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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Maryland Enacts Paid Family Leave Law
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Maryland Enacts Paid Family Leave Law
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Resources

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 Alerts
IRS Issues 2023 Limits for HSAs, High-Deductible Health Plans and Excepted Benefit HRAs

05.04.2022
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New Funding Law Extends HSA Telehealth Relief

03.17.2022
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Supreme Court Blocks OSHA Vaccine Mandate for Large Employers; Allows Healthcare Worker Mandate to Proceed

01.14.2022
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Agencies Issue Guidance Requiring Coverage of OTC COVID-19 Tests without Cost-Sharing

01.11.2022
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6th Circuit Reinstates OSHA Vaccine Mandate for Large Employers; Mandate for Federal Contractors Remains Blocked by 11th Circuit

12.21.2021
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Massachusetts Health Insurance Reporting Form Must be Filed by December 15

12.07.2021
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Proposed Rule Extends ACA Deadline for Furnishing Forms 1095-C/1095-B

12.03.2021
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IRS Issues Final 2021 ACA Information Reporting Forms; Good Faith Penalty Relief Ends

11.19.2021
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5th Circuit Blocks OSHA from Enforcing Vaccine Mandate for Large Employers

11.16.2021
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IRS Announces Health FSA and Other 2022 Plan Limits

11.11.2021
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OSHA Issues Emergency Rule Requiring COVID-19 Vaccinations or Tests for Most Employers

11.05.2021
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Agencies Issue Guidance on COVID-19 Vaccine-Related Premium Surcharges and Discounts

10.07.2021
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New York Paid Family Leave Premium Rates Set for 2022

10.04.2021
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IRS Decreases ACA Employer Mandate Affordability Percentage for 2022

09.20.2021
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Agencies Delay Healthcare Price Transparency Rules

08.30.2021
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Deadline for Medicare Part D Notice of Creditable Coverage Nears

08.26.2021
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IRS Proposes Substantial Changes to ACA Information Reporting Requirements

08.06.2021
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IRS Issues COBRA Subsidy Guidance Less Than A Week Before Tax Credit Filing Deadline

07.30.2021
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Agencies Issue Interim Final Rule Implementing the No Surprises Act

07.09.2021
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Reminder: PCORI Fees Due July 31, 2021

06.03.2021
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IRS Issues Guidance on COBRA Subsidies under ARPA​​​

05.20.2021
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IRS Issues 2022 Limits for HSAs, High-Deductible Health Plans and Excepted Benefit HRAs​​​ ​​

05.13.2021
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Update Regarding Blue Cross Blue Shield Class Action Settlement​ ​​

05.04.2021
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DOL Issues FAQs and Model Notices on the new ARPA COBRA Subsidies​

04.08.2021
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IRS Clarifies that COVID-19-Related PPE Qualifies as Medical Care Expenses​

04.05.2021
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$1.9T COVID-19 Relief Package Includes Rules to Expand COBRA and ACA Exchange Subsidies​

03.11.2021
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What to Do if Your Organization Receives a Notice about the $2.67 Billion Blue Cross Blue Shield Antitrust Settlement

03.08.2021
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Agencies Issue Guidance on COVID-19 Testing and Vaccines

03.02.2021
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DOL Issues Guidance on Duration of “Outbreak Period” Rules

03.01.2021
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IRS Issues Guidance Clarifying COVID-19 Relief Rules for FSAs and Cafeteria Plans​​

02.24.2021
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President Biden Signs Executive Orders Expanding Access to Health Coverage​​

02.01.2021
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$900B COVID-19 Relief Package Signed into Law; Includes Rules to End Surprise Medical Billing​​

12.28.2020
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Massachusetts Health Insurance Reporting Form Must be Filed by December 15​​

11.12.2020
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Agencies Issue Healthcare Transparency Rules for 2022 and Beyond

11.09.2020
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IRS Announces Health FSA and other 2021 Plan Limits ​​​​​

10.29.2020
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IRS Releases Final Forms and Instructions for 2020 ACA Information Reporting ​​​​​

10.23.2020
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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​​​​

10.06.2020
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New York Paid Family Leave Contributions and Benefits Set to Increase January 1, 2021​​​

10.06.2020
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New York City Amends Paid Sick Leave Law to Align with State Law​​

10.1.2020
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NY Sick Leave Law Goes Into Effect 9.30.20​

09.23.2020
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DOL Revises COVID-19 Leave Regulation in Light of a Recent Court Decision​

09.17.2020
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IRS Releases 2021 ACA Employer Mandate Penalty Amounts​

08.21.2020
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Judge Blocks Key Provisions of New ACA Section 1557 Regulation

