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Health & Welfare Plans Newsletter

August 26, 2024

 

[Guidance Overview]

What Employer Health Plan Sponsors Should Do When the Final MHPAEA Rules Are Published

"[1] Review service agreements for all delegated service providers that assist with the administration of your health plan benefits to ensure that agreements clearly identify and allocate obligations to ensure compliance with the new requirements.... [2] Develop a work plan to update your MHPAEA compliance documentation to align with the new requirement ... [identifying] responsibilities and timelines for the health plan and each designated service provider.... [3] Identify the named fiduciary that will be required to review each comparative analysis and certify that they believe the analysis complies with the new content requirements."  MORE >>

Health Law Advisor, Epstein Becker Green

[Guidance Overview]

State Voting Leave Requirements

"Employers may want to consider each state’s unique legal framework surrounding voting leave to ensure compliance with applicable law, including whether voting leave is affected by the timing of an employee’s working hours and polling hours, whether voting leave is required, whether voting leave is paid or unpaid, what notice employees must provide to utilize the voting leave, what notice employers must provide to employees, restrictions on action against employees related to voting or political opinions or exercising political rights, and any applicable exceptions."  MORE >>

Ogletree Deakins

[Guidance Overview]

The COBRA Triggering Events

"Not all losses of health coverage create COBRA rights. Only a loss of health coverage caused by one of the COBRA triggering events creates a qualifying event to continue coverage through COBRA."  MORE >>

Newfront

Latest Healthcare Fiduciary Lawsuit Filed Against Wells Fargo

"[T]he plaintiffs ... allege that Wells Fargo paid its pharmacy benefit manager high prices for generic drugs that were available at significantly lower prices ... [and] that most of the increased cost was paid by plan assets.... The suit also alleges that Wells Fargo paid too much in administrative fees compared to plans both similar in size to and smaller than the Wells Fargo plan." [Navarro v. Wells Fargo & Co., No. 24-3043 (D. Minn. complaint filed Jul. 30, 2024)]  MORE >>

OneDigital

District Court Finds No Abuse of Discretion in Denial of ERISA LTD Benefits for Claimant with Autoimmune Disorders

"[T]he Court found that the plan provision requiring Plaintiff to 'provide proof that you continue to be Totally or Partially Disabled' was reasonably interpreted by Sun Life to require objective evidence of disability. The Court also concluded that ... [Sun Life's] decision to deny benefits based upon its acceptance of the opinions of its reviewing physicians over the conflicting opinions of Plaintiff's treating providers was not arbitrary or capricious." [Ziegler v. Sun Life Assurance Company of Canada, No. 22-1115 (E.D. Mo. Aug. 19, 2024)]  MORE >>

Roberts Disability Law

Benefits in General

[Official Guidance]

IRS Disaster Relief Notice PR-2024-05, for Victims of Tropical Storm Ernesto in Puerto Rico

"[I]ndividuals and businesses in Puerto Rico that were affected by severe storms and flooding that began on Aug. 13, 2024 ... now have until Feb. 3, 2025, to file various federal individual and business tax returns and make tax payments.... [I]ndividuals and households that reside or have a business in all 78 municipalities qualify for tax relief."  MORE >>

Internal Revenue Service [IRS]

[Official Guidance]

IRS Disaster Relief Notice SD-2024-13, for Victims of Severe Storms, Straight-Line Winds, and Flooding in South Dakota

"[I]ndividuals and businesses in South Dakota that were affected by severe storms, straight-line winds, and flooding that began on June 16, 2024 ... now have until Feb. 3, 2025, to file various federal individual and business tax returns and make tax payments.... [I]ndividuals and households that reside or have a business in Aurora, Bennett, Bon Homme, Brule, Buffalo, Charles Mix, Clay, Davison, Douglas, Gregory, Hand, Hanson, Hutchinson, Jackson, Lake, Lincoln, McCook, Miner, Minnehaha, Moody, Sanborn, Tripp, Turner, Union, and Yankton counties qualify for tax relief."  MORE >>

Internal Revenue Service [IRS]

FTC Noncompete Rule Is Set Aside, But Appeal Is Expected and States May Act

"The validity of the rule is likely to come before the Third, Fifth and Eleventh Circuits, and the possibility of circuit conflict also means that the issue could potentially receive Supreme Court review. At the same time, states are also undertaking their own efforts to restrict noncompete clauses under state law." [Ryan LLC v. Federal Trade Commission, No. 24-0986 (N.D. Tex. Aug. 20, 2024)]   MORE >>

Skadden

Press Releases

Closing the Retirement Savings Gap: Innovative Insurance Protects 401(k)s During Job Transitions

Custodia Financial

JULY Welcomes Bill Riccio as Vice President of National Sales & Promotes Adam Barker to Vice President of TPA Partner Services

JULY Business Services

Ascensus Names Industry Veteran Michael Dunn to Lead Enterprise Solutions Business

Ascensus

Webcasts and Conferences
(Health & Welfare Plans)

Evaluating Your Third-Party Administrator: Are You Getting What You're Paying For?

October 22, 2024 WEBINAR

Lorman Education Services

Last Issue's Most Popular Items

Trends in Self-Insured Health Coverage

Employee Benefit Research Institute [EBRI]

Providing Claims and Appeals Notices in a Culturally and Linguistically Appropriate Manner (PDF)

Thomson Reuters / EBIA

Stop-Loss Insurance Changes Create Hurdles for Employers

Corporate Synergies

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

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