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Health & Welfare Plans Newsletter

January 16, 2025

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[Official Guidance]

Text of IRS Rev. Rul. 2025-4: Income and Employment Tax Treatment of Contributions and Benefits Under State Paid Family and Medical Leave Statutes (PDF)

"Mandatory employee contributions that the employer withholds from the employee's wages and remits to the State pursuant to the State's PFML statute are employee payments of State income tax.... Mandatory employer contributions required to be paid from the employer's own funds pursuant to the State's PFML statute are employer payments of State excise tax.... Amounts paid to the employee by the State as family leave benefits pursuant to the State's PFML statute are included in the Federal gross income of the employee[.]"  MORE >>

Internal Revenue Service [IRS]

[Guidance Overview]

IRS Issues Guidance for the District of Columbia and States That Have Paid Family and Medical Leave Programs

"The revenue ruling explains multiple tax treatment scenarios for contributions to and benefits paid in certain situations under these programs, and the related reporting requirements.... In addition, the revenue ruling provides transition relief to the District of Columbia, states, and employers from certain withholding, payment, and information reporting requirements for State paid medical leave benefits paid made during calendar year 2025."  MORE >>

Internal Revenue Service [IRS]

[Guidance Overview]

DOL Sheds Light on Administering FMLA Leave When an Absence Triggers Both FMLA and State Paid Leave Laws

"DOL clarified two principles when an employee is taking leave covered by both the federal FMLA and state paid family and medical leave: ... [1] In situations where an employee takes leave under a state/local paid leave program, if the absence ALSO triggers the protections of FMLA, the absence must be designated as FMLA leave.... [2] [If] an employee, during leave covered by the FMLA, receives any compensation from a state/local family or medical leave program, the employer cannot force the employee to exhaust any employer-provided paid leave at the same time."  MORE >>

FMLA Insights

[Guidance Overview]

DOL Opinion Letter Addresses Applicability of the FMLA Substitution Rule When Employee on FMLA Is Receiving PFML Benefits

"The Opinion Letter confirms that when an employee on FMLA is receiving PFML benefits, the FMLA substitution rule does not apply because the employee is not on unpaid FMLA leave. Instead, receipt of PFML benefits is treated akin to partial income replacement through STD or workers’ compensation. Therefore, both the employer and employee must agree to the employee’s use of accrued paid leave to “top up” the PFML benefits to receive 100% of pay."  MORE >>

Littler

[Guidance Overview]

Administration Rescinds Proposal for Mandatory Coverage of Over-the-Counter Contraceptives

"[T]he rescinded proposed regulations would have required first-dollar coverage of daily birth control, emergency contraceptives, and male condoms, among other contraceptive drugs or devices."  MORE >>

Miller Johnson

[Guidance Overview]

W-2 Reporting Issues for Health and Welfare Benefit Plans

"[1] The ACA requires that employers who issue at least 250 W-2s reflect the applicable premium for health coverage on Box 12 of Form W-2. Reporting health care costs is optional for employers issuing fewer than 250 W-2s, but the IRS encourages reporting the applicable cost of health coverage.... [2] Employer-provided group-term life insurance.... [3] Health care benefits for domestic partners and other non-dependents.... [4] Dependent Care Assistance Plans (DCAPs).... [5] Health Savings Accounts (HSAs).... [6] Third-party sick pay reporting for disability benefits."  MORE >>

Brown & Brown, Inc.

[Guidance Overview]

New Artificial Intelligence (Ai) Regs and Potential Fiduciary Implications

"To navigate this evolving landscape, fiduciaries should take proactive steps to manage AI-related risks while leveraging the benefits of these technologies: [1] Evaluate AI tools ... [2] Audit service providers ... [3] Review and update policies ... [4] Enhance risk mitigation  ... [5] Integrate AI considerations into requests for proposals (RFPs) ... [6] Monitor legal and regulatory developments ... [7] Provide training  ... [8] Document due diligence  ... [9] Assess applicability of Section 1557 to your plan."  MORE >>

Foley & Lardner LLP

[Guidance Overview]

DEA Pitches Registry to Boost Scrutiny of Telehealth Prescribing

"In this proposed rulemaking's approach, DEA distinguishes telemedicine providers by architecting three distinct categories subject to different levels of scrutiny.... This is the first time the agency is proposing to regulate the slew of telehealth businesses that rose in popularity after the onset of the COVID-19 public health emergency.... DEA clarifies that a telehealth platform 'explicitly excludes certain types of entities, including hospitals, clinics, insurance providers, and local in-person medical practices.' "  MORE >>

FierceHealthcare

SCOTUS Asks: Does the ADA Permit a Retiree to Sue for Benefits Discrimination?

"Multiple U.S. Supreme Court justices challenged a Florida city government's position ... that a retired firefighter could not sue under the Americans with Disabilities Act over alleged disability discrimination with respect to a retirement healthcare benefit that she earned while working for the city." [Stanley v. City of Sanford, Florida, No. 22-10002 (11th Cir. Oct. 11, 2023; cert. pet granted No. 23-997, Jun. 24, 2024; oral arg. Jan. 13, 2025; transcript and audio available)]  MORE >>

HR Dive

FTC Report Shows PBMs Profit from Specialty Generic Drug Markups and Reimbursements

"The [FTC report] found that PBMs earn several billion dollars annually from increasing the cost of specialty generic drugs by dispensing them through affiliated pharmacies. Of the specialty generic drugs the FTC analyzed, PBMs marked up nearly two-thirds of them by more than 100 percent [and] marked up the cost of over one in five ... by over 1,000 percent. The report also finds evidence that PBMs steer patients with highly profitable medications toward affiliated pharmacies more aggressively than for patients with less profitable medications."  MORE >>

Duane Morris LLP

How Companies Can Tackle the Rising Costs of Large Claims

"Companies can adopt several strategies to manage high costs such as ensuring effective condition management, disease management, and chronic care management programs are in place. These strategies emphasize intensive medical care management, medication adherence, and promoting healthier lifestyles to lower overall expenses."  MORE >>

Sequoia

Employee Benefits Jobs

View job as 401(k) Plan Conversion Analyst for Sentinel Group

401(k) Plan Conversion Analyst

Sentinel Group

Remote / Wakefield MA / Troy MI / Hybrid

View job as 401(k) Plan Conversion Analyst for Sentinel Group

Press Releases

Prudential, Dimensional Fund Advisors and FIDx collaborate to help reinvent retirement income in wealth management

Prudential Financial, Inc.

OneDigital Welcomes Nonprofit HR, Expanding Capabilities for the Social Impact Sector

OneDigital

Kelsey Stevens Named CEO of Wakely Consulting Group

Wakely Consulting Group

President Names Davey Grubbs as New Member to PBGC Advisory Committee

PBGC [Pension Benefit Guaranty Corporation]

Webcasts and Conferences
(Health & Welfare Plans)

HSA Fundamentals

February 6, 2025 WEBINAR

Ascensus

Last Issue's Most Popular Items

Text of WHD Opinion Letter FMLA2025-01-A: Whether FMLA Regs Pertaining to Substitution of Paid Leave Apply When Employees Take Leave Under State or Local Paid Family Leave Programs (PDF)

Wage and Hour Division [WHD], U.S. Department of Labor [DOL]

New ACA Penalty and Reporting Relief

Trucker Huss

Holy Smokes: Is Your Tobacco Surcharge Program Compliant?

Warner Norcross + Judd LLP

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

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