed their laws to prohibiting exclusive telehealth platform arrangements, increasing competition among software companies and allowing individual clinics and hospitals to make decisions based on what works for them and their patients. There has been progress with payment parity -- reimbursing providers at the same rate for telehealth as in-person, but there is still a way to go."  MORE >>

Foley & Lardner LLP

CRS Report: No Surprises Act Independent Dispute Resolution (IDR) Process Data Analysis for the First Half of 2023 (PDF)

20 pages. "On February 15, 2024, the Departments of Health and Human Services, Labor, and the Treasury released the first two public-use files (PUFs), which contain data from the first two quarters of IDR operations in calendar year 2023. The Departments also published certain federal IDR supplemental tables that summarize the relevant data to provide additional transparency. This report provides an overview and analysis of the data contained in the PUFs and supplemental tables." [R48058 May 2, 2024]  MORE >>

Congressional Research Service [CRS]

'Deny, Deny, Deny!' That's How a Staff Doctor at Cigna Says She Was Told to Review Claims

"Cigna had used a productivity dashboard for years, but by 2019, these metrics began playing a more prominent role in the company's evaluations of medical directors, Day said. Now, making a fast decision seemed more important than making the right decision, she said. In February 2019 emails to her managers, Day openly questioned this system."  MORE >>

BenefitsPro; free registration required

Benefits in General

IRS Publication 5709: How to Create a Written Information Security Plan for Data Safety (PDF)

"Having a [written information security plan (WISP)] protects businesses and clients while providing a blueprint of action in the event of a security incident. In addition, a WISP can help if other events occur that can seriously disrupt a tax professional's ability to conduct normal business, including fire, flood, tornado, earthquake and theft. The Security Summit developed a plain language sample plan that tax pros can use for guidance in making their own WISP. The sample plan is available on the IRS website]."  MORE >>

Internal Revenue Service [IRS]

ERISA Exceptions: Understanding Government and Church Plans

"While the exceptions for government and church plans serve important policy objectives, they also present challenges and potential consequences."  MORE >>

DeBofsky Law

Employee Benefits Jobs

View job as Participant Services/Collections Department Representative for Benefits Fund Office

Participant Services/Collections Department Representative

Benefits Fund Office

Long Island City NY

View job as Retirement Plan Onboarding Coordinator for The Finway Group

Retirement Plan Onboarding Coordinator

The Finway Group

Remote / West Des Moines IA / Hybrid

View job as Retirement Plan Onboarding Coordinator for The Finway Group

View job as Retirement Plans Sales Consultant for Bremer Bank

Retirement Plans Sales Consultant

Bremer Bank

Saint Cloud MN / Fargo ND / Hybrid

View job as Retirement Plans Sales Consultant for Bremer Bank

Selected New Discussions

Guidance on Short-Term Relocation (or Extended Travel) vs Change of Residence as a Qualifying Life Event?

"Is there any guidance on the difference between a true change in residence and extended travel (i.e., length of time)? In February of this year Employee submitted an election change form to remove spouse from health coverage due to spouse's move out of the country. 6 weeks later Employee requested to add spouse back to health coverage due to spouse's move back into the US. Employee has now requested to remove spouse from health coverage again due to spouse's move out of the country again. The Employer thinks the spouse travels back and forth to the couple's home country a few times a year for 6 weeks at a time. Are these qualifying life events?"

BenefitsLink Message Boards

I Had an HSA and Spouse Enrolled in FSA

"I have an individual HDHP & have been contributing to an HSA. I am not covered under my spouse's medical plan (only dental and vision) and in 2020 my husband enrolled in an FSA. It is a general purpose FSA because it can be used for doctors visits. I'm just finding out now that it's an issue and would have made me ineligible to contribute to my HSA. Since this has gone on for 4 years, how do we correct this error and what are the penalties?"

BenefitsLink Message Boards

Specifying HRA Maximum Dollar Amount

"For HRAs that reimburse employees for premiums, is it acceptable to specify the maximum dollar amount as follows: 'the amount of premiums that the employee incurs during the coverage period,' or does have to be an actual dollar amount?"

BenefitsLink Message Boards

Webcasts and Conferences
(Health & Welfare Plans)

The Future of Benefits HR & Finance Forum

May 22, 2024 in NY

Corporate Synergies

Last Issue's Most Popular Items

HHS Finalizes Changes with Respect to Strengthening the Privacy of Reproductive Health Care Information Under HIPAA

Ropes & Gray LLP

Ban on Non-Competition Agreements: What Employers Need to Know and Do Now

The Wagner Law Group

Flexible Spending Accounts, 2022: Forfeitures on the Rise

Employee Benefit Research Institute [EBRI]

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

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