Employee Benefits Compliance Resource Center

Our employee benefits compliance experts regularly examine state & federal insurance regulations to keep our clients from incurring costly fees or penalties. The Employee Benefits Compliance Resource Center is a repository of new laws/regulations, expert guidance and insightful news articles, where HR & Finance professionals gain actionable information for their benefit programs.

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04.08.2021 | Compliance Alert!

DOL Issues FAQs and Model Notices on the new ARPA COBRA Subsidies​
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04.08.2021 | Compliance Alert!

DOL Issues FAQs and Model Notices on the new ARPA COBRA Subsidies​
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Coronavirus Employer Insurance ResourcesCOVID-19 Compliance Guidance, Insurance Carrier Notices & Infographics
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Below are our compliance resource postings over the last 6 months. For your convenience the sections are color-coded in chronological order. Orange Compliance Alerts discuss new guidance interpreted by our staff ERISA attorney and team. U.S. Policy postings represent new state and Federal laws and In the News articles convey current commentary from reputable news outlets.

Compliance Alert
IRS Clarifies that COVID-19-Related PPE Qualifies as Medical Care Expenses​

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$1.9T COVID-19 Relief Package Includes Rules to Expand COBRA and ACA Exchange Subsidies​

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What to Do if Your Organization Receives a Notice about the $2.67 Billion Blue Cross Blue Shield Antitrust Settlement

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Agencies Issue Guidance on COVID-19 Testing and Vaccines

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DOL Issues Guidance on Duration of “Outbreak Period” Rules

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IRS Issues Guidance Clarifying COVID-19 Relief Rules for FSAs and Cafeteria Plans​​

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President Biden Signs Executive Orders Expanding Access to Health Coverage​​

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$900B COVID-19 Relief Package Signed into Law; Includes Rules to End Surprise Medical Billing​​

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Massachusetts Health Insurance Reporting Form Must be Filed by December 15​​

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Agencies Issue Healthcare Transparency Rules for 2022 and Beyond

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IRS Announces Health FSA and other 2021 Plan Limits ​​​​​

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IRS Releases Final Forms and Instructions for 2020 ACA Information Reporting ​​​​​

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IRS Extends Deadline for Distributing 2020 Forms 1095-C and 1095-B; Extends "Good Faith" Penalty Relief for One More Year​​​​

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New York Paid Family Leave Contributions and Benefits Set to Increase January 1, 2021​​​

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New York City Amends Paid Sick Leave Law to Align with State Law​​

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NY Sick Leave Law Goes Into Effect 9.30.20​

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DOL Revises COVID-19 Leave Regulation in Light of a Recent Court Decision​

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IRS Releases 2021 ACA Employer Mandate Penalty Amounts​

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Judge Blocks Key Provisions of New ACA Section 1557 Regulation

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Deadline for Medicare Part D Notice of Creditable Coverage Nears

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Court Eliminates Key Provisions of COVID-19 Leave Regulation​

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Supreme Court Upholds Religious and Moral Exemptions to ACA Contraceptive Mandate ​

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Agencies Issue Guidance on COVID-19 Testing and Treatment​

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Agencies Issue Plan Limits and other New ACA Rules for 2021 and Future Plan Years​

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HHS Removes ACA Rules Prohibiting Gender Identity Discrimination; Supreme Court Concludes That Title VII Prohibits Discrimination Against LGBTQ Employees​

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Insurers Issue Refunds Due to COVID-19

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The PCOR Fee Continues: IRS Issues Long-awaited PCOR Fee Update​

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Reminder: PCOR Fees for Non-calendar Year Plans are Due July 31, 2020 ​

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Internal Revenue Service Issues 2021 HSA Limits​

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IRS Guidance Gives Cafeteria Plans Flexibility During COVID-19 Pandemic​

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DOL Issues New COBRA Model Notices and FAQ Guidance​

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Agencies Issue COV​​ID-19-Rela​​ted Compliance Relief for Benefit Plans​​​

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President Signs Coronavirus Stimulus Package into Law​

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President Signs Coronavirus Stimulus Package into Law​

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Senate Approves Coronavirus Bill; Now Under Review by the House​

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DOL Guidance Clarifies Coronavirus Paid Leave Requirements​

