"This article provides an update on recent administrative actions regarding implementation of the NSA, including [1] a status update on implementation of the advanced explanation of benefits (AEOBs) requirement; [2] guidance extending the Administration's enforcement discretion with regards to the qualifying payment amount (QPA); and [3] a report to Congress on QPA audits (posted for readers' reference on the Health Affairs website with permission from the [CMS])."  MORE >>

"These proposed changes applied further restrictions on abortion-related health information disclosures and have now been revised and issued in their final form. The final rules now impose key administrative burdens on plan sponsors that must be put into effect by December 23, 2024."  MORE >>

"Compliance with the rule is required by December 23, 2024, which means that employers who sponsor self-insured group health plans, and other covered entities, must amend their HIPAA privacy and security policies and operations. Covered entities subject to the Rule are not, however, required to amend their Notice of Privacy Practices until February 16, 2026."  MORE >>

"Over the last 20 years, the District of Columbia and 21 states have ... [introduced] laws requiring or allowing employers to provide paid family and medical leave. California started the trend in 2004, enabling employees to receive eight weeks of paid family and medical leave, while Maine is the most recent state to pass a law (effective May 1, 2026), allowing for up to 12 weeks of paid family and medical leave. PFML laws in Delaware, Maryland, and Minnesota will go into effect on January 1, 2026."  MORE >>

"The most substantial change to Connecticut's Paid Sick Leave Law will be an expansion of employers and individuals covered by the law.... The new law also expands the reasons an employee is permitted to take leave ... Employers will be prohibited from requiring employees who will use or are using paid sick leave to search for or find another employee to replace them."  MORE >>

"[T]he court compared short-term military leave to bereavement and jury-duty leave. Specifically, it examined how comparable the forms of leave were in [1] duration, [2] purpose, and [3] control (i.e., the ability of the employee to choose when to take the leave).... The Third Circuit concluded that a jury should always decide." [Scanlan v. American Airlines Group, Inc., No. 22-3294 (3d Cir. May 21, 2024)]   MORE >>

"[T]he Eleventh Circuit concluded that the district court was correct in ruling that the Exclusion violated Title VII, stating that '[b]ecause transgender persons are the only plan participants who qualify for gender-affirming surgery, the plan denies health care coverage based on transgender status'. The court added that the discrimination claim was not affected by the fact that other transition-related care was available for coverage under the plan." [Lange v. Houston County, Georgia., No. 22-13626 (11th Cir. May 13, 2024)]  MORE >>

"[T]he Fourth Circuit affirmed both district court rulings that the exclusions discriminate based on sex, with specific reference to the district court's observation that these exclusions 'cannot be applied 'without referencing sex'.' " [Kadel v. Folwell, No. 22-1721 (4th Cir. Apr. 29, 2024)]  MORE >>

"The New York Court of Appeals ruled ... that an administrative rule requiring employer-provided insurance plans to cover medically necessary abortions is not unconstitutional, rejecting a challenge by a number of religious groups who said an exemption carved out for religious employers was too narrow." [Roman Catholic Diocese of Albany v. Vullo, No. 45 (Ct. App. N.Y. May 21, 2024)]  MORE >>

"This white paper peels back the layers of this data to address 10 specific questions regarding 2024 ACA product rate filings submitted by individual and small group market carriers in all 50 states and the District of Columbia. The questions include insights on: [1] Rate changes filed; [2] Annual trend assumptions by carriers; [3] Markets with the highest and lowest participation; [4] States with the most ACA product enrollment."  MORE >>

"Disclosure changes should focus on simplification and actionability.... The agencies should recommend fully authorizing universal default electronic delivery.... Plans should not be required to track engagement with electronically-delivered documents.... Reporting to the agencies should be tailored."  MORE >>