In our January 2022 update, we discussed new federal requirements that group health plans should pay close attention to in 2022. The sponsor of a self-funded plan will need to work closely with its legal counsel, benefits consultant, and administrative services only (ASO) provider or other third-party administrator (collectively, TPA) to modify its plan
New FAQs Clarify Prior Agency Guidance on Requirement to Cover OTC COVID-19 Tests
On February 4, the tri-agencies (DOL, HHS and Treasury) issued new FAQs on the requirement for group health plans and issuers to cover over-the-counter (OTC) COVID-19 tests without cost-sharing, prior authorization, or other medical management requirements. We discussed the tri-agencies’ initial FAQs in our prior blog post.
The coverage requirement is still in place, but these new FAQs provide clarifications in response to the tri-agencies’ receipt of stakeholder questions—primarily about the “safe harbor” permitting the limit of reimbursements to $12 per test (or actual cost, if less) if the test is purchased outside a direct coverage program.
Continue Reading New FAQs Clarify Prior Agency Guidance on Requirement to Cover OTC COVID-19 Tests
Washington Legislature Amends WA Cares Fund, Delays Premium Collection until July 2023
On January 27, 2002, Washington Governor Jay Inslee signed House Bills 1732 and 1733 into law, officially delaying the assessment of WA Cares Fund premiums until July 1, 2023. As a result, WA Cares Fund benefits will not be available until July 1, 2026. These delays give state lawmakers additional time to resolve key issues
2022 Cybersecurity Issues and Recommendations for ERISA Plan Fiduciaries
New cybersecurity developments and observations, including those relating to U.S. Department of Labor review of cybersecurity issues, warrant prompt consideration by plan fiduciaries, including those plans covered by HIPAA. The following update includes recommendations to help ERISA retirement and health and welfare plan sponsors and responsible fiduciaries protect benefit plans and participants against cybersecurity risks
Ringing in the New Year: Key Developments for Health Plan Sponsors
There are many new and expanding legal requirements for group health plans and issuers of group health plan coverage to pay attention to this year. Many of these requirements were enacted as part of the Consolidated Appropriations Act of 2021, which passed in December 2020. This update describes the key legal requirements that we are
New FAQs Require Group Health Plans and Issuers to Cover OTC COVID-19 Tests
This week, the Department of Labor, Health and Human Services and the Treasury issued a new set of Frequently Asked Questions (FAQs) confirming that group health plans and issuers must provide 100% coverage of over-the-counter (OTC) COVID-19 diagnostic tests beginning January 15, 2022.
The FAQs are further interpretation of the coverage mandate required by the
IRS Issues FAQs on COBRA Subsidy
On Tuesday, May 18, 2021 the IRS issued Notice 2021-31 providing 86 FAQs related to premium assistance for COBRA benefits under the American Rescue Plan Act, 2021. The full text version of the FAQs is available below. These provide additional guidance on, among other things:
- Whether an individual has had an “involuntary” termination, including employee-initiated
Washington Governor Inslee Modifies COVID-19 Proclamation Protections for High-Risk Employees
On April 8, 2021, Washington Governor Jay Inslee issued Proclamation 20-46.3, which modifies proclamations issued in 2020 that provide employment and benefit protections during the COVID-19 pandemic emergency for “high-risk employees.” (For purposes of the Proclamation, a “high-risk employee” is any employee that the Centers for Disease Control defines as being more likely to
EBSA Guidance on COBRA Subsidy in the American Rescue Plan Act
The American Rescue Plan Act of 2021 includes a 100% federal subsidy of COBRA premiums (including the up-to-2% administrative fees) during the period of April 1, 2021, through September 30, 2021. Earlier this week, the Employee Benefits Security Administration published clarifying FAQs and model notices related to the COBRA subsidy. This update discusses the guidance
Employer Responsibilities Under the ARPA COBRA Subsidy
The American Rescue Plan Act of 2021 (ARPA) includes a 100% federal subsidy of COBRA premiums (including the up-to-2% administrative fees) during the period of April 1, 2021, through September 30, 2021. The subsidy applies to group health coverage typically subject to COBRA, except for health flexible spending accounts. This update summarizes the ARPA’s COBRA