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Important State & Federal Reporting and Enrollment Extensions

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Agencies Issue Guidance on Coronavirus Paid Leave Tax Credits

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Agencies Issue Guidance Relaxing Enforcement of Benefits Compliance Rules During Coronavirus Health Emergency

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Coronavirus Bill Requiring Paid Leave and Other Benefits Signed Into Law

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House Coronavirus Bill Awaits Senate Approval​

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COVID-19 Compliance Guidance, Insurance Carrier Notices & Infographics for Employees

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State "Individual Mandate" Law Impose New Compliance Requirements on Employers and Employees

2.20.2020 revised from 11.18.2019
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For earlier Compliance Alerts, please contact your Corporate Synergies Account Manager.​

U.S. Policy

IRS Issues Guidance Explaining ARPA Tax Credits for COVID-19 Vaccinations
4.21.2021 — The new IRS guidance clarifies which employers are eligible for the tax credits and explains how such employers may claim the credit. The American Rescue Plan Act of 2021 (ARPA) allows employers with fewer than 500 employees to claim refundable tax credits that reimburse them for the cost of providing paid sick and family leave to their employees due to COVID-19 and COVID-19 vaccinations.
IRS Guidance »

DOL Issues Guidance on Cybersecurity Best Practices for Benefit Plan Sponsors, Participants, and Fiduciaries
4.14.2021 — The DOL’s Employee Benefits Security Administration (EBSA) guidance identifies 12 best practices, including maintaining a written cybersecurity plan, annual risk assessments and third-party audits of security controls. Additionally, the guidance recommends clearly defined roles and responsibilities and strong access and technical controls—including encryption—combined with annual workforce training.
Cybersecurity “Best Practices” »
DOL/EBSA Press Release »

Agencies Issue FAQ Guidance on Mental Health Parity Comparative Analysis Requirements under the CAA
4.2.2021 — The DOL, HHS, and IRS have jointly issued FAQ guidance explaining the CAA requirement to perform and document a comparative analysis of nonquantitative treatment limitations (NQTL) on mental health or substance use disorder (MH/SUD) benefits. Each NQTL must demonstrate whether the factors used in developing and applying the NQTL are comparable and applied no more stringently to MH/SUD than to medical/surgical benefits.
FAQ Guidance »

IRS: Face Masks and PPE to Prevent the Spread of COVID-19 are Covered by HSAs, HRAs and Health FSAs
03.29.2021 — The IRS has clarified that amounts paid for personal protective equipment such as masks, hand sanitizer, and sanitizing wipes that are purchased “for the primary purpose of preventing the spread of COVID-19” are qualified medical expenses under Section 213(d) of the Code. Participants in health savings accounts (HSAs), health flexible spending accounts (health FSAs) and health reimbursement arrangements (HRAs) can now use the funds in these accounts for purchases of these items.
IRS Announcement 2021-7 »

San Francisco Postpones HCSO Reporting Deadline
03.24.2021 — The San Francisco Office of Labor Standards Enforcement (OLSE) has postponed the normal April 30 deadline for reporting compliance with the San Francisco Health Care Security Ordinance (HCSO). The postponement will be for a minimum of 6 months, to at least October 31, 2021.
San Francisco OLSE »

NJ Issues Guidance on Employer-Mandated Vaccines
03.19.2021 — Closely echoing the U.S. EEOC guidance, the NJ Dept. of Health has clarified that employers can require employees receive the COVID-19 vaccine to return to the workplace, unless the employee cannot get the vaccine because of a disability, because their doctor has advised them not to get the vaccine while pregnant or breastfeeding, or because of a sincerely held religious belief.
NJ Dept. of Health »

CA Retroactively Expands Supplemental COVID-19 Paid Sick Leave
03.19.2021 — The bill would provide for 80 hours of COVID-19 supplemental paid sick leave for covered employees who are unable to work or telework due to COVID-19. This applies to public and private employers with more than 25 employees.
Senate Bill 95 »
EBG Law »

NY Signs Law Permitting Paid Leave for COVID-19 Vaccines
03.12.2021 — The New York State Department of Labor has issued guidance clarifying the rules regarding when and how employees can take paid leave for COVID-19 vaccine injections. Generally, employees in New York are allowed to take up to 4 hours of paid leave per vaccine injection.
Senate Bill S2588A »

