Legal Update: Final Notice of Benefit and Payment Parameters for 2023
On April 28, 2022, the Department of Health and Human Services (HHS) filed its final Notice of Benefit and Payment Parameters for 2023. This final rule describes benefit and payment parameters under the Affordable Care Act (ACA) that apply for the 2023 benefit year.
HHS finalized benefit and payment standards that will apply for the 2023 benefit year.
Highlights:
- Dec. 28, 2021
- The proposed Notice of Benefit and Payment Parameters for 2023 was released.
- April 28, 2022
- The final Notice of Benefit and Payment Parameters for 2023 was issued.
- 2023 Benefit Year
- The changes included in the final rule will generally apply for the 2023 benefit year.
Legal Update: DOJ Issues Guidance on Opioid Addiction and the ADA
On April 5, 2022, the U.S. Department of Justice (DOJ) issued guidance on how the Americans with Disabilities Act (ADA) can protect individuals with opioid use disorder (OUD) and other drug addictions from discrimination.
Preventing discrimination based on drug addiction is an important part of the DOJ’s efforts to combat the opioid epidemic.
Highlights:
- Addiction Under the ADA
- The ADA generally protects individuals with OUD and other drug addictions from discrimination as long as they are not engaged in “current illegal use of drugs.”
- Prescription Drugs
- The use of prescribed medications, including those to treat OUD, is not considered illegal if supervised by a licensed health care professional.
- Drug Testing
- The ADA does not prohibit employers from drug testing or otherwise enforcing reasonable policies that prohibit current illegal drug use.
Legal Update: IRS Proposes Change to Family Coverage Affordability Rules
On April 5, 2022, the IRS released a proposed rule that would change the existing rules for eligibility for the premium tax credit (PTC). The PTC is available to eligible individuals who purchase health insurance coverage through the Exchange. Individuals who have access to affordable, minimum value employer sponsored coverage are not eligible for the PTC.
Coverage would be affordable for family members if the employee’s required contribution for family coverage does not exceed 9.5% of household income.
Highlights:
- The proposed rule addresses eligibility for the premium tax credit, which is available for Exchange health coverage.
- The rule would provide that affordability of employer-sponsored coverage for family members is determined based on the cost of family coverage.
- This rule is in proposed form and will not take effect unless and until it is finalized.
Legal Update: House Passes Federal Marijuana Decriminalization Bill (MORE Act)
On April 1, 2022, the U.S. House of Representatives voted 220-204 in favor of decriminalizing marijuana at the federal level.
The MORE Act would remove marijuana from the federal Controlled Substances Act. State laws would still apply.
Highlights:
- The MORE Act
- The U.S. House approved a bill that would remove all criminal penalties for marijuana use under federal law. It might get a vote in the Senate.
- State Marijuana Laws
- The MORE Act would not directly affect any state laws addressing marijuana.
- Workplace Study
- The MORE Act would require a federal study of legalized marijuana’s effects on the workplace.
Legal Update: Spending Bill Extends Telehealth Coverage for HDHPs
A spending bill signed into law on March 15, 2022, extends the ability of high-deductible health plans (HDHPs) to provide benefits for telehealth or other remote care services before plan deductibles have been met without jeopardizing health savings account (HSA) eligibility. This extension applies to any telehealth services from April 2022 through the end of the year.
HDHPs may waive the deductible for telehealth services from April 2022 through the end of the year without jeopardizing HSA eligibility.
Important Dates:
- Jan. 1, 2022
- The CARES Act rule allowing pre-deductible coverage of telehealth services expired for plan years beginning in 2022.
- March 15, 2022
- A spending bill extended the rule to apply through 2022.
- April 2022 – Dec. 2022
- This extension applies to any telehealth services from April 2022 through the end of the year.
Legal Update: OSHA Withdraws COVID-19 ETS, but Not the Proposed Permanent Rule
On Jan. 25, 2022, OSHA provided notice that it is withdrawing its COVID-19 vaccination and weekly testing emergency temporary standard (ETS). The withdrawal will be effective once the notice is published in the Federal Register. The expected publication date is Jan. 26, 2022.
OSHA is withdrawing the vaccination and weekly testing standard as an ETS, but not as a proposed permanent rule.
