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04.01.21

2021 health and welfare benefits legislative update

BY , , , , Eric Paley

Congress and federal agencies have enacted sweeping legislative and regulatory changes that affect health and welfare benefits. It is critical that employers understand the steps they need to take now in response. In this special benefits briefing, we discuss important takeaways for employers to consider.

Please reach out to the blog post authors or your Nixon Peabody benefits attorney with any questions.

  • The COBRA subsidy rules will create administrative and communication challenges for employers. Because the subsidies commence on April 1, 2021, it is important that employers adopt a game plan expeditiously for implementing the subsidy.
  • Under recently issued guidance, employers can adopt optional cafeteria plan relief to address employees’ unused health and dependent care FSA balances in plan years ending in 2020 and 2021. Employers should consult with their plan administrators and advisors in considering whether to adopt the relief, because there are various ways to structure it to accommodate administrative and employee needs.
  • The No Surprises Act will require plans to cover certain out-of-network services at INN rates and also require plans and providers to arbitrate disputed reimbursements. Employers and plan sponsors should work with their TPAs and insurance carriers now to make sure service agreements and plan documents reflect these new requirements starting in 2022.
  • Recent legislation and regulations require plans and insurance carriers to be more transparent with respect to the cost of medical services. Many of these requirements become effective in 2022, so employers and plan sponsors should ensure that their TPAs and insurance carriers are taking the steps necessary to comply.
  • Sponsors of group health plans have to be prepared for an audit of plan compliance with the mental health parity requirements and to that end, need to start working closely with plan vendors and legal counsel.
  • Now that fee disclosures apply to health and welfare plan brokers and consultants, plan fiduciaries have to gear up for working with their plan vendors on analyzing the reasonableness of service arrangements.

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Lena Gionnette

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Yelena F. Gray

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Brian Kopp

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Damian A. Myers

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Eric Paley

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