"This post examines other approaches available to employers seeking to make these benefits available. These include health reimbursement arrangements (HRAs), health flexible spending accounts (health FSAs), excepted benefit employee assistance plans (excepted benefit EAPs), and health savings accounts (HSAs)."   MORE >>

"Based on its finding that residential treatment was not medically necessary even without the application of the additional criteria, the court denied the requests for surcharge, disgorgement, and restitution because no harm or loss had been proven." [ M.S. v. Premera Blue Cross , No. 19-0199 (D. Utah Jun. 21, 2022)]   MORE >>

"State and local leave laws create a host of compliance issues for employers. Employers may want to review their current policies taking into account their industry and the state, or sometimes even the specific ZIP code in which they operate. They may also want to consider the evolving definitions of what is a qualified event, particularly in light of the COVID-19 public health crisis."   MORE >>

"The plan insures more than 750,000 teachers, state employees, the governor, current and former legislators, state university and community college personnel and their dependents, and non-Medicare retirees and their dependents. It is the largest buyer of medical and pharmaceutical services in North Carolina.... [State Treasurer Dale Folwell] and the health plan board claim Biggs' order 'deprived the Plan of the benefit of a jury trial, where experts could transparently debate whether sex transition operations are or are not medically necessary.' " [ Kadel v. Folwell , No. 19-0272 (M.D.N.C. Jun. 10, 2022; on appeal to 4th Cir. No. 22-1730)] MORE >>

"Sen. Joe Manchin, D-West Virginia, said he is apprehensive about adding ACA enhanced subsidies to a narrow spending package that is expected to include a deal on prescription drug pricing reforms. The remarks ... come as the enhanced subsidies -- which helped spark record-level enrollment -- are going to expire after this year unless Congress acts."   MORE >>

" The court reasoned that the deadlines were inapplicable to the cases at issue because the entity's final denial letters to the participants did not contain notice of the deadlines.... Since the court determined that the plan-imposed filing deadlines did not apply in these cases, the court looked to the most closely related statute of limitations under state law, which was six years." [ E.F. v. United Healthcare Ins. Co. , No. 21-190 (D. Utah Mar. 30, 2022); Anne A. v. United Healthcare Ins. Co. , No. 20-814 (D. Utah Mar. 30, 2022)]   MORE >>