Important Dates:
- Nov. 5, 2021
- OSHA published the ETS both as an emergency rule and as the proposed the rule for its permanent standard.
- Jan. 13, 2022
- The Supreme Court ordered a stay on the implementation and enforcement of OSHA’s COVID-19 ETS.
- Jan. 25, 2022
- OSHA announced it will be withdrawing its COVID-19 vaccination and weekly testing ETS.
Legal Update: Agencies Issue Guidance on Coverage of OTC COVID-19 Tests
On Jan. 10, 2022, the Depts. of Labor, Health and Human Services (HHS), and the Treasury issued FAQ guidance regarding the requirements for group health plans and health insurance issuers to cover over-the-counter (OTC) COVID-19 diagnostic tests.
At-home COVID-19 tests must be covered even if they are obtained without the involvement of a health care provider.
Important Dates:
- Dec. 2, 2021
- President Biden announced that guidance would be issued clarifying coverage of OTC COVID-19 tests.
- Jan. 10, 2022
- Federal agencies issued the guidance implementing the requirements for coverage of OTC COVID-19 tests.
- Jan. 15, 2022
- Deadline for plans and issuers to provide coverage for OTC COVID-19 tests available without a health care provider order or assessment.
Legal Update: Supreme Court Stays OSHA ETS Vaccination and Testing Mandate
On Jan. 13, 2022, the Supreme Court of the United States (SCOTUS) ruled to stay the Occupational Safety and Health Administration’s (OSHA) vaccination and testing emergency temporary standard (ETS). The ETS was developed to
establish a mandatory vaccination policy requirement for private employers with 100 or more employees.
Given this new stay, employers are not required to comply with the OSHA ETS vaccination and testing mandate at this time.
Important Dates:
- Dec. 17, 2021
- The 6th Circuit reinstates the ETS.
- Jan. 13, 2022
- SCOTUS stays the ETS and sends it back to the 6th Circuit.
Legal Update: PCORI Fee Amount Adjusted for 2022
The Internal Revenue Service (IRS) has issued Notice 2022-04 to increase the Patient-Centered Outcomes Research Institute (PCORI) fee amount for plan years ending on or after Oct. 1, 2021, and before Oct. 1, 2022. The updated PCORI fee amount is $2.79 multiplied by the average number of lives covered under the plan.
At-home COFor plan years ending on or after Oct. 1, 2021, and before Oct. 1, 2022, the PCORI fee amount was increased to $2.79 per covered life.
Key Facts:
- Covered Plans
- The PCORI fees generally apply to insurance policies providing accident and health coverage and self-insured group health plans.
- Applicability Dates
- The PCORI fee applies to plan or policy years ending after Sept. 30, 2012, and before Oct. 1, 2029.
- Payment Deadline
- PCORI fees are due for plan or policy years ending in 2021 on Aug. 1, 2022.
Legal Update: Agencies Issue Guidance on
Coverage of OTC COVID-19 Tests
On Jan. 10, 2022, the Depts. of Labor, Health and Human Services (HHS), and the Treasury issued FAQ guidance regarding the requirements for group health plans and health insurance issuers to cover over-the-counter (OTC) COVID-19 diagnostic tests.
At-home COVID-19 tests must be covered even if they are obtained without the involvement of a health care provider.
Important Dates:
- Dec. 2, 2021
- President Biden announced that guidance would be issued clarifying coverage of OTC COVID-19 tests.
- Jan. 10, 2022
- Federal agencies issued the guidance implementing the requirements for coverage of OTC COVID-19 tests.
- Jan. 15, 2022
- Deadline for plans and issuers to provide coverage for OTC COVID-19 tests available without a health care provider order or assessment.
Client and Employee Resources
The more your employees understand your benefit plans the more they become educated, empowered consumers. The programs you provide will also gain an enhanced value.
As your strategic partners in employee benefits, we can provide multiple avenues of ongoing support, including:
- Employee Meetings (English and Spanish)
- Webcasts
- Payroll Stuffers
- Poster Campaigns
- Newsletters
Carrier Directories
E-Verify is a web-based system that allows enrolled employers to confirm the eligibility of their employees to work in the United States. Click the image below to begin.
