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Health & Welfare Plans Newsletter

July 11, 2024

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[Guidance Overview]

Final Anti-Discrimination Rule Protecting Gender Identity May Indirectly Impact Employer Health Plans

"Although employers are exempt from the Final Rule with regard to their employee benefits, many self-insured employer group health plans could still be indirectly affected by the Final Rule's applicability to many third party administrators (TPAs). This is because the Final Rule holds TPAs responsible for the plans that they design, control, or play a role in developing."  MORE >>

Quarles & Brady LLP

Courts Invoke Loper Bright to Block Expansion of ACA Section 1557 Nondiscrimination Rules to Gender Identity (PDF)

"The 2024 Section 1557 regulations have become an early casualty of Loper Bright. Employers and their advisors will need to parse the regulations to determine which provisions apply after these court decisions. To the extent that a provision has been stayed, statutory language and the 2020 regulations (minus certain portions previously set aside by courts) remain in effect." [Texas v. Becerra, No. 24-0211 (E.D. Tex. July 3, 2024); Tennessee v. Becerra, No. 24-0161 (S.D. Miss. July 3, 2024)]  MORE >>

Thomson Reuters / EBIA

Courts Delay Enforcement of New HHS Regs on Discrimination in Health Plans

"The new regulations were scheduled to take effect on July 5, 2024. However, on July 3, 2024, a Mississippi federal court postponed the effective date of certain provisions ... and prohibited HHS from enforcing those provisions nationwide. That same day, another federal court prohibited HHS from enforcing a subset of provisions that include gender identity in the definition of sex discrimination in Florida, while a third federal court postponed the effective date of the new rule in its entirety in Texas and Montana." [Texas v. Becerra, No. 24-0211 (E.D. Tex. July 3, 2024); Tennessee v. Becerra, No. 24-0161 (S.D. Miss. July 3, 2024); Florida v. HHS, No. 24-1080 (M.D. Fla. July 3, 2024)]  MORE >>

The Commonwealth Fund

FTC Report Documents Impact of Pharmacy Benefit Managers on Independent Pharmacies

"By its interim report, ... the FTC determines that PBMs are wielding immense power over patients' ability to access and afford their prescription drugs, allowing PBMs to significantly influence what drugs are available and at what price. The report finds that this consolidated market power (of which the three largest PBMs control 80 percent) can have dire consequences for consumers, with nearly 30 percent of Americans surveyed reporting rationing or even skipping doses of their prescribed medicines due to their high costs."  MORE >>

Duane Morris LLP

Most Patients Quit GLP-1 Drugs in Two Years

"Four in five people taking GLP-1 medications for weight loss quit them in two years, even though the drugs are supposed to be taken much longer to maintain their benefits, according to a new report ... [M]any people regain all their weight after discontinuing the injectable drugs such as Wegovy and put themselves back at risk for costly chronic diseases[.]"  MORE >>

StarTribune

Global Minimum Benefits Standards Are Becoming the New Normal

"Globally the most prevalent minimum benefit standards companies currently offer are employee assistance programs and life insurance (73 percent), maternity leave (70 percent), and paternity leave (69 percent).... Globally, one-in-three multinationals are currently drafting and articulating their global benefits strategy and reviewing these annually.... Fifty nine percent of organizations surveyed say they are capturing the employee voice to guide strategic priorities."  MORE >>

Aon

Benefits in General

Plaintiffs Ask Court to Reconsider a Nationwide Injunction on the FTC Noncompete Rule

"The plaintiffs argue that expanding the injunction from just the parties to the lawsuit to all businesses nationwide is appropriate under controlling law in the Fifth Circuit, which covers the Northern District of Texas, where the lawsuit is pending. Specifically, the Administrative Procedure Act authorizes a district court, like the one here, to 'postpone the effective date of an agency action.' " [Ryan LLC v. Federal Trade Commission (no. 24-0986 (N.D. Tex. Jul. 3, 2024; motion for reconsideration filed Jul. 10, 2024)]  MORE >>

Pierson Ferdinand LLP

Opportunities and Risks of Using AI in Employee Benefits Administration

"Companies must diligently work with their data security and ERISA counsel to ensure that AI tools appropriately comply with privacy, data security, and other applicable employee benefit laws, including HIPAA and ERISA, as well as newly enacted state laws regulating the use of AI technologies. AI tools should be carefully vetted for accuracy and reliability. For this purpose, an employer may want to allocate oversight responsibility to its employee benefit plan committee."  MORE >>

Davis & Gilbert LLP

Cyber Liability Insurance: A Buying Guide (PDF)

11 pages. "[This Guide provides information] to better identify the cyber risks in your own organization, understand what cyber insurance covers, and recognize how a comprehensive approach is the best way to protect your organization. [1] 8 Reasons to buy cyber insurance ... [2] Getting started: Cyber risk assessment ... [3] Risk transfer: What's in a good cyber policy? ... [4] Incident response: Planning for the worst-case scenario ... [5] Cyber ransomware scenario."  MORE >>

Woodruff Sawyer

Employee Benefits Jobs

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Selected New Discussions

DOL Challenging Health Plan Grandfathered Status

"A self-funded plan is under audit from DOL. The investigator alleges the plan lost grandfathered status a decade ago when switching networks. The rationale is that the schedule of benefits under the old network arrangement offered an incentive for participants to seek care from certain high-quality providers. In other words, the copayment for office visits for certain specialty physicians has always been $30, but under the old network agreement, participants benefitted from a $15 copayment when using certain highly-qualified providers. This program was proprietary and designed to ensure participants were receiving the highest level of care for certain conditions. The incentive program stopped when a network change was made and participants could no longer benefit from a lower copay when using the specialty network. The DOL argues this was a change in cost-sharing that cost the plan its grandfathered status. However, the plan had no access to the specialty program when the network change was made. Any input is appreciated."

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Press Releases

Principal® Adds New Annuity with Guaranteed Lifetime Income Option

Principal Financial Group

Webcasts and Conferences
(Health & Welfare Plans)

The 2024 Revolution in Administrative Law: Chevron and Beyond

July 16, 2024 WEBINAR

Squire Patton Boggs

Last Issue's Most Popular Items

Preparing for 2025: Creditable Coverage Changes and Medicare-Eligible Employees

Arthur J. Gallagher & Co.

How the SCOTUS Chevron Ruling Affects Benefit Plans

Segal

Employer Considerations While Awaiting Further District Court Action on the FTC Non-Compete Ban:

Jackson Lewis P.C.

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

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