"This document rescinds the [DOL's] 2018 rule entitled ' Definition of Employer Under Section 3(5) of ERISA -- Association Health Plans '.... The 2018 AHP Rule was a significant departure from the Department's longstanding pre-rule guidance on the definition of 'employer' under ERISA. This departure substantially weakened the Department's traditional criteria in a manner that would have enabled the creation of commercial AHPs functioning effectively as health insurance issuers. The Department now believes that the core provisions of the 2018 AHP Rule are, at a minimum, not consistent with the best reading of ERISA's statutory requirements governing group health plans."   MORE >>

"Among other things, the rule : [1] Holds HHS' health programs and activities to the same nondiscrimination standards as recipients of Federal financial assistance.... [2] Requires covered health care providers, insurers, grantees, and others, to proactively let people know that language assistance services are available at no cost to patients.... [3] Protects patients from discriminatory health insurance benefit designs made by insurers. [4] Clarifies the application of Section 1557 nondiscrimination requirements to health insurance plans."   MORE >>

19 Q&As, including: "Why is OCR issuing a new final rule addressing Section 1557? ... Are those covered by the rule required to provide notice to let patients and consumers know about their rights under Section 1557? ... What does the final rule require for individuals with limited English proficiency? ... What does the final rule require concerning individuals with disabilities? ... Does the final rule prevent covered providers from using algorithms, devices, or tools in a way that results in discrimination? ... What types of discrimination constitute discrimination on the basis of sex? ... Does the final rule include a religious freedom and conscience exemption? ... Does the final rule require the coverage or provision of treatment (e.g., hormone therapy, surgery, etc.) for children and/or adults with gender dysphoria if prescribed by a doctor?   MORE >>

"[One] company is using AI to provide a personalized virtual benefits assistant for workforces 24/7. The machine learning system ... not only helps employees select the right benefits, but offers guidance on how to utilize those benefits when the need arises.  ... [P]ersonalized support at enrollment led to 80% of employees feeling like they picked the right health plan -- a notoriously difficult choice to get right."   MORE >>

"ERISA (and IRC section 125) requires an official written plan document for each health and welfare benefit plan as well as a summary of that plan document, called a summary plan description (SPD).... Some employers rely on insurance carrier documents (e.g., policies, certificates of coverage) as their ERISA plan documents. Typically, these do not meet ERISA's plan document requirements."   MORE >>

"Develop family building programs that provide comprehensive support for all paths to parenthood including fertility, adoption and surrogacy and access to clinical resources ... Implement family wellbeing programs to include all aspects of wellness ... Design leave and return-to-work policies that embrace part-time and phased in approaches ... Provide caregiving support ... Give mothers (and parents) control over their schedules."   MORE >>

"[T]he average annual incurred medical cost per dependent exceeds $6,860, and a DEV audit yields a 3%-10% removal rate of ineligible dependents.... Ineligible dependents can inadvertently lead to denied insurance claims, creating unnecessary administrative burdens and financial strain for both employers and participants.... By verifying dependent eligibility, employers can enhance their financial controls and reduce the risk of fraud."   MORE >>

"Among all private industry workers participating in medical care plans, 51 percent were participating in high deductible health plans in 2023. Across occupational groups, 49 percent of management, professional, and related workers and 58 percent of natural resources, construction, and maintenance workers participated in high deductible health plans.... In 2023, the median annual individual deductible amount was $2,500 for all private industry workers participating in a high deductible health plan."   MORE >>

"The implemented changes strengthen protections for LGBTQI+ individuals. These revisions protect the right to health care free from prejudice and discrimination, addressing specific concerns related to gender-affirming care and hormonal replacement therapy.... The regulatory changes also affirm that people with disabilities are shielded not only from coverage rejection but also from discriminatory pricing practices, including co-pays, prescription tiering, and coverage limits."   MORE >>

"[N]on-compete clauses can be found in a variety of compensation arrangements, including employment agreements, severance plans, and incentive awards.... [T]he final rule largely preserves the proposed rule's sweeping scope, while incorporating a narrow legacy exception for existing non-compete clauses with senior executives. Assuming it survives court challenges, the rule will transform employee compensation arrangements in the United States, forcing many employers to rethink how they incentivize, retain, and part ways with their employees."   MORE >>

"Although three lawsuits have been filed so far, the lawsuit to watch is the United States Chamber of Commerce lawsuit filed in the United States District Court for the District of Texas.... [C] ompanies should know in June whether the Rule will be enacted (and thereby require companies to come into compliance within 120 days of the Rule being published in the Federal Register) or enjoined. " [Chamber of Commerce of the United States of America v. Federal Trade Commission, No. 24-00148 (E.D. Tex. complaint filed Apr 23, 2024)]   MORE >>