CDC Publishes New Vaccination Guidance for the Workplace
02.02.2021 — The CDC recently updated its guidance to include information to educate employers and employees about COVID-19 vaccines, raise awareness of the benefits of vaccination, and address common questions. This guidance lists potential benefits of having a workplace COVID-19 vaccination program for both employers and employees and includes practical advice on putting such a program in place.
CDC Vaccine Communication Toolkit »
CDC FAQ Guidance »

DOL/OSHA Publishes New Guidance for Workplace Safety during the Pandemic
01.29.2021 — The Department of Labor’s (DOL) Occupational Safety and Health Agency (OSHA) issued what it described as “stronger worker safety guidance” to help employers fight the spread of COVID-19 in the workplace. While OSHA is using the new guidance to advocate for businesses to establish infection prevention programs, the guidance is not legally binding.
OSHA Guidance »

Biden Administration Freezes EEOC’s Proposed Wellness Incentive Rules
01.21.2021 — Newly proposed wellness plan regulations issued by the EEOC that were designed to clarify how plan incentives should work under the ADA and GINA were removed by the White House. Specifically, the Biden administration has instructed the EEOC to withdraw these regulations to allow for review and approval by the current administration.
White House Memorandum »

EEOC Issues Proposed Wellness Incentive Rules
01.07.2021 — Because the ADA and GINA do not define what constitutes a “voluntary” wellness plan, new regulations from the EEOC propose that, to comply with the ADA and GINA, employers may offer no more than a minimal incentive to encourage participation in wellness programs, except in certain wellness programs that would be permitted to offer the maximum allowed incentive under the 2013 HIPAA regulations.
New EEOC Proposed Regulations »
EEOC Press Release »

DOL Issues Final Rules Making it Easier to Provide Benefits to Independent Contractors
01.06.2021 — The new regulation, issued under the Fair Labor Standards Act, is designed to streamline and simplify the complex rules used to identify independent contractor status, making it easier to determine when such a worker should receive employee benefits. Scheduled to be implemented on March 8, 2021, the incoming Biden administration may freeze this rule and prevent it from going into effect.
DOL Final Regulation »
Morgan Lewis Labor & Employment Law »

IRS Releases Temporary COVID-19 Relief Rules for Employer-provided Automobile Benefit
01.04.2021 — Under the new rules, employers and employees will have increased flexibility about how they choose to calculate the value of an employee’s personal use of an employer-provided automobile for employment tax and tax reporting purposes.
IRS Notice 2021-7 »

California Updates Healthcare Information Reporting Guidance
01.01.2021 — The California Franchise Tax Board (FTB) recently clarified that employers sponsoring fully-insured health plans are required to report insurance information to the FTB by March 31, but only if their insurance providers do not report to FTB.
CA FTB Guidance »

New Jersey Division of Taxation Requirements
12.14.2020 — Employers sponsoring fully-insured health plans are required to transmit 1095 health coverage forms to the New Jersey Division of Taxation by March 31, but only if their insurance providers do not report it.
NJ Division of Taxation »

IRS Issues FAQ Guidance Clarifying COVID-19 Relief for Van Pool Benefits
12.10.2020 — The IRS guidance clarifies that, for 2020, the “80/50 rule” (defined in the guidance linked below) will be considered satisfied for a vehicle if, at the beginning of the 2020 calendar year, the employer reasonably expected the vehicle’s use would satisfy the 80/50 rule but the rule was not actually satisfied “due to the COVID-19 emergency.” The relief applies to van pools using employer-operated or employee-operated vehicles.

