Insights

On April 6, 2022, Gov. DeSantis signed SB 292 into law. As background, Florida law currently requires group health insurance policies to provide coverage for a screening to detect hearing loss in newborns. The test must be administered prior to discharge from the hospital or other facility. The new law, effective January 1, 2023, will require group health insurance policies to provide additional testing to newborns who fail the initial screening. Policies must cover testing to screen for conge

On March 17, 2022, in Vista Health Plan, Inc. v. US Department of Health & Hum. Servs., the US Court of Appeals for the Fifth Circuit ruled in favor of the Department of Health and Human Services' (HHS) risk-adjustment program. The ACA prohibits health insurers from denying coverage or charging higher premiums based on someone's health status. To disincentivize these prohibited practices, HHS administers the risk-adjustment program by redistributing enrollees' actuarial risk among health in

Effective March 17, 2022, the HHS has increased penalty amounts adjusted by inflation related to Summary of Benefits and Coverage (SBC), Medicare secondary payer (MSP) and HIPAA privacy and security rules violations. The new amounts are applied to penalties assessed on or after March 17, 2022, for violations occurring on or after November 2, 2015. Summary of Benefits and Coverage (SBC) The ACA requires insurers and group health plan sponsors to provide SBCs to eligible employees and their ben

Effective February 8, 2022, the automatic escalation provisions of the Illinois Secure Choice Retirement Savings Program took effect. Under these provisions, employees who have been enrolled in the program for at least six months will have their contribution automatically increased by one percent each subsequent calendar year. However, the employee has the right to opt out of the contributions and/or the automatic increase. As background, since November 1, 2018, employers with 500 or more empl

On April 5, 2022, the IRS and Treasury Department announced a proposed rule to fix the 'family glitch' in eligibility rules for the ACA premium tax credit (PTC). In a press statement, the Biden administration reported the 'family glitch' affects about 5 million people. A PTC for purchasing health insurance on the ACA's marketplace is available to people who do not have access to 'affordable' coverage through their jobs. Under current regulations, spouses and children are ineligible for the PTC

On April 6, 2022, Gov. DeSantis signed HB 1099 into law, which prohibits group life insurance policies from discriminating against living organ donors in terms of coverage, premiums or any other condition of the policy. The new law is effective July 1, 2022. Employer plan sponsors should work with their insurer to understand the new prohibition and update documents accordingly. Florida House of Representatives, CS/HB 1099 (PDF)

On April 6, 2022, the Office of Civil Rights published a Request for Information (RFI) related to certain provisions of the Health Information Technology for Economic and Clinical Health (HITECH). The request includes 30 specific questions. Entities may choose to answer all or just some of the questions. Specifically, OCR would like to hear how covered entities and business associates are complying with HIPAA's Security rules related to the safeguarding of electronic PHI. Under those rules, en

Effective April 1, 2022, the Oregon Bureau of Labor and Industries (BOLI) added the use of Oregon paid sick and safe leave to include an eligible employee to take time off in case of an emergency evacuation order and in situations when the air quality index or heat index exceeds a certain level. The authorized public officials will determine a level where continued exposure to such levels would jeopardize the employee's health. Employers who have employees in Oregon should be aware of this new

On March 24, 2022, Gov. Cox signed legislation that will require certain state employers to offer paid parental leave for eligible state employees effective July 1, 2022. The qualifying reasons to take paid parental leave are: The birth of the employee's child The adoption of a minor child The appointment of legal guardianship of a minor child or incapacitated adult  Covered state employers do not include an institute of higher education under the law. SB 100 »