Insights

Through May and June of this year, Gov. Pritzker signed a series of bills into law mandating health insurers in the state provide certain coverage for the following services: SB2969 (signed June 15, 2022): medically necessary continuous glucose monitors for individuals with Type 1 or Type 2 diabetes, effective January 1, 2023Press Release on SB2969 HB5318 (signed June 10, 2022): annual prostate cancer screening and medically necessary follow-up testing without imposing a deductible, coinsur

On June 13, 2022, the Office of Civil Rights (OCR) updated its website with guidance related to audio-only telehealth and HIPAA Privacy and Security Rules. The OCR stated the guidance was in direct response to Executive Order 14058, which was issued in December 2021 and ordered the federal government agencies to design and deliver services in a more equitable and effective manner, especially for those who have been historically underserved. The guidance notes that telehealth that includes video

On June 3, 2022, the IRS announced that they will begin a new pre-examination retirement plan compliance program in June of 2022. Plan sponsors who are selected for the program will receive a letter from the IRS indicating that they have 90 days to review their retirement plan's documentation and operation to determine if they meet the IRS' requirements. The IRS will potentially schedule a full exam for those employers who do not respond. Upon completing the review, employers who find mistakes

On June 9, 2022, the IRS released Announcement 2022-13, in which the agency increased the optional standard mileage rate for computing the deductible costs of operating an automobile for business to 62.5 cents per mile. The optional standard mileage rate for medical and moving expenses is increased to 22 cents per mile. These increases are effective starting on July 1, 2022, and were increased in part due to higher fuel costs. Taxpayers may use the optional standard mileage rates to calculate t

On June 1, 2022, the US Court of Appeals for the Seventh Circuit held in Zicarrelli v. Dart et al. that an employee's FMLA rights may be violated without an actual denial of leave '” simply interfering with an employee's attempt to exercise those rights can violate the law. Plaintiff Salvatore Zicarrelli worked for the Cook County Sheriff's Office for over 27 years. During that time, he periodically took FMLA leave. In September 2016, he called the Sheriff's Office FMLA manager to discuss taki

On June 9, 2022, Gov. Pritzker signed the Illinois Family Bereavement Leave Act (FBLA) into law, expanding unpaid bereavement leave for Illinois employees to cover additional family member losses, pregnancy losses and failed adoptions. The FBLA amends the existing Child Bereavement Leave Act, which requires employers with at least 50 employees to provide up to 10 days of unpaid leave to parents and guardians after the loss of a child. Specifically, the FBLA expands the scope of family member lo

On June 8, 2022, the Department of Insurance issued Bulletin Number 2022-02 to announce an extension of transitional relief for certain non-grandfathered individual and small group policies known as 'grandmothered' policies. The bulletin follows the recent CMS extension of the federal nonenforcement policy concerning specific ACA compliance requirements for these plans. On November 14, 2013, CMS announced a transitional policy with respect to the healthcare reform mandates for coverage in the

The structure of an organization can significantly impact health and welfare benefits compliance. In this webinar, we'll review the basic types of IRS controlled groups and how controlled group status affects compliance with laws such as the ACA, COBRA, and Section 125 and 105 nondiscrimination rules. The presentation will also discuss special compliance considerations that may arise from changes in controlled group status (e.g., through mergers and acquisitions). Agenda Controlled Groups: O

On May 23, 2022, in Zahuranec v. Cigna Healthcare, Inc., et al., the Sixth Circuit Court of Appeals affirmed a district court decision that upheld a self-funded plan's subrogation and reimbursement rights. The plaintiff-appellant, Lisa Zahuranec, was a plan participant who suffered serious complications after undergoing bariatric surgery. The plan approved and paid for the surgery, although it did not meet medical necessity criteria. Zahuranec received a settlement from a medical malpractice s