"[1] Mental Health Parity and Addiction Equity Act (MHPAEA) non-quantitative treatment limit (NQTL) comparative analysis ... [2] Prescription drug data collection ... [3] Gag clause attestation ... [4] Broker and consultant compensation disclosures ... [5] ACA form distribution ... [6] Telehealth HSA relief ... [7] Updated 2024 benefit limits ... [8] Overview of significant health and welfare benefit plan compliance tasks."   MORE >>

"Caution is needed because sometimes, dependents or spouses are dropped from coverage during open enrollment due to a COBRA triggering event.... [A] plan administrator that becomes aware that one of these qualifying events (such as a divorce) has occurred may wish to act on that information and provide a COBRA election notice immediately, even without formal notice. Sending the election notice will start the 60-day COBRA election period running at the earliest possible time."   MORE >>

"California Senate Bill 848 ... builds on California's 2023 bereavement leave law, which provided five days of unpaid bereavement leave to eligible employees following the death of a covered family member. This new reproductive loss law applies to all employers with five or more employees."   MORE >>

"New York's Department of Health (DOH) has posted the 2024 regional covered-lives assessment (CLA) rates and percentage surcharges for graduate medical education (GME) under the state's Health Care Reform Act (HCRA). The HCRA imposes an annual CLA ... on 'electing' health claim payors, including self-funded plans.... The GME CLA rates and percentage surcharges vary among eight regions, and the applicable rate depends on where the covered individual resides or receives in-state hospital care."   MORE >>

"This [post] covers cases relating to [1] the enforceability of contractual statute of limitations provisions described as a 'labyrinth,' [2] ERISA claims when the carrier allegedly misrepresents benefits, [3] federal courts retaining ERISA jurisdiction following a related state court case, [4] a court excusing an administrator's regulatory violations under the arbitrary and capricious standard, and [5] a court enforcing the clear terms of a plan relating to when coverage for benefits ends."   MORE >>

"[1] Supporting employee wellbeing ... [2] Controlling rising healthcare costs ... [3] Improving benefits literacy and adoption across a diverse workforce ... [4] Using AI to level up your benefits."   MORE >>

"[This post examines] the impact of the proposed regulations on small and medium-sized self-funded plans through the lens of a National Association of Benefits and Insurance Professionals (NABIP) comment letter  ... [which] addressed ... [1] The need for a compliance safe harbor ... [2] Focus on cooperation from service providers ... [3] MHPAEA Self-Compliance Tool."   MORE >>

"The proposal, which has bipartisan support, would exempt individual and small employer health insurance markets. Covered services would include intrauterine insemination, genetic testing, embryo transfers, and other fertility services recommended by a physician in accordance with American Society for Reproductive Medicine guidelines."   MORE >>

"Sometimes an investigation takes months to complete, and the HIPAA deadline for providing notice may have passed before a health plan or health care provider even knows who was affected by the breach and is entitled to notice. Plan administrators ... need to consider how and when they can provide appropriate notice to individuals ... taking into account HIPAA's requirements, the terms of the applicable business associate agreement, concerns about causing undue alarm, and other factors."   MORE >>

"HHS has made it clear that they will be focused on ransomware attacks going forward. All covered entities, including health plans that process or store ePHI, must be proactive in protecting their systems from cyberattacks. Plan sponsors should ensure that their security policies are up to date and that their workforce is regularly trained on all security procedures."   MORE >>