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Health & Welfare Plans Newsletter

July 2, 2024

4 New Job Opportunities 4 New Job Opportunities


[Guidance Overview]

Cook County, Illinois Implements Final Rules on Paid Leave Ordinance: Employer FAQs

"The Final Rules confirm that the Commission will defer to the paid leave laws of any municipality within Cook County that has enacted a paid leave law with requirements equal to or greater than that of Cook County, including the City of Chicago's Paid Leave and Paid Sick and Safe Leave Ordinance.... [E]mployers of Chicago-located workers will not need to comply with both the Cook County Paid Leave Ordinance and the Chicago Paid Leave and Paid Sick and Safe Leave Ordinance."  MORE >>

Jackson Lewis P.C.

[Guidance Overview]

Proposed Rules for Maine Paid Family and Medical Leave Provide Some Helpful Information for Employers

"The Program applies to almost all employers with one or more employees in Maine.... [C]overed family members include individuals with whom the covered employee 'has a significant bond that is or is like a family relationship,' even if there is no biological or legal relationship. Under the proposed rules, an employee may take leave with respect to only one such individual in a benefit year."  MORE >>

Verrill Dana LLP

The Ongoing Challenge to the ACA's Preventive Services Mandate

"Despite the court's holding being limited in application to the plaintiffs in the case, the decision that the USPSTF Preventive Care Requirement is constitutionally defective is still binding law in the Fifth Circuit -- i.e., Texas, Louisiana, and Mississippi. Thus, the USPSTF Preventive Care Requirement is unlikely to be enforced in these states." [Braidwood Mgmt, Inc. v. Becerra, No. 23-10326 (5th Cir. Jun. 21, 2024)]  MORE >>

Groom Law Group

ACA Preventive Services Coverage and Litigation Continue, for Now

"[Mercer] surveyed employers about their most likely response if they were no longer required to provide ACA-mandated preventive services without cost-sharing. With regard to PrEP, while over a third weren't sure how they would respond, and about a fifth would most likely add some level of participant cost-sharing, the largest portion -- 41% -- said they would most likely continue to cover it without participant cost-sharing." [Braidwood Mgmt, Inc. v. Becerra, No. 23-10326 (5th Cir. Jun. 21, 2024)]  MORE >>


Supreme Court's Decision on Emergency Abortions: Overview for Employers

"[W]hile the litigation continues, Idaho can't limit emergency room abortions to only those situations where a pregnant person's life is at risk. But questions remain and access to quality reproductive healthcare may still be challenging ... particularly for those with pregnancy complications. There are, however, a number of practical steps employers can consider[.]" [Moyle v. U.S. and Idaho v. U.S., Nos. 23-726 and 23-727 (S. Ct. Jun.27, 2024;)]  MORE >>


Surmounting the Fiduciary Risk of Rampant Medical Overbilling

"One major culprit in benefit cost inflation ... is medical overbilling. It has become increasingly clear that the business of medicine is replete with systemic billing errors, abuses and fraud that go undetected by health plan sponsors and administrators.... Risk managers alongside their C-Suite and HR colleagues can employ emerging technology and human expertise for a holistic approach with meaningful results."  MORE >>

BenefitsPro; free registration required

Uncommon State Leave Laws May Be Worth Broader Employer Adoption

"[S]ometimes employers go well beyond what the law requires, especially when doing so aligns with corporate values. [This article provides] a sampling of uncommon state leave laws that -- while not applicable to all employers -- are worth review and consideration for an employer's leave policies."  MORE >>



Supreme Court Decision Limiting the Authority of Federal Agencies Could Have Far-Reaching Impacts for Health Policy

"A natural result will mean less agency regulation. No law passed by Congress can include every possible nuance needed to implement the law. Limitation on the ability of regulators to fill in those gaps could result in impacts to health care consumer and patient protections.... Without regulations to fill in technical gaps, it will be more difficult to operationalize requirements to carry out the intent of Congress." [Loper Bright Enterprises, Inc. v. Raimondo, Sec. of Comm., No. 22-451 (S. Ct. Jun. 28, 2024)]  MORE >>

Henry J. Kaiser Family Foundation

Benefits in General

Supreme Court Lifts Time Bar on Challenges to Federal Actions

"In essence, any new business can challenge federal rules regardless of how long the rules have been on the books.... After overruling a landmark precedent on government authority, the Supreme Court ruled Monday to expand the time frame businesses have to challenge federal government actions." [Corner Post v. Bd. of Gov. of the Federal Reserve System, No. 22-1008 (S. Ct. Jul. 1, 2024)]  MORE >>

