Insights

On April 3, 2024, the DOL, HHS, and IRS (the departments) published final rules (with an accompanying fact sheet) to amend certain requirements regarding fixed indemnity excepted benefits coverage and limited duration insurance. These rules finalize some of the amendments proposed on July 12, 2023. Notably, beginning in 2025, plan sponsors offering fixed indemnity coverage must provide a new consumer protection notice to enrollees. The final rules follow several Biden Administration Executive O

On April 2, 2024, the HHS, CMS, and IRS released the 2025 Notice of Final Benefit and Payment Parameters (the 2025 final rule), an accompanying fact sheet, and, in coordination with the DOL, a related FAQ. The 2025 final rule, which follows a proposed rule issued on November 15, 2023, is primarily directed at health insurers and the ACA marketplace but includes certain information that directly or indirectly impacts group health plans. Notably, the final rule and FAQ codify that prescription dr

On March 24, 2024, in McKee Foods Corporation v. BFP, Inc. dba Thrifty Med Plus Pharmacy, the Sixth Circuit US Court of Appeals (Sixth Circuit) held that McKee Foods’ claims that Tennessee’s “any willing pharmacy” (“any-willing-pharmacy”) laws are preempted by ERISA, and that state law does not require it to include Thrifty Med in its approved network of pharmacies, were not rendered moot following changes to the underlying state laws and other factual developments in the case. The Sixth Circui

On March 19, 2024, a federal trial court held that the hearing-impaired mother and daughter stated a sufficient claim of “proxy” discrimination under ACA Section 1557 against Regence BlueShield, a health insurer, for its plans’ exclusion of all hearing devices except cochlear implants to proceed to trial. ACA section 1557 prohibits discrimination in certain health programs or activities based on race, color, national origin, sex, age, or disability. “Proxy” discrimination can result from (in th

On April 2, 2024, the DOL announced that it amended a rule that provides an exemption for qualified professional asset managers (QPAMs). A QPAM is defined as a bank, savings and loan association, insurance company, or registered investment adviser that assists retirement plans in making financial investments. QPAMS are particularly useful in that they can facilitate transactions that would otherwise not be allowed under ERISA, through the exemption granted by the DOL. The amendment clarifies la

In short, it depends on what the qualifying life event is. As a reminder, when an employer offers pre-tax coverage through a Section 125 cafeteria plan, employee elections are generally irrevocable and cannot be changed midyear without a qualifying life event. There are two types of qualifying life events: HIPAA Special Enrollment Rights (SER) and optional, or permissible, Section 125 events. The HIPAA SER events are: Birth Adoption Marriage Loss of eligibility for other group coverage Loss of

Effective January 1, 2024, fully insured group health plans issued in Maine that provide abortion coverage are not allowed to impose any deductible, copayment, coinsurance, or other cost-sharing requirement for the costs of abortion services. Notably, this new requirement does not apply to qualified HDHPs. As background, a health plan issued in Maine that provides coverage for maternity services has been required to provide coverage for abortion services unless sponsored by a religious employer

WINT Water Intelligence has joined NFP’s Construction and Infrastructure (C&I) Technology Alliance to mitigate client project risk by pairing WINT’s AI-based leak mitigation solution with NFP’s expertise in providing risk advisory solutions.

The WellCents^® Show hosts explore key financial topics, including financial planning and Indexed Universal Life (IUL) insurance.