DOL Indicates the COVID-19 National Emergency’s Outbreak Period Extends to July 10, 2023
DOL Settlement with Prudential Highlights Risks for Employers Administering Supplemental Life Coverage
Can an employer pay for an employee’s or spouse’s Medicare plan or provide an incentive to enroll in Medicare instead of the group health plan?
Delaware Mandatory Retirement Savings Program
April 25, 2023
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, has been conducting business in Delaware for at least six months in the immediately preceding calendar year, and does not offer employees tax-favored retirement plans (e.g., 401(k), 403(b)). Covered employees are employees who are at least 18 years old, have been employed by a covered employer, and have earned wages or other compensation in Delaware.
Employers should monitor the development and forthcoming regulations for the details of the program, including the effective date.
Maine Retirement Savings Program Effective Dates by Group Size
April 25, 2023
The Maine Retirement Savings Program was signed into law in June 2021 to require covered employers that do not offer a specified tax-favored retirement plan (e.g., 401(k), 403(b)) to automatically enroll covered employees in a state-operated Roth individual retirement plan. “Covered employee" means an individual who is at least 18 years old, who is employed by a covered employer, and who has wages or other compensation in Maine during a calendar year.
Covered employers are responsible for withholding, by payroll deduction, and remitting participating employees' contributions into the Maine Retirement Savings Program Enterprise Fund. Covered employers with at least 25 covered employees were required to begin offering the Maine Retirement Savings Program by April 1, 2023. Additionally, covered employers with 15 – 24 covered employees must offer the program by October 1, 2023. Moreover, covered employers with 5 – 14 covered employees must offer the program by April 1, 2024.
State Moves to Protect Preventive Healthcare
April 25, 2023
On April 3, 2023, Gov. Whitmer issued a letter to the Department of Insurance in response to the judgment issued by a Texas federal district court in Braidwood Management Inc. v. Becerra. The judgment 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.
Gov. Whitmer stated concern that the ruling would put the state’s citizens at risk, so the letter instructs the department to do the following:
- Promptly issue guidance to help inform Michiganders of which preventive care services are affected by the court’s decision.
- Immediately begin working with Michigan’s health insurers to determine what steps can be taken to ensure that Michigan families continue to have affordable coverage for these lifesaving healthcare services.
- Develop recommendations as to other ways the State of Michigan can take action to ensure every Michigander continues to receive preventive healthcare now and in the future.
In addition, Gov. Whitmer announced that, as of April 6, 2023, insurers representing 100% of the fully insured health insurance market in Michigan have agreed to maintain no-cost preventive healthcare services.
Employers with policies issued in the state should be aware of these developments.
Executive Order Announces Protections for Gender Affirming Care
April 25, 2023
On March 8, 2023, Gov. Walz issued Executive Order 23-03. In this order, Gov. Walz notes that while gender affirming care is legal in Minnesota, other states are curtailing access or criminalizing access to that care. Accordingly, the order instructs various state agencies to take action to make sure that gender affirming care will continue to be provided in the state.
Among other things, the order instructs the Department of Commerce (COMM) to request affidavits from health plans under its jurisdiction that they have processes in place to affirm that their contracted healthcare providers are aware they may bill for medically necessary gender affirming healthcare services. COMM must also deny approval for any health plan that discriminates on the basis of sex, sexual orientation, gender identity or gender expression and investigate complaints of discrimination on those bases.
In addition, the order requires that:
- State agencies will coordinate to protect people or entities who are providing, assisting, seeking or obtaining gender affirming healthcare services.
- The Minnesota Department of Health (MDH), COMM, and the Minnesota Department of Human Rights (MDHR) will investigate and take administrative actions for unfair or deceptive practices related to the denial of gender affirming healthcare services.
- MDH will prepare a report summarizing the literature on the scientific evidence about the safety and effectiveness of gender affirming healthcare and its public health effects.
- The state will decline to help other states that try to penalize individuals and entities seeking gender affirming healthcare services.
- To the maximum extent possible, the state will refuse requests to extradite individuals accused of committing acts related to, securing of, or receipt of gender affirming healthcare services.
- MDH, COMM, MDHR, and the Minnesota Department of Human Services will issue a joint bulletin to health plan companies regarding the availability of health insurance coverage and the provision of health insurance benefits for medically necessary gender affirming healthcare services.
Employers with plans regulated by the state should be aware of these developments.
Tobacco Surcharges Now Prohibited in Small Group Market
April 25, 2023
On March 23, 2023, Gov. Youngkin signed SB 1011/HB 1375 into law. The law prohibits health insurance carriers in Virginia from charging higher premiums for coverage in the small group and individual markets based on tobacco use. The prohibition applies to policies issued or renewed in Virginia on and after January 1, 2024, and sunsets on January 1, 2026.
The law also requires an annual report from the State Corporation Commission on premium reductions related to the elimination of the tobacco surcharge and increased enrollment trends. Employers sponsoring health plans in Virginia should be aware of this development and contact their carrier for further information.
Insurance Commissioner Urges Carriers to Continue Coverage of Preventive Services
April 25, 2023
Earlier this month, Insurance Commissioner Mike Kreidler sent a letter to Washington health insurers in response to the ruling by a US District Court judge in the Northern District of Texas in Braidwood Management, Inc. v. Becerra, which placed a number of the ACA’s preventive service mandates in jeopardy.
In the letter, the commissioner requested that Washington insurers continue the coverage of preventive services, pointing out that filings for Plan Year 2023 already include coverage of these services.
The commissioner also asked each carrier offering health plans in Washington to inform his office whether they plan to continue to offer all services with an “A” or “B” rating from the US Preventive Health Services Task Force without cost-sharing in their 2024 health plan filings, even in the absence of a stay of the court’s ruling.
New Restrictions on Cost-Sharing for Treatment of Diabetes
April 25, 2023
On March 23, 2023, Gov. Justice signed SB 577 into law. The law restricts health insurance carriers in West Virginia from charging more than $35 total for a 30-day supply of prescription insulin (including where more than one insulin drug is prescribed) or more than $100 total for a 30-day supply of a covered device (including where more than one device is prescribed). Each cost-share maximum is required to be covered regardless of the person’s deductible, copayment, coinsurance, or any other cost-sharing requirement. These limitations apply to policies issued or renewed in West Virginia on and after January 1, 2024. Employers sponsoring health plans in West Virginia should be aware of this development and contact their carrier for further information.
This material was created by PPI Benefit Solutions to provide accurate and reliable information on the subjects covered but should not be regarded as a complete analysis of these subjects. It is not intended to provide specific legal, tax or other professional advice. The service of an appropriate professional should be sought regarding your individual situation. PPI does not offer tax or legal advice. "PPI®" is a service mark of Professional Pensions, Inc., a subsidiary of NFP Corp. (NFP). All rights reserved.