Insights

Recently, Gov. Huckabee Sanders signed several healthcare bills into law. Act 490 (previously HB 1102) creates the Universal Newborn Screening Act to ensure newborns are screened for core medical conditions as determined by HHS. Specifically, Act 490 requires a health benefit plan offered, issued or renewed in the state to provide coverage not subject to policy deductibles or copayments for newborn screenings by a healthcare professional for core medical conditions. Act 494 (previously HB 1129)

On March 31, 2023, the Maryland Insurance Administration issued a bulletin in response to Braidwood Management Inc. v. Becerra, a judgment that invalidates and prohibits enforcement of certain ACA preventive care requirements on a nationwide basis. More information concerning this case can be found in an April 11, 2023, article in Compliance Corner. The bulletin confirms to carriers that the Braidwood decision does not impact health benefit plans issued in Maryland. Bulletin 23-6 »

On March 29, 2023, the IRS Chief Counsel's office published a memorandum that addresses the claim substantiation requirements for health FSA and dependent care assistance program (DCAP) expenses. The memo illustrates the situations when an expense fails to be properly substantiated in accordance with IRS rules. The memo affirms that any health FSA and DCAP expense, regardless of the amount, must be fully substantiated. Otherwise, the expense must be included in an employee's gross income and is

Recently, Gov. Kemp signed House Bill 85 into law. Under the new law, health benefit policies must cover testing for biomarkers, such as gene mutations or known gene-drug interactions, if supported by medical and scientific evidence to diagnose or treat an insured's disease or condition. The law also requires insurers to approve or deny preauthorization requests for biomarker testing within specified timeframes and to provide a process for covered individuals to request exceptions to coverage p

On May 3, 2023, Gov. Moore approved SB0828/HB0988, which delays the implementation Maryland's paid family and medical leave program, known as the Time to Care Act of 2022. The Time to Care Act applies to employers with at least one employee in Maryland, though employers with fewer than fifteen employees are not required to make employer contributions. More information on the Time to Care Act can be found in the April 26, 2022, edition of Compliance Corner. Most notably, contributions have been

The Seventh Circuit Court of Appeals (Seventh Circuit) has remanded two of three of the plaintiffs' claims for further proceedings in Hughes v. Northwestern University after the US Supreme Court overturned its previous ruling that dismissed all three claims. The plaintiffs originally sued Northwestern in 2016, alleging breaches of ERISA fiduciary duties regarding its defined contribution retirement plans, including: Retaining plan recordkeepers that charged 'excessive' revenue-sharing fees rat

If an employer has 20 or more employees, the answer is no. Employers with 20 or more employees are subject to Medicare Secondary Payer (MSP) rules, which say an employer cannot provide a financial incentive to an active employee or spouse to encourage enrollment in Medicare instead of the group health plan. Reimbursing an employee's Medicare premiums or providing additional compensation if the employee drops the group health plan are both considered to be providing a financial incentive. There

The Delaware Expanding Access for Retirement and Necessary Saving (EARNS) program was signed into law in August 2022 without an effective date. When it takes effect, the Delaware EARNS program allows covered employees with no access to employer-sponsored retirement plans to voluntarily contribute to a state-facilitated payroll deduction individual retirement savings account program similar to a Roth IRA. An employer is subject to the EARNS program if it employs at least five covered employees,

On April 19, 2023, the DOL announced a settlement with Prudential Insurance Company of America (Prudential) following an investigation into the carrier's group supplemental life insurance claims practices. The DOL investigation found that Prudential, based on the terms of its group life insurance policies, has denied claims for failure to provide evidence of insurability (EOI) after collecting supplemental life insurance premiums from participants (via employer payroll deductions) for extended