US Department of Labor Archives - Page 5 of 16

Are Out-of-Pocket Costs on Their Way Out? At-Home COVID-19 Testing and Expanded Preventative Healthcare for Women and Children

by Jacob Mattinson and Teal Trujillo | Jan 14, 2022 | Employee Benefits, Employment, Health and Welfare Plans

In response to a directive from the White House, based on provisions of the Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief and Economic Security (CARES) Act that eliminated cost sharing for COVID-19 diagnostic testing, three federal government departments—the US Department of Health and Human Services (HHS), the US Department of Labor (Labor) and the US Department of the Treasury (Treasury)—issued guidance in the form of frequently asked questions (FAQs) that states group health plans and insurers must also cover over-the-counter (OTC) COVID-19 diagnostic testing. This guidance is effective beginning January 15, 2022.

In addition, the Health Resources and Services Administration (HRSA) updated the Affordable Care Act’s (ACA) comprehensive preventive care and screening guidelines for women and children to cover additional services and supplies without a copay or deductible, effective 2023.

COVID-19 AT-HOME TESTING COVERAGE

On January 10, 2022, HHS, Labor and the Treasury together issued FAQs that elaborated on prior guidance and indicated that group health plans and insurers are required to cover OTC COVID-19 diagnostic tests without cost sharing. Because of the recent spike in COVID-19 cases resulting from the rapid spread of the Omicron variant, the guidance will continue for the duration of the public emergency.

Most consumers with private health coverage will be able to buy OTC COVID-19 tests and either have the cost covered upfront or be reimbursed later by submitting a claim to their health plan. The new requirement only applies to “diagnostic” OTC COVID-19 testing. It does not include the treatment of COVID-19 or testing that is for employment purposes.

The guidance provides that health plans and insurers must cover at least eight OTC COVID-19 diagnostic tests per covered individual per a 30-day period. Insurers will be able to set up networks of preferred suppliers to provide OTC COVID-19 tests directly to participants without upfront costs. Insurers must still reimburse OTC COVID-19 tests purchased outside the direct coverage program, however, the reimbursable amount is limited to $12 per test if the health plan also provides tests through its preferred pharmacy network and through a direct-to-consumer shipping program without upfront costs.

Besides the risk of increasing the average cost of OTC COVID-19 tests, the new initiative raises concerns over fraud and abuse. For health plans and insurers to protect themselves, the FAQs provide several examples of permissible activities to prevent fraud and abuse, like requiring proof of purchase or an attestation that the test was purchased for proper purposes (i.e., is being used by the covered individual, is not being reimbursed by another source, is not being resold and is not for employment purposes).

HRSA UPDATES ACA PREVENTIVE HEALTHCARE GUIDELINES

On January 11, 2022, HRSA announced that it updated the preventive health and screening guidelines for women, infants, children and adolescents. Under the ACA, certain group health plans and insurers must provide coverage with no out-of-pocket costs for preventive health services within these HRSA-endorsed comprehensive guidelines.

HRSA accepted the updates recommended by the Women’s Preventative [...]

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Environmental, Social and Governance (ESG) Investing for Retirement Plans: Where We’ve Been, and Where We Are Now

by Brian Tiemann | Dec 23, 2021 | Employee Benefits, Fiduciary and Investment Issues, Retirement Plans

Over the past year, the regulatory backdrop around environmental, social and governance (ESG) investing has shifted. As McDermott Partner Brian J. Tiemann explains in these slides, the US Department of Labor (DOL) under the Trump administration dropped ESG terminology and set a high standard for considering factors other than purely financial projections for investment alternatives. However, the Biden administration’s DOL has said that it will not enforce Trump-era regulations or pursue enforcement actions against plan fiduciaries for failure to comply with those regulations.

Access the slides.

Agencies Clarify How Employers Can Charge COVID-19 Vaccine Premium Incentives

by Sarah Raaii and McDermott Will & Emery | Nov 2, 2021 | Employee Benefits, Employment, Health and Welfare Plans

On October 4, 2021, the US Departments of Labor, Treasury, and Health and Human Services issued guidance regarding the application of the Health Insurance Portability and Accountability Act (HIPAA) wellness rules to vaccine-related premium surcharges and discounts, clarifying that employers may charge vaccine premium incentives if they adhere to the requirements of activity-only health-contingent programs.

