Health & Welfare Plans Newsletter
April 30, 2025
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💼 New Job Opportunity Today
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[Guidance Overview]
Wellness Plan Litigation: Compliance Risks for Employers
"Recent litigation centered around wellness programs requirements based on tobacco use serves as a reminder for employers of the importance of understanding their compliance obligations.... Employers should consider ... [1] Are individuals given the opportunity to
earn wellness incentives each year? [2] Are the incentives compliant with the regulations limiting the value of the incentives? [3] Is [a reasonable alternative standard (RAS)] available under the plan? [4] Is the availability of the RAS disclosed in all materials describing the terms of the program? [5] Is the full incentive available to all similarly situated individuals? [6] Does the plan have a process for
ensuring any incentives required to be paid retroactively due to completing an RAS are accounted for?" MORE >>
HUB International
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[Sponsor]
Webinar: Employer Health Plans in 2025 -- Navigating the New Horizon
In this May 29 webcast, three experienced benefits lawyers will break down the latest benefit designs, real-life questions they're receiving from plan sponsors, and issues to consider to help plans navigate these shifting seas. Use code BLENHP for 25% off.
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[Guidance Overview]
IRS Clarifies Taxation of State and DC PFML Contributions, Benefits
"Revenue Ruling 2025-4 gives employers
long-awaited guidance on the federal tax treatment of contributions and benefits mandated by state paid family and medical leave (PFML) laws. The revenue ruling also covers reporting and tax withholding requirements and provides transitional relief for 2025. The guidance does not address federal tax treatment of contributions to -- or benefits from -- equivalent private PFML plans (fully insured or self-insured) employers offer in lieu of
participating in a state program." MORE >>
Mercer
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[Guidance Overview]
Washington State Expands Covered Uses of Paid Sick Leave to Include Immigration Proceedings
"The amendment will become effective July 27, 2025.... [It] allows the employee or driver to use such leave to prepare for, or participate in, any judicial or administrative immigration proceeding involving the employee or driver or their family member. Additionally, the law
outlines the verification process for such leave[.]" MORE >>
Littler
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District Court Finds Health Plan Had Fiduciary Duty to Negotiate Provider Rates (PDF)
"Mejia's counsel [argued that] absent a fiduciary duty to attempt to negotiate, the Plan's provision stating that Defendants would pay 'negotiated rates' if such rates exist would be rendered meaningless ... The Court finds that Defendants do not owe a contractual
duty to attempt to negotiate -- or to negotiate -- on Mejia's behalf. The Court, however, finds that insofar as Defendants owe fiduciary duties to act in the best interest of Plan participants and beneficiaries ... Defendants have a fiduciary duty to attempt to negotiate with the Medical Providers." [Mejia v. Credence Mgmt. Solutions, No. 23-2028 (C.D. Calif. Apr. 21, 2025)] MORE >>
U.S. District Court for the Central District of California
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District Court Declares Current HHS Regs for Assessing ACA Section 4980H Excise Taxes to Be Void and Unenforceable
"The practical effect of the court's potentially earthshaking declaration would seem to be that ... employers who have paid such excise taxes under Code Section 4980H are entitled to a refund of such taxes assuming the three-year statute of limitations for making a
refund claim has not lapsed." [Faulk Company, Inc. v. HHS, No. 24-0609 (N.D. Tex. Apr. 10, 2025)] MORE >>
The Wagner Law Group
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Case Study: Modernizing Paid Family Leave For A Competitive Edge
"While its existing benefits package met the needs of many of its employees, one New York-based financial technology company found it was coming up short with its paid family leave (PFL) policy. Employees expressed a strong desire for a policy including salary continuation
alongside their state-mandated PFL or disability benefits -- a benefit they observed at other tech firms." MORE >>
Corporate Synergies
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[Opinion]
Arkansas Prescription Drug Law Could Raise Costs and Limit Access
"ERIC shares many of the frustrations regarding anti-competitive practices by PBMs and the lack of much needed price transparency.... [T]he Arkansas law could jeopardize Arkansans' access to both physical pharmacy locations and mail-order delivery pharmacies, causing patients
to travel farther and pay more for medicines." MORE >>
The ERISA Industry Committee [ERIC]
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Benefits in General |
How Employee Benefit Plan Sponsors Benefit from SOC Reports
"Reviewing System and Organization Control (SOC) reports isn't just a compliance checkbox -- it's a vital risk management tool. A SOC report can offer an inside look at a provider's controls and the operating effectiveness of those controls, helping plan sponsors
identify potential red flags." MORE >>
Moss Adams LLP
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Employee Benefits Jobs
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Selected New Discussions |
Special Enrollment Deadline Missed - Ineligible Dependent
"Can a participant's enrollment be changed if they failed to inform the employer of a dependent's ineligibility during the special enrollment period? The participant presented a 'nonsuit' to the employer that indicates the participant, as of February 2025, is
no longer proceeding with formally adopting a child. The participant divorced his spouse in 2024 and the ex-spouse is currently receiving COBRA. Assuming the nonsuit constitutes a qualifying event, the participant did not present the nonsuit to the employer until after the end of the special enrollment period. The employer has been made aware that the child is ineligible because he/she is no longer a dependent of the participant. Coverage by
the insurer for the now ineligible dependent can be dropped prospectively; however, can the participant's coverage be also be changed from Employee + Dependent to Employee Only given that he no longer has a dependent? What about COBRA? Who should receive the notice? The participant or the participant's ex-spouse who is proceeding with adopting the child?"
BenefitsLink Message Boards
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Press Releases |
Payroll Integrations and UKG Partner to Automate Payroll and Benefits Administration
Payroll Integrations
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Lyra Health Unveils AI Platform to Build Workforce Resilience
Lyra Health
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Apex Fintech Solutions and 401GO Announce Strategic Collaboration to Expand Retirement and Investment Services
401GO
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Empower Launches First-Ever Zero-Fee Index Fund for Retirement Investors
Empower
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MissionSquare Retirement names Tom McAndrews as Chief Legal Officer
MissionSquare Research Institute
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Webcasts and Conferences (Health & Welfare Plans) |
Health Benefits Decoded: Transformative Strategies for Business Growth
RECORDED
OneDigital
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The Impact of AI on Employee Benefits
May 13, 2025 WEBINAR
Worldwide Employee Benefits Network [WEB]
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Last Issue's Most Popular Items |
Washington Update Briefing, April 2025 (PDF)
Mercer
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Florida PBM Audits Ensnare Self-Insured Employer Health Plans
Bloomberg Law
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Demystifying PEOs (PDF)
HUB International
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BenefitsLink® Health & Welfare Plans Newsletter, ISSN no. 1536-9595.
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