Insights

A rulemaking stakeholder meeting has been scheduled for February 29, 2024, at 9:00 a.m. PT to discuss amendments that clarify under which circumstances family leave can be taken to bond with a child as well as amendments that clarify under which circumstances decisions appealed to the Commissioner’s Review Office will be made available to the public. The meeting will be held via Teams. The draft rules are available on the Rulemaking page. Information on how to participate in the meeting is avai

The Department of Family and Medical Leave (DFML) recently announced that all approved MA PFML private plans (fully insured and self-insured plans) are required to furnish required data to DFML for the 2024 fiscal year. The submission form will open online on July 1, 2024, and the deadline for submission is August 31, 2024. As background, employers with approved MA PFML private plans are required to maintain reports, information and records related to their approved plan and furnish required da

On February 13, 2024, the Employee Benefits Security Administration (EBSA), the DOL agency responsible for enforcement of ERISA, reported monetary recoveries totaling over $1.434 billion in its report on enforcement activities for fiscal year (FY) 2023. EBSA oversees approximately 2.8 million health plans, 619,000 other welfare benefit plans, and 765,000 private pension plans. These ERISA-covered plans cover 153 million workers, retirees, and dependents who participate in private-sector pension

On February 14, 2024, the HHS Office for Civil Rights (OCR) released two annual reports to Congress summarizing the agency's key HIPAA enforcement activities during the 2022 calendar year as required by the Health Information Technology for Economic and Clinical Health (HITECH) Act. The first report, HIPAA Privacy, Security, and Breach Notification Rule Compliance, identifies the number of complaints received, the method by which those complaints were resolved, and other OCR HIPAA compliance en

On February 9, 2024, the IRS updated its frequently asked questions (FAQs) for the premium tax credit. These FAQs superseded earlier FAQs that were posted on February 24, 2022. Nine existing FAQs were updated, and four new FAQs were added. Among other items, the FAQs explain the basics of the premium tax credit, the eligibility requirements, and how the affordability of employer coverage affects eligibility. The updates include the addition of a new section, “Affordability of employer coverage

Having an employment practices liability insurance (EPLI) policy in place can protect employers against the potential financial burdens associated with claims arising from the employment relationship.

A provocative new study that questions the value of common workplace wellness initiatives was released in the Industrial Relations Journal in January of 2024. After the study analyzed survey data from over 46,000 employees across 233 British organizations, the research found that outside of employee volunteer offerings, common well-being interventions like apps, resilience training, and meditation programs proved to have little to no clear benefits for workers. Before we ring the death knell fo

On February 2, 2024, the DOL, HHS, and IRS (the departments) issued FAQ guidance on the implementation of certain requirements under the Transparency in Coverage (TiC) Final Rules. This FAQ clarifies the participant cost-sharing tool compliance requirements where a plan is providing cost estimates based on claims data, but there is extremely low utilization of the item or service at issue. As background, the TiC Final Rule issued in October 2020 requires non-grandfathered group health plans to

On December 5, 2023, in Ian C. v. United Healthcare Ins. Co., the Tenth Circuit Court of Appeals (Tenth Circuit) reversed the district court’s ruling that the defendant’s claim denial was not arbitrary and capricious because the defendant did not provide a “full and fair review” of the plaintiff’s claims. The plaintiff was a participant covered by an employer-sponsored group health plan. The plaintiff’s son underwent inpatient residential treatment for mental health and substance abuse issues,