Supreme Court Gives States Green Light to Regulate PBMs
12.10.2020 — The U.S. Supreme Court unanimously ruled to uphold an Arkansas law (Act 900) regulating pharmacy benefit managers (PBMs) in the state. Act 900 was enacted in 2015 to protect pharmacists when PBMs set their prescription reimbursement rates below wholesale costs. This ruling opens the door for other states to impose new rules and restrictions on PBMs.
Supreme Court Opinion »

Reminder: New SBC Requirements Effective for Plan Years Beginning On or After 1/1/2021
12.04.2020 — DOL and CMS updated their SBC materials which must be used for plan or policy years beginning on or after January 1, 2021. The updated materials reflect the Tax Cuts and Jobs Act’s (TCJA) reduction of the penalty for violating the ACA's individual mandate to zero dollars.
DOL Regulation »

CDC Issues Updated Guidance on When Quarantine Period Can End Rule
12.02.2020 — The CDC has offered additional guidance on the option to shorten quarantine periods for those who may have been exposed to the coronavirus, hoping to improve compliance and reduce the negative economic and psychological impact of long periods of isolation. The new guidance allows those without symptoms to end quarantine after seven days if they test negative or after 10 days without a negative test. The CDC still recommends a full 14 days of quarantine whenever possible.
CDC Guidance »

Cal/OSHA Emergency Regulations to Protect Workers from COVID-19 in Effect
12.01.2020 — The regulations require that employers implement a site-specific written COVID-19 prevention program to address COVID-19 health hazards, correct unsafe or unhealthy conditions and provide face coverings. When there are multiple COVID-19 infections or outbreaks at the worksite, employers must provide COVID-19 testing and notify public health departments. The regulations also require accurate recordkeeping and reporting of COVID-19 cases.
CA Dept. of Industrial Relations »

IRS Announces Annual PCOR Fee Adjustment
11.24.2020 — The new adjusted PCOR fees, applicable to health insurers and sponsors of self-insured health plans, for plan and policy years ending on or after October 1, 2020, and before October 1, 2021, is $2.66. This is a $0.12 increase from the previous amount.
IRS Notice 2020-84 »

CMS Issues Final Most-favored-nation Rule for Medicare Part B Drug Pricing
11.20.2020 — The final “most-favored-nation (MFN) rule” aims to reduce the cost of prescription drugs in Medicare Part B plans by tying prices to a new MFN model that relies on international price competition. The new pricing model is intended to be phased in over time but is expected to face significant legal challenges before implementation.
Centers for Medicare & Medicaid Services »
Health Affairs »

HHS Issues Final Drug Pricing Rebate Rule
11.20.2020 — The rule intends to force pharmacy benefit managers and insurers to pass rebates they receive from pharmaceutical companies to Medicare Part D patients at the point of sale – directly benefiting patients with high out-of-pocket costs – rather than using those rebates to lower overall premiums or provide other benefits. The rule is scheduled to take effect in 2022.
Department of Health & Human Services »
Health Affairs »

IRS Issues Informal Guidance Clarifying Rules for Unused Funds in Qualified Transportation Plans
11.19.2020 — Unused funds in qualified transportation plans can be applied to another qualified transportation fringe benefit if the other benefit is offered under the employer’s plan and the monthly maximum is not exceeded. However, the letter cautions that refunds of qualified transportation fringe benefits provided through a compensation reduction agreement are not allowed.
IRS Information Letter 2020-0024 »

UPDATE: Connecticut Paid Leave Effective 1/1/2021
11.16.2020 — On June 25, 2020, Connecticut signed into law a new paid family leave (PFL) insurance program funded through mandatory payroll deduction. Employers must begin withholding from employees’ paychecks for the PFMLA on January 1, 2021, however, no benefits will be paid to employees before January 1, 2022.
Connecticut Paid Leave FAQ »

In The News

Biden Administration Encourages Employers to Provide Paid Leave and Financial Incentives for Employees’ COVID-19 Vaccinations
04.21.2021 — Tax credits are available for employers with fewer than 500 employees for providing workers with paid leave for COVID-19 vaccinations as part of the American Rescue Plan Act. The administration is also calling for employers to incentivize employees to get vaccinated, which they say could convince an additional 25% of Americans.
Biden Administration Fact Sheet »

Biden Administration Asks Supreme Court to Uphold the ACA
02.10.2021 — The Biden administration has withdrawn the federal government's support for a challenge to the Affordable Care Act’s (ACA) constitutionality before the U.S. Supreme Court, telling the Supreme Court that the law should remain on the books. While the move shows the policy shift between the two presidential administrations, it is not expected to have a major impact on the outcome of the case.
Solicitor General’s Request »
Politico »

