8 pages. Patient-Centered Outcomes Research (PCORI) Fee to be reported on page 2. [Also see Draft Instructions for 2024 Form 720, rev. June 2024]  MORE >>

"The FAQs clarify that -- [1] covered entities affected by a breach may delegate to the business associate the task of providing the required HIPAA breach notifications on their behalf; [2] only one entity needs to complete breach notifications to affected individuals, HHS, and the media; and [3] if covered entities work with a business associate to perform the required breach notifications consistent with the HITECH Act and the HIPAA breach notification rule, there are no further notice obligations."  MORE >>

"The proposed rules provide greater detail as to how the Maine DOL plans to implement and enforce the new program. The program allows Maine employees up to 12 weeks of family and medical leave benefits over a one-year period."  MORE >>

"The [Lewandowski] Complaint cherry-picks specific aspects of the PBM arrangements without looking at the arrangement in its totality. Established case law and DOL guidance [support] a fiduciary prudence standard that looks at the overall economics of the service provider arrangement versus a more limited focus on any specific item or service. " [Lewandowski v. Johnson & Johnson, No. 24-0671 (D.N.J. amended complaint filed Feb. 5, 2024)]  MORE >>

"Premera Blue Cross challenged the district court's consideration of two sets of guidelines from the American Academy of Child and Adolescent Psychiatry ... The court found that the term 'generally accepted standards of medical practice' to be ambiguous, so the district court did not abuse its discretion in considering the Principles of Care." [N.C. v. Premera Blue Cross, No. 23-35381, 2024 WL 2862586 (9th Cir. June 6, 2024; unpub.)]  MORE >>

"The court ruled that the employer fulfilled its COBRA obligation by directing the TPA to mail the notice to the address on file. Citing another decision in a similar case, the court explained that -- despite the employer's alleged knowledge of the employee's move -- the employer was not obligated to update the address in its system on its own accord." [Anaya v. Birck, No. 21-2624 (N.D. Ill. May 15, 2024)]  MORE >>

"[T]he dependent's parent requested that the plan provide (among other documents) a full copy of the medical necessity criteria that the plan used regarding "skilled nursing facilities, sub-acute inpatient rehabilitation treatment, and inpatient hospice treatment." ... The court rejected the argument that the requested documents fell outside the scope of ERISA's disclosure requirements." [W.H. v. Allegiance Benefit Plan Mgmt. Inc., No. 22-0166 (D. Mont. June 4, 2024)]  MORE >>

"While the public may view these drugs as a silver bullet solution, there is also a cloud of potential misinformation regarding who should use them, possible side effects, and other long-term risks and successes. As employers navigate whether to begin or continue covering GLP-1s for obesity, they also need to consider how they will support and educate their workforce about appropriate indications and uses."  MORE >>

"Across all generations, employees continue to enroll in traditional plans (PPOs) at a higher rate than HDHPs, and more than half of employees are still choosing traditional plans. ... Across accident, critical illness, hospital indemnity, identity theft, legal and pet benefits, Generation X has the highest participation overall, followed by Millennials and Baby Boomers.  ... Participation in HSA plans is higher than FSA plans across all generations except Traditionalists. ... Across generations, higher salaried individuals choose HDHPs over traditional plans when both are offered."  MORE >>

"Eliminating the firewall leads to 1.8 million people (1.2%) shifting out of [employer-sponsored insurance (ESI)] ... [T]he tax subsidies for ESI are large enough that most of those with ESI benefit by staying enrolled in that coverage. Removing the firewall would save households $4.4 billion in premiums and other health care spending. The federal government would increase spending by $17.8 billion, primarily for marketplace premium tax credits. This would represent an increase of 18 percent in federal spending on premium tax credits."  MORE >>

"Vermont Gov. Phil Scott signed into law H233, which strengthens PBM reform and oversight. The law requires PBM certification instead of the state's previous policy of registration. The law also prohibits spread pricing, gag clauses, and making classifications of drugs beyond what is established by state and federal governments and the Board of Pharmacy."  MORE >>

"An effort in Congress has recently made clear that policymakers understand the value of telehealth care, with two house committees unanimously approving legislation to extend pandemic-era Medicare telehealth flexibilities for two years ... Protecting Americans' Coverage Together (PACT), a coalition of employer voices committed to strengthening employer-provided coverage for the 160 million Americans that rely on it, commends the House's action to advance robust telehealth provisions."  MORE >>

"The ranking member of the Senate Health, Education, Labor, and Pensions (HELP) Committee has requested feedback on ways to modernize federal law to allow independent workers access to portable workplace benefits, such as retirement and health care.... Sen. Cassidy notes that at least 27 million Americans engage in independent work ... [and] would like access to portable workplace benefits"  MORE >>

12 pages. "Although there are some contrary holdings, the great majority of cases hold that state law claims of undue influence with respect to ERISA plans are preempted by ERISA. That a counterclaim involves a dispute over a change of beneficiary form in no way defeats ERISA preemption."  MORE >>