"Plan sponsors with fixed indemnity notices in enrollment packets and systems may
remove those notices. Regarding the Executive Orders on the topics of prescription
drugs and gender identity, plan sponsors should stay tuned for new guidance from CMS
and HHS on the new path forward to compliance. There is currently a 60-day pause on
rules being published in the Federal Register, so any related guidance is not likely to
come for another few months."  MORE >>

"Calendar year plans must cover the following preventive care services without cost-sharing, effective January 1, 2025: [1] Poliovirus Vaccine (expanded coverage).... [2] Anxiety disorder screenings (expanded coverage).... [3] Respiratory Syncytial Virus (RSV) vaccine (new requirement).... [4] Mpox vaccine (new requirement)."  MORE >>

"While the PBRA and ERIA provide some relief for employers, there are a few remaining unknowns that may make implementation of the PBRA method complicated for employers deciding how to meet the Form 1095 obligations for the 2024 plan year."  MORE >>

"The Proposed Rule contains significant textual modifications to the current HIPAA Security Rule.... [T]he proposed new requirements are aimed at aligning with current cybersecurity best practices as reflected across risk management frameworks, including NIST's Cybersecurity Framework."  MORE >>

"New FAQs provide guidance on the federal prohibition on gag clauses and related attestation requirement. The FAQs clarify that agreements with TPAs and other service providers should prohibit these service providers from entering into downstream agreements that restrict the plan from accessing or sharing relevant information or data. The FAQs also provide examples of impermissible clauses."  MORE >>

"The newly issued FAQs clarify that the gag clause prohibition not only precludes plans from entering into agreements that contain gag clauses, but it also prohibits any restrictions contained in downstream agreements.... The FAQs also provide examples of restrictions that would amount to prohibited gag clauses. "  MORE >>

"[Rev. Rul. 2025-1] is effective for family and medical leave benefits paid by a state on or after January 1, 2025, but treats 2025 as a transition period, which provides relief from certain withholding and reporting requirements. The Revenue Ruling provides guidance on the federal income and employment tax treatment of taxes paid to, and benefits paid from, state paid family and medical leave programs, as well as Form 1099 and W-2 reporting responsibilities. The Revenue Ruling is relevant to states, employers and employees."  MORE >>

"Modeled after the Insurance Data Security Model Law issued by the National Association of` Insurance Commissioners, [Puerto Rico Insurance Code] Rule No. 108 requires all insurance companies doing business in Puerto Rico to develop, implement, and periodically update a cybersecurity program reasonably designed to protect the confidentiality, integrity, and availability of the nonpublic information kept in their computer, communications, or information systems and ensure the security of such systems.... Rule No. 108 does not regulate nor impose any requirements on employers doing business in Puerto Rico, their ERISA plan administrative committees, or self- funded employee benefits plans."  MORE >>

"Proposed regulations for Maryland’s FAMLI program cover claims and dispute resolution, detailing procedures for benefit claims, employer responses, and appeals, while also highlighting significant employer concerns such as limited options to challenge fraudulent applications. Comments on the dispute resolution proposed regulations may be submitted through February 10, 2025."  MORE >>

28 presentation slides. Topics include: [1] Telemedicine relief for HDHPs ending ... [2] Employer Reporting Improvement Act ... [3] Fiduciary duties ... [4] Supreme Court case impacts benefit regulations ... [5] Updates to rules for reproductive healthcare ... [6] Proposed rules for enhanced HIPAA cybersecurity ... [7] MHPAEA: 2024 final rules ... [8] Disaster relief extensions ... [9] Hospital indemnity notice requirement vacated ... [10] 2025 IRS limits for health plans ... [11] 2025 predictions.  MORE >>

"Many employers, enticed by the promise of value-based care for better outcomes at lower costs, have been looking to integrate these solutions into their benefits programs.... Health systems that can successfully create and launch direct-to-employer health benefits can produce a win-win for all parties involved, including not only employers, employee-patients and providers but also the nation's healthcare system as a whole."  MORE >>

"[F]loat periods on health insurance premiums are materially shorter than those enjoyed by other forms of insurance. This restriction on health insurers ultimately results in a limited ability to compound returns over extended periods of time, reducing ROI and narrowing net margins, while limiting the ability to offer more competitive rates. ... [If] health insurers had the opportunity to extend these periods it would result in significant increases in non-operating revenue.... [A] new class of financial instrument called HIBS (Health Insurance Backed Securities) [would] enable health insurers [to] achieve these outcomes while maintaining their risk profile and without increasing long-term debt."  MORE >>

"State insurance regulators are now looking hard at use of artificial intelligence tools and other high-tech tools at life and annuity issuers' vendors.... The NAIC's Third-Party Data and Models Task Force is developing a framework for the regulatory oversight of the data files, predictive models and related tools that insurers get from outside sources."  MORE >>

"[1] Invest wisely in rewards ... [2] Make rewards count for employees ... [3] Help employees grow and deliver to their best [4] ... Solve for workforce health and wellbeing as a business performance vulnerability ... [5] Make total rewards work better globally."  MORE >>