Congress Passes Resolution to Clear the Way for $1.9 Trillion Stimulus Legislation
02.05.2021 — The House and Senate have approved a budget resolution that paves the way to pass President Joe Biden’s $1.9 trillion stimulus bill in the coming weeks with only Democratic votes.
Bloomberg »

Biden Selects Marty Walsh to Head U.S. Dept. of Labor
01.07.2021 — President-elect Joe Biden has named Boston Mayor Marty Walsh to be Secretary of the U.S. Department of Labor (DOL). If confirmed, Walsh will work with the Biden administration on significant issues, including an emergency standard to protect workers from on-the-job COVID-19 infection, and coordinating states’ payment of unemployment insurance benefits to millions of unemployed workers.
Bloomberg »

President-elect Biden will Halt Agency Rules Described as “Midnight Regulations”
12.30.2020 — President-elect Joe Biden will issue a memo on Inauguration Day seeking to halt or delay so-called “midnight regulations” issued by the Trump administration that have not taken effect by Inauguration Day.
The Hill »

Lawmakers strike deal to end 'surprise' medical bills
12.11.2020 — The “No Surprises Act” calls for parties to negotiate an agreed-upon rate or bring their dispute to a mediator. However, providers would still be allowed to bill patients to make up the difference if they inform patients the services won’t be covered and they provide an estimate of charges 72 hours before care.
No Surprises Act »
Politico »

FDA Panel Votes to Approve Pfizer COVID-19 Vaccine for Emergency Use
12.10.2020 — A U.S. Food and Drug Administration advisory committee voted Thursday to approve an emergency use authorization request from Pfizer and BioNTech for their COVID-19 vaccine, clearing the way for some groups to start getting vaccinated as early as next week. Under the CARES Act, the vaccine will be covered under all employer-sponsored group health plans without cost sharing.
U.S. Food and Drug Administration»

FDA Authorizes Monoclonal Antibody for Treatment of COVID-19
11.9.2020 — The U.S. Food and Drug Administration issued an emergency use authorization (EUA) for the investigational monoclonal antibody therapy bamlanivimab for the treatment of mild-to-moderate COVID-19 in adult and pediatric patients. Under the CARES Act, treatments with EUA are covered under all group health plans without cost sharing.
U.S. Food and Drug Administration»

CDC Says Airborne Transmission Plays a Role in Coronavirus Spread
10.5.2020 — The Centers for Disease Control and Prevention acknowledged that people can sometimes become infected with the novel coronavirus through airborne transmission, especially in enclosed spaces with inadequate ventilation.
The Washington Post »

Pelosi, Mnuchin Talk Coronavirus Aid as Presidential Illness Complicates Picture
10.5.2020 — The renewed effort in the U.S. Congress to reach a fresh deal to pump coronavirus relief funds into the pandemic-hit economy has been further complicated by the news that President Donald Trump and three Senate Republicans have tested positive.
Reuters »

Former Vice President Joe Biden Urges Americans to Vote to Protect the ACA
9.26.2020 — In response to President Trump's nomination of Judge Amy Coney Barrett to the U.S. Supreme Court, Democratic nominee Joe Biden urged Democrats to vote in the presidential election to protect the Affordable Care Act.

Dr. Fauci Advises Americans to Hunker Down During Flu Season
9.10.2020 — As the country heads into flu season, Americans can't let up in the fight against the coronavirus pandemic, said Dr. Anthony Fauci. Although the number of new daily cases of coronavirus has slowly declined over the last two weeks, the country is still closing in on 200,000 deaths from COVID-19 and more than 6 million confirmed infections.
NBC News »

U.S. Senate Fails to Advance GOP Coronavirus Relief Bill
9.10.2020 — The Senate failed to advance a Republican proposal to address the health and economic crises caused by the pandemic, four months after House Democrats passed their $3 trillion plan. But the narrower Senate bill could help Republican senators in tough reelection races by giving them a rebuttal to Democratic challengers attacking their delayed response.