Courthouse News Service

Chevron Deference Is No More: ERISA, Employee Benefits and Executive/Equity Compensation Rule-Making Is Likely to Be Affected

"Little doubt exists that challenges to regulatory and sub-regulatory guidance in the ERISA, employee benefits and executive/equity compensation space will ramp up. However, courts sympathetic to the DOL's, IRS', SEC's or PBGC's views can still invoke Skidmore deference to rule in favor of the agency. The real issue is likely to be, at least initially, the scope of injunctive relief obtained by those litigants challenging the guidance." [Loper Bright Enterprises, Inc. v. Raimondo, Sec. of Comm., No. 22-451 (S. Ct. Jun. 28, 2024)]  MORE >>


Chevron Doctrine Overruled: Potential Impacts on Plan Sponsors and Employee Benefit Plans

"While the Court explained that when a statute delegates authority to an agency to interpret it, courts must continue to respect the delegation, it noted that courts must still ensure that the agency acts within its constitutional limits. As such, it is likely that there will be more litigation challenging rules and regulations promulgated by the Departments that affect employee benefit plans." [Loper Bright Enterprises, Inc. v. Raimondo, Sec. of Comm., No. 22-451 (S. Ct. Jun. 28, 2024)]  MORE >>

Smith, Gambrell & Russell, LLP

The World of Work — and Workplace Benefits — Is Changing

"[M]ore employers are looking to leverage freelance workers, and many employers are looking to provide benefits to these workers. For carriers and other benefits providers, this will have an impact on things like product design and who is eligible for benefits.... Over half (55%) of employers said [in the past two years] their company negotiated with providers for better terms, lower premiums, fees, etc., to better manage costs. Yet almost half (45%) said they added one or more benefits to remain competitive."  MORE >>


Employee Benefits Jobs

View job as DC Retirement Plan Administrator for Heritage Administrative Services, LLC

DC Retirement Plan Administrator

Heritage Administrative Services, LLC

Woodbury NY / Hybrid

View job as DC Retirement Plan Administrator for Heritage Administrative Services, LLC

View job as New Business Administrator (Onboarding Specialist) for Pension Financial Services, a Strongpoint Partner

New Business Administrator (Onboarding Specialist)

Pension Financial Services, a Strongpoint Partner

Duluth GA / Hybrid

View job as New Business Administrator (Onboarding Specialist) for Pension Financial Services, a Strongpoint Partner

View job as Distributions Analyst for PCS Retirement

Distributions Analyst

PCS Retirement


View job as Distributions Analyst for PCS Retirement

View job as Retirement Plan Manager for SetAway, LLC

Retirement Plan Manager

SetAway, LLC

Remote / Bedford NH / CT / MA / ME / VT

View job as Retirement Plan Manager for SetAway, LLC

Selected New Discussions

Health FSA Forfeitures

"Lets assume employer has 100K in Health FSA forfeitures fro the applicable year. As I understand it, to the extent forfeitures represent 'experience gains,' the section 125 rules and ERISA would regulate what an employer can do with the forfeitures (i.e, defray plan expenses, reduce EE salary reductions for the following PY or refund). Lets assume now that the loss experience (i.e., the amounts the employer ate in overspent accounts relating to mid-year terms) is 95K resulting in net experience gains of 5K. lets assume further that the admin expenses for the Heath FSA for the applicable year are 5K. 5K out of the 100K in gross forfeitures is eaten up by the admin expenses leaving gross forfeitures of 95K, which after applying the the experience loss results in 0 net experience gain for the applicable year. Does that mean that the employer can use the 95K in forfeitures (i.e, net forfeitures after deducting the 5k in admin expenses) as its sees fit (even for paying expenses for unrelated benefit plans) since there are no experience gains?"

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Press Releases

Application Period Opens for 11th Annual PenChecks/ASPPA Scholarship Program

ASPPA [American Society of Pension Professionals & Actuaries]

Webcasts and Conferences
(Health & Welfare Plans)

2024 Mid-Year Pharmacy Benefits Update

July 11, 2024 WEBINAR

Woodruff Sawyer

Last Issue's Most Popular Items

CRS Legal Sidebar: Supreme Court Overrules Chevron Framework

Congressional Research Service [CRS]

Final Regs Under the ACA Section 1557 Nondiscrimination Rules: Highlights for Group Health Plans

Spencer Fane

Air Ambulance Ruling Undermines No Surprises Act Protections

DeBofsky Law

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

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