"The departments have issued interim final rules detailing the data to report and recently updated submission instructions describing the mechanics of the reporting process. The updated instructions provide important information about reporting wellness services, prescription drug expenses that are covered by the pharmacy benefit manager and more."   MORE >>

"The federal agencies recommend that plan sponsors and agencies take the following steps to ensure compliance with the ACA contraceptive coverage mandate and avoid unwanted enforcement actions.... [1] Developing an appropriate exceptions process or reviewing the existing exceptions process; [2] Developing and implementing standardized forms for the exceptions process; [3] Providing information and instructions about the exceptions process to members through plan documentation and online resources; and [4] Eliminating non-compliant medical management techniques."   MORE >>

"[T]he Fifth Circuit reasoned that the advisory opinion was arbitrary and capricious because it relied on a definition of 'working owner' that was 'materially different' from the one applied in prior guidance. The Fifth Circuit held that the DOL's failure to explain its departure from the prior definition resulted in the kind of 'unexplained inconsistency' that is the 'hallmark' of arbitrary and capricious agency action." [ Data Marketing Partnership, LP v. DOL , No. 20-11179 (5th Cir. Aug. 17, 2022)]   MORE >>

"The denial letter informed her of her right to bring a civil suit under ERISA Section 502(a). The letter did not specify any deadlines but did advise her that she could request documents and records relevant to her claim for benefits. The court found that one of the documents she could have requested would have contained the provision alerting Bakos that she had three years following Unum's denial to file a civil suit in federal court." [ Bakos v. Unum Life Ins. Co. of America , No. 22-11131 (11th Cir. Aug. 25, 2022; unpub.)]   MORE >>

"[Aon] used data of nearly 700 employers representing approximately 5.6 million employees and found that healthcare expenditures will rise significantly from the budgeted $13,020 per employee in 2022. The projection of a 6.5% increase is more than double the rate employers experienced from 2021 to 2022"   MORE >>

"Most employers expect to continue to cover abortion services in states where permitted by law ... Half of employers offer or plan to offer travel benefits for elective and medically necessary abortions.... Most plans place limits on abortion-related travel benefits."   MORE >>

"As more companies offer voluntary products, employees are analyzing this coverage to see how it fits into their strategy to mitigate or transfer risk. These plans can deliver some important financial benefits to workers who enroll and incur a covered claim. For an employee who owns and funds a Health Savings Account (HSA) and incurs a covered claim, a payment from a voluntary plan may allow the account owner to retain a balance that continues to grow and can later be used to reimburse tax-free qualified expenses up and into retirement."   MORE >>