Employers have grown more interested in exploring incentives designed to increase COVID-19 vaccination rates among employees. Some employers have announced plans to charge unvaccinated employees higher contributions for health coverage than vaccinated employees, while some have been considering other options, such as excluding coverage for COVID-related illnesses, charging higher cost-sharing for COVID-19-related illnesses and offering more generous plan options to employees who are vaccinated.

Missing Participants, Cybersecurity Top Challenges for Plan Advisors

by McDermott Will & Emery | Oct 28, 2021 | Employee Benefits, Privacy and Data Security, Retirement Plans

Missing participants and cybersecurity are among the top challenges for retirement plan advisors, according to participants at the National Association of Plan Advisors’ 2021 NAPA 401(k) Summit in Las Vegas. During the Summit’s opening day workshop session, McDermott Partner Erin Turley said advisors should make an effort to discuss cybersecurity with clients in advance of a US Department of Labor audit.

“The plan document says X, the recordkeeping agreement says Y, and maybe the (summary plan description) says something different—if it’s even addressed in the SPD,” Turley noted. “So make sure all those documents sync and your process actually matches your documents as equally.”

Employers on Hook for Mental Health Parity Despite New Target

by McDermott Will & Emery | Oct 20, 2021 | Employee Benefits, Health and Welfare Plans

The US Department of Labor (DOL) is casting a skeptical eye on health insurance companies’ inconsistent coverage of mental health and substance use disorder benefits. The DOL recently commenced litigation against an insurer to require mental health and substance use disorder coverage be on par with regular physical care.

In an article in Bloomberg Law, McDermott Partner Judith Wethall said employers are usually unaware about these violations. Self-funded employers typically simply accept whatever their third-party administrator (TPA) is offering.

“Sometimes a TPA does things behind the scenes that might violate mental health parity and an employer might not even know it,” Wethall said.

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Mitigating ERISA Litigation in Current Environment

by Andrew Liazos | Oct 7, 2021 | Employee Benefits, Retirement Plans

What steps can retirement plan sponsors take to mitigate Employee Retirement Income Security Act of 1974 litigation risks? McDermott Partner Andrew Liazos presented on this topic and shared best practices during the Plan Sponsor Council of America’s National Conference.

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$4 Billion in Pension Payments Returned

by Jeffrey Holdvogt | Oct 5, 2021 | Employee Benefits, Retirement Plans

Even though it is the employer’s responsibility to track down former employees and let them know of leftover retirement benefits, it doesn’t always work out that way. In recent years, the US Department of Labor’s Employee Benefits Security Administration has demanded companies improve their methods for finding former workers.

In this article published by the Center for Retirement Research at Boston College, McDermott Partner Jeffrey M. Holdvogt said regulators “put a lot of pressure, in a good sense, on plan administrators to really up their games.” Holdvogt shared his comments in a May webinar hosted by the Pension Action Center at the University of Massachusetts, Boston.

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Business Groups Want to Have a Say in Biden’s Vaccine Requirement

by Michelle S. Strowhiro | Oct 1, 2021 | Employment

While many of the United States’ largest corporations don’t oppose the Biden administration’s vaccine requirements for many employers, those companies say many of their questions about the administration’s rule have gone unanswered. The new rule requires employers with more than 100 employers to mandate COVID-19 vaccinations or require weekly testing of employees.

In an article published in The Hill, McDermott Partner Michelle Strowhiro said some employers may decide to scrap the testing alternative altogether.

“Administratively, it’s going to be quite burdensome for employers, especially large employers with hundreds or thousands of employees, to track weekly the testing results for employees,” Strowhiro said.

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Current Trends in DOL and IRS Investigations

by Allison Wilkerson | Sep 23, 2021 | Employee Benefits, Employee Stock Ownership Plans (ESOPs), Retirement Plans

What can employee stock ownership plan (ESOP) managers due to prepare an effective record in advance of a potential US Department of Labor or Internal Revenue Service investigation? McDermott Partner Allison Wilkerson presented on this topic during The ESOP Association‘s TEA National 2021 Conference.

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Red Tape, Legal Risk Douse Fervor for Surcharges on Unvaccinated

by McDermott Will & Emery | Sep 16, 2021 | Employee Benefits, Employment, Health and Welfare Plans

Companies curious about a major airline’s unvaccinated healthcare premium surcharge are discovering that it may be too complex to copy. The airline recently announced that unvaccinated employees enrolled in the company’s health plan would see a $200 monthly surcharge. In this Bloomberg Law article, McDermott Partner Judith Wethall said the compliance hurdles are “tricky and kind of dilute the message.”

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