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Health & Welfare Plans Newsletter

May 22, 2024

6 New Job Opportunities 6 New Job Opportunities


[Guidance Overview]

Recent Developments in No Surprises Act Implementation

"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 >>

Health Affairs Forefront


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

Join WEB Network's webinar on June 20: panelists J. Mark Iwry, Israel Goldowitz, Carol Buckmann, and Jeff Mamorsky 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]

HIPAA Rules Impose New Requirements on Abortion-Related Information

"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 >>

HUB International

[Guidance Overview]

Final HIPAA Privacy Rule Provides New Protections for Reproductive Health Care Information

"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 >>

Hodgson Russ LLP

[Guidance Overview]

Does Your State Have Laws About Paid Family Medical Leave?

"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 >>

Adams and Reese LLP

[Guidance Overview]

What Connecticut Employers Need to Know About the Upcoming Changes to Connecticut's Paid Sick Leave Law

"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 >>


Third Circuit Describes Factors Determining Pay and Benefits for Military Leave Under USERRA

"[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 >>

Pierson Ferdinand LLP

Eleventh Circuit Holds Exclusion of Gender-Affirming Surgery Violates Title VII

"[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 >>

Haynes and Boone, LLP

Fourth Circuit Finds Gender-Dysphoria Care Exclusion Violates Equal Protection

"[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 >>


New York Top Court Upholds Abortion Insurance Coverage Requirement

"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 >>

Courthouse News Service

ACA Market Insights Derived from 2024 Unified Rate Review Templates

"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 >>


Benefits in General


ERIC Comment Letter to EBSA Responding to SECURE 2.0 RFI on Effectiveness of Reporting and Disclosure Requirements (PDF)

"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 >>

The ERISA Industry Committee [ERIC]

Employee Benefits Jobs

View job as Senior Benefits Administrator for First Hill Trust Company

Senior Benefits Administrator

First Hill Trust Company

Remote / Seattle WA / Hybrid

View job as Senior Benefits Administrator for First Hill Trust Company

View job as Client Service Manager for July Business Services

Client Service Manager

July Business Services


View job as Client Service Manager for July Business Services

View job as Retirement Solutions Advisor for Buckingham Wealth Partners

Retirement Solutions Advisor

Buckingham Wealth Partners


View job as Retirement Solutions Advisor for Buckingham Wealth Partners

View job as Senior Pension Administrator for The Hilb Group

Senior Pension Administrator

The Hilb Group


View job as Senior Pension Administrator for The Hilb Group

View job as Office of Strategic Health Policy Director for State of Wisconsin- Department of Employee Trust Funds (ETF)

Office of Strategic Health Policy Director

State of Wisconsin- Department of Employee Trust Funds (ETF)

Madison WI / Hybrid

View job as Enrolled Actuary / Reviewer for Retirement Plans for Pension Consultants, Inc.

Enrolled Actuary / Reviewer for Retirement Plans

Pension Consultants, Inc.

Remote / MN

View job as Enrolled Actuary / Reviewer for Retirement Plans for Pension Consultants, Inc.

Press Releases

Arch Insurance Publishes State Disability & Paid Family Leave Reference Guide

Arch Insurance

Nadia Matthie Appointed to the AICPA’s Employee Benefit Plans Expert Panel


Jason S. Kane Joins DATAIR’s Sales Team

DATAIR Employee Benefit Systems, Inc.

Webcasts and Conferences
(Health & Welfare Plans)

Fully Insured Health Plan Alternatives

June 18, 2024 WEBINAR

UBA [United Benefit Advisors]

Gear Up for 2025: Your Roadmap to Benefits Success!

June 20, 2024 WEBINAR


Last Issue's Most Popular Items

(Another) Fiduciary Breach Asserted in TPA Healthcare Claims Processing

American Retirement Association [ARA]

Most Americans Do Not Use Weight-Loss Drugs Long Enough to See Meaningful Weight-Loss

Blue Cross Blue Shield Association

2024 Milliman Medical Index: Employer Costs for Typical Family of Four Top $32,000


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

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