AstraZeneca Halts Vaccine Trial After Patient Becomes Sick
9.9.2020 — AstraZeneca Plc halted phase 3 testing of its experimental coronavirus vaccine after a person participating in one of the company’s studies became ill. The study participant’s adverse reaction could delay or derail efforts to speed an immunization against COVID-19.
Bloomberg »

N.J. Health Insurance Tax: What It Means for Employers
9.8.2020 — New Jersey Governor Phil Murphy recently signed a new law levying a 2.5% health insurance tax on insurance carriers based on net premiums they collect for individual and large business plans across the state. Premiums for small businesses, non-profit dental plans, Medicaid, Medicare and certain self-funded coverages are not included.
Corporate Synergies “Our Take” »
nj.com »

Bad Flu Season Colliding with COVID-19 Could Be Overwhelming
9.5.2020 — Doctors and health officials are urging Americans to get vaccinated against influenza in record numbers this fall to avoid a dreaded scenario: flu colliding with a raging coronavirus pandemic. They worry that tens of millions of ¬flu-related illnesses could overwhelm hospitals, doctor offices and laboratories that test for both respiratory illnesses.
Washington Post »

FDA Issues Emergency Use Authorization for Blood Plasma Treatment Despite Scientists' Objections
8.23.2020 — The Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for blood plasma as a coronavirus treatment, one day after President Trump attacked the drug regulator for moving too slowly to back the treatment. The agency held off on the decision last week over concerns from government scientists that evidence for the treatment's effectiveness is thin, prompting Trump to accuse the FDA of slow-walking the therapy to harm his reelection chances without offering any evidence to support his claim. On 8/25/2020, FDA Commissioner Stephen Hahn issued an apology for overstating the effectiveness of the blood plasma treatment at the press conference to announce the EUA.
Politico »

$400 COVID-19 Unemployment Checks May Take Weeks to Reach Individuals
8.14.2020 — The extra $400 in weekly COVID-19 unemployment insurance benefits, authorized by President’s Trump’s recent executive order, is designed to be retroactive to August 1. But the checks may take several more weeks to reach individuals.
CBS News »

U.S. Chamber Raises Concerns about Implementing Payroll Tax Deferral
8.14.2020 — The U.S. Chamber of Commerce, the largest lobbying group for U.S. businesses, asked the Treasury Department to clear up uncertainty about how Trump's executive order initiating a payroll tax deferral could be implemented by firms, their employees and payroll processors. The payroll tax deferral is scheduled to go into effect on September 1, 2020.

HHS Posts State COVID-19 Testing Plans
8.10.2020 — The U.S. Dept. of Health & Human Services (HHS) has publicly posted the July through December COVID-19 Testing Plans from all states, territories, and localities on its website, HHS.gov. The State Testing Plans serve as a roadmap, developed in partnership with the federal government, for each jurisdiction's monthly 2020 COVID-19 testing strategy. The plans include details on responding to surges in specific cases and reaching vulnerable populations, including minorities, immunocompromised individuals and older adults.
HHS News Release on COVID-19 Testing Plans »
State-by-State COVID-19 Testing Plans »

President Signs Measures to Provide Additional Benefits during Pandemic
8.9.2020 — President Trump signed an executive order and three memoranda designed to provide economic aid to those struggling during the coronavirus pandemic, with additional benefits for the unemployed and tax cuts for workers. The executive actions are intended to bypass Congress — which has been deadlocked in negotiations to extend relief — and could face legal challenges. These executive actions, if implemented, would provide $400 in added unemployment benefits for those out of work because of the pandemic, and defer payroll taxes for those earning less than $100,000 a year. Unemployed workers had been receiving a weekly unemployment insurance supplement of $600, a benefit that expired on July 31, 2020.
CBS News »

Encryption and Tracking Failure Leads to $1,040,000 HIPAA Settlement
7.27.2020 — An HHS Office for Civil Rights (OCR) News Release has announced a $1,040,000 settlement with a health system (a HIPAA covered entity) to resolve alleged violations of HIPAA’s security rule. OCR’s investigation followed the theft of an unencrypted laptop computer from an employee’s car. The laptop contained electronic protected health information (ePHI) including: patients’ names, medical record numbers, demographic information, and medication information. The breach affected 20,431 individuals. The non-profit health system, based in Rhode Island, will also implement a corrective action plan to settle potential violations of the HIPAA Privacy and Security Rules.
HHS News Release »

For questions on earlier news/guidance, please contact your Corporate Synergies Account Manager or call 877.426.7779.​

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