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Court Strikes Down a Portion of the No Surprises Act Interim Regulations

While health plans, insurers, and providers are busy understanding and implementing the new requirements under the No Surprises Act, a U.S. District Court recently vacated an essential portion of the interim regulations carrying out the Act.  While this decision applies nationwide, the court only vacated a portion of the interim regulations affecting the new dispute...
March 3, 2022

A Brief Status Report On COBRA

The normal difficulties that employers have adhering to the technical requirements of COBRA have been exacerbated during the past two years as COBRA rules were changed to recognize the complications accompanying the COVID-19 pandemic.  This added complexity is particularly worrisome as an employer’s simple oversight in administering COBRA can result in ERISA penalties, an excise...
February 11, 2022

More Clarity Regarding Employer Mandates for At-Home COVID-19 Testing

As employers and insurers continue to establish programs to enable participants in group health plans to receive at-home COVID-19 tests at no cost, even without a prescription, the Department of Labor (DOL) has issued additional guidance and an updated FAQ providing further clarification and flexibility to insurers and plan sponsors in providing coverage to eligible...
February 7, 2022

Private Equity Investments In 401(K) Plans – The DOL Says Not So Fast

Hot button ERISA fiduciary issues remain a focus for investment committees of 401(k) plans in 2022.  From “excessive” fee litigation – including litigation over the duty to monitor the fees charged by various mutual funds made available to plan participants (the U.S. Supreme Court reaffirmed this duty in January 2022) – to the U.S. Department...
February 4, 2022

The 2021 Mental Health Parity Grades Are In – Everybody Failed

Most group health plan sponsors understand that the Mental Health Parity and Addiction Equity Act (MHPAEA) requires that coverage for mental health conditions and substance use disorders be no more restrictive than coverage for other medical and surgical conditions.  In 2020, Congress changed the law to require plans to perform and document comparative analyses of...
February 1, 2022

At-Home COVID-19 Testing Options and Alternatives

In fulfillment of President Biden’s promise to make at-home COVID tests more available for all of us, two significant action steps have now occurred: Every U.S. household has access to free at-home COVID-19 tests. As of January 18, 2022, any individual with a residence in the United States may request up to four (4) at-home...
January 19, 2022

Updated Rates for California EDD Benefits and San Francisco Paid Family Leave Ordinance

The California Employment Development Department (EDD) has released the Voluntary Plan Employee Contribution and Benefit Rates for 2022. Employers with employees located in California are generally required to withhold and send state disability contributions to the EDD. The 2022 rates are as follows: “Employee Contribution Rate” 1.10% “Taxable Wage Ceiling” (per employee per year) $145,600.00 “Maximum...
January 10, 2022

Understanding the Multiemployer Pension Plan Construction Industry Exemption

The Multiemployer Pension Plan Amendments Act (MPPAA), the Employee Retirement Income Security Act’s (ERISA) progeny, can create significant unexpected liabilities for companies that have agreed to collective bargaining agreements (CBAs) requiring participation in and contributions to multiemployer-defined benefit pension funds (often referred to as Taft-Hartley Funds). However, a special exemption is available to employers in...
December 30, 2021

New PCORI Fee Amounts Announced for the 2022 Reporting Period

The IRS just released IRS Notice 2022-04 that provides the updated fee for Patient-Centered Outcomes Research Institute (PCORI) paid by fully insured and self-funded health plans for the upcoming tax reporting period. As we stated before, even though the original PCORI fee assessments under the Affordable Care Act were scheduled to end after September 30,...
December 22, 2021

It’s Almost the End of 2021. Do You Know Where Your Healthcare Dollars Go?

The CAA Transparency Rules Will Let Plans and Participants Know.  The Department of Labor, Health and Human Services, and the IRS (collectively the Departments) recently released the Interim Final Rules with a request for Comment (IFC), Prescription Drug and Health Care Spending.  These rules implement Section 204, Title II, another phase of the transparency provisions...
December 10, 2021

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