"[If] your plan is subject to ERISA, you will have a fiduciary obligation to monitor the process for completion of the comparative analysis.... You should learn enough about the rules to be able to identify NQTLs, engage one or more service providers to assist with the comparative analysis, and especially if your plan is subject to ERISA, monitor and review the work of those service providers and ask appropriate questions.... The rules require a comparative analysis to be conducted and documented regardless of whether a government official ever asks for it."  MORE >>

"MHPAEA does NOT require group health plans to cover MH/SUB benefits. If your plan does -- get help.... Whether you are newly subject to MHPAEA with the elimination of the opt out or have an insured plan that has been subject to the law from the inception of the [ACA], compliance with the final regulations will require time and effort."  MORE >>

"The [Paid Family Leave (PFL)] law now prohibits employers from requiring an employee to use up to two weeks of earned but unused vacation before they can receive PFL benefits. This new prohibition applies to any period of disability commencing on or after January 1, 2025. However, the option for employees to voluntarily use their vacation time remains available."  MORE >>

"Hospital and physician advocates are urging an appeals court to reverse a district court's decision that would render No Surprises Act arbitration payments unenforceable.... If the ruling stands, it would set a troubling precedent for providers, which have won a large majority of decisions since the IDR process was implemented ... in 2022. The most recent report from CMS examined the second half of 2023 and found providers won 82% of the time." [Guardian Flight LLC v. Health Care Service Corp., No. 23-1861 (N.D. Tex. May 30, 2024; on appeal to 5th Cir. No. 24-10561)]  MORE >>

"[1] AI could help employees pick health plans ... [2] Employees could interact with AI-powered self-service to get answers to common questions ... [3] AI could automate claims processing ... [4] Analyze current and model potential plan designs with AI."  MORE >>

"About 165 million Americans get their health insurance through work, and yet ... employees only spent about 45 minutes a year, on average, deciding which benefit options suit them best ... Open enrollment season, which typically runs through early December, is an opportunity to take a closer look at what's at stake. And, for starters, costs are going way up."  MORE >>

"Amazon already has an incredibly mature and developed supply-chain, fulfillment, logistics and delivery network -- meaning that the infrastructure that it is working with is incredibly strong. If Walgreens or CVS were to try and match same-day delivery to the same scale, they would require massive infrastructure and capital investments to do so."  MORE >>

"more than 90 percent of independent pharmacists may not sell drugs for which the Medicare Part D program is trying to negotiate lower prices.... NCPA CEO B. Douglas Hoey [said,] 'Unfortunately, the new CMS guidance fails to ensure fair reimbursement for pharmacies that dispense the drugs. It also fails to ensure timely reimbursement. Pharmacists are health care providers and pharmacies are also businesses that can't afford to lose money on prescriptions they dispense. The president's entire program is in jeopardy if that isn't addressed.' "  MORE >>

"[A] foreign-based corporation (or group of individuals) may have wholly owned subsidiaries in other countries that in turn have wholly owned subsidiaries in the U.S., which are in fact part of a controlled group. Most often, these U.S. controlled groups do not have centralized operations and are not even aware that there are other related entities in the U.S. ... Less familiar to many service-type companies are the rules treating affiliated service organizations as a single employer for retirement and cafeteria plan purposes. The ownership thresholds triggering application of these rules are much lower for this type of group than for controlled groups."  MORE >>

"To identify which international benefits work for your people, there are three key areas to consider per country: [1] employee benefits that are required by law, [2] benefits that might be expected by your people and [3] benefits that can help you stand out as an employer of choice."  MORE >>

"States such as Utah and Pennsylvania are already showing how portable benefits can allow individuals to maintain their nontraditional work arrangements while accessing work-related benefits. These kinds of benefits are the best sustainable solution if the nature of work in the United States continues to change and flexible forms of work become the new norm." [Also available: State Policy Guide]  MORE >>