Insights

Recently, the Massachusetts Department of Family and Medical Leave (the 'Department') updated Massachusetts Paid Family and Medical Leave (MAPFML) program resources for employers and employees to provide additional guidance and clarifications through frequently asked questions and other online publications. The updated guidance describes how employers' paid leaves and MAPFML benefits coordinate, and how employees can check the status of their PFML payments and report other leave(s) and income o

In 2006, the social media tag '#MeToo' was coined by Tarana Burke, a survivor of sexual assault, as a way to help other girls and women of color who also survived sexual assault. On March 3, 2022, President Joe Biden signed into law the 'Ending Forced Arbitration of Sexual Assault and Sexual Harassment Act' (the Act). The Act, which had bipartisan support, invalidates pre-dispute arbitration agreements with respect to cases filed under federal, state or tribal law that prevent a party from fi

Understanding what is happening in a specific market is essential for making the best decisions for your business. Knowing the latest trends and projections helps you stay agile, adjust your strategy and make smarter choices, even in a dynamic landscape. The Q1 2022 Specialty Claims Journal and Trend Report offers analysis and insight into the first quarter of the year from industry specialists, in addition to key predictions going forward. Discover the latest P&C claims activity and recent

In short, likely no. A growing number of states have implemented or are planning to implement statutory PFML programs soon. A statutory PFML generally applies to an employee who works in the state (including telecommuting) regardless of the physical office location or employee's residence state. For example, an employee who works from his or her home in California is subject to California's paid family leave (PFL) and disability insurance even if his or her company is located outside of Califor

On April 12, 2022, the DOL, IRS and HHS jointly released revised process guides for independent dispute resolution (IDR) under the No Surprises Act (NSA), enacted as part of the Consolidated Appropriations Act, 2021 (CAA). Additionally, the online Federal IDR system portal for resolving payment disputes between insurers/plans and providers for certain out-of-network (OON) charges is now open. The NSA provisions protect participants from surprise bills for OON emergency and air ambulance service

On April 19, 2022, the DOL issued Part 53 of a series of FAQs concerning the ACA. Specifically, the FAQs cover the requirement under the Transparency in Coverage Rule (the Rule) to provide certain disclosures in machine-readable files. The Departments of HHS, Treasury and Labor (the departments) promulgated the Rule on October 29, 2020. The Rule imposes new cost-sharing and pricing disclosure requirements upon group health plans and health insurers. Among other requirements, non-grandfathered g

On April 20, 2022, the US Court of Appeals for the Fourth Circuit held, in Garner v. Central States, Southeast and Southwest Areas Health and Welfare Fund Active Plan, that the trustees of the plan had abused their discretion by denying the plaintiff's spinal surgery claim based on two independent physicians' review. Dorothy Garner suffered from back and neck pain for several years. Upon being advised by her neurosurgeon, she performed postural exercises and used medication to manage the sympt

On April 13, 2022, the HHS renewed the COVID-19 pandemic Public Health Emergency (PHE) for an additional 90 days, effective April 16, 2022. With this extension, the PHE is now set to expire on July 15, 2022. The PHE is being extended for the ninth time since it was initially declared in January 2020, when the coronavirus pandemic began. The Biden Administration has said that it will give states a 60-day notice before the PHE expires. The PHE impacts several important benefits for employer spons

The Department of Health and Human Services (HHS) recently issued two reports to Congress regarding HIPAA compliance, breach notifications and enforcement actions for the calendar year 2020. Annually, HHS is required to submit HIPAA reports to Congress and post this information on the HHS website. The first report focuses on compliance with the HIPAA privacy and security requirements. According to the report, in 2020, HHS received 27,182 new complaints alleging HIPAA violations. The top five a