08.20.2020
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Deadline for Medicare Part D Notice of Creditable Coverage Nears

08.19.2020
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Court Eliminates Key Provisions of COVID-19 Leave Regulation​

08.7.2020
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Supreme Court Upholds Religious and Moral Exemptions to ACA Contraceptive Mandate ​

07.10.2020
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Agencies Issue Guidance on COVID-19 Testing and Treatment​

06.29.2020
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Agencies Issue Plan Limits and other New ACA Rules for 2021 and Future Plan Years​

06.22.2020
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HHS Removes ACA Rules Prohibiting Gender Identity Discrimination; Supreme Court Concludes That Title VII Prohibits Discrimination Against LGBTQ Employees​

06.18.2020
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Insurers Issue Refunds Due to COVID-19

06.12.2020
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The PCOR Fee Continues: IRS Issues Long-awaited PCOR Fee Update​

06.10.2020
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Reminder: PCOR Fees for Non-calendar Year Plans are Due July 31, 2020 ​

05.28.2020
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Internal Revenue Service Issues 2021 HSA Limits​

05.28.2020
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IRS Guidance Gives Cafeteria Plans Flexibility During COVID-19 Pandemic​

05.15.2020
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DOL Issues New COBRA Model Notices and FAQ Guidance​

05.4.2020
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Agencies Issue COV​​ID-19-Rela​​ted Compliance Relief for Benefit Plans​​​

05.4.2020
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President Signs Coronavirus Stimulus Package into Law​

04.24.2020
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President Signs Coronavirus Stimulus Package into Law​

03.30.2020
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Senate Approves Coronavirus Bill; Now Under Review by the House​

03.27.2020
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DOL Guidance Clarifies Coronavirus Paid Leave Requirements​

03.26.2020
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Important State & Federal Reporting and Enrollment Extensions

03.25.2020
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Agencies Issue Guidance on Coronavirus Paid Leave Tax Credits

03.25.2020
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Agencies Issue Guidance Relaxing Enforcement of Benefits Compliance Rules During Coronavirus Health Emergency

03.20.2020
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Coronavirus Bill Requiring Paid Leave and Other Benefits Signed Into Law

03.20.2020
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House Coronavirus Bill Awaits Senate Approval​

3.17.2020
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COVID-19 Compliance Guidance, Insurance Carrier Notices & Infographics for Employees

03.12.2020
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State "Individual Mandate" Law Impose New Compliance Requirements on Employers and Employees

02.20.2020 revised from 11.18.2019
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For earlier Compliance Alerts, please contact your Corporate Synergies Account Manager.​

U.S. Policy

DOL, HHS, IRS Issue FAQ Guidance on Machine Readable File Disclosure Requirements and Enforcement Safe Harbor Provisions
04.19.2022 — In advance of the July 1, 2022 enforcement deadline for machine-readable files disclosures, the FAQs describe two safe-harbor provisions: 1) a percentage number instead of a dollar amount may be used by plans and insurers using percentage-of-billed charges reimbursement arrangements where it is not possible to accurately determine specific dollar amounts prior to providing services, and 2) an open text field will be permitted to allow for descriptions of reimbursement arrangements if unsupported by the provided price transparency schema.
New FAQ guidance »
Price Transparency Schema »

IRS Issues Proposed Rule to Fix the ACA’s “Family Glitch”
04.05.2022 — The proposed regulations would change the eligibility standards for an Affordable Care Act (ACA) premium tax credit (PTC) by providing that affordability of employer-sponsored coverage for an employee’s family members would be based on the employee’s cost to cover the employee and those family members, rather than the cost of the “employee-only” or “single” tier coverage. The proposed rule would, if finalized, extend PTCs to millions of people who are currently ineligible for financial help through the Exchanges. Since the proposed rule does not impact eligibility of employees (only family members), it should not implicate the ACA’s Employer Mandate.
Proposed regulation »
Health Affairs »

San Francisco Reinstates Reporting for its Health Care Security Ordinance (HCSO)
04.04.2022 — Following a 2-year hiatus, employers with employees working in San Francisco must submit their annual HCSO reporting on their 2021 compliance by May 2, 2022. The annual reporting requirement had been waived for the 2019 and 2020 reporting years due to the pandemic. The Office of Labor Standards Enforcement (OLSE) has posted the reporting form, related instructions and a webinar. The online form will not be available after May 2. Employers failing to file by that date can face penalties up to $500 per quarter.
New annual reporting form »
Annual reporting instructions »
HCSO reporting webinar »
OLSE HCSO guidance page »

Texas Court Vacates Portions of No Surprises Act (NSA) Rule Related to Arbitration Process
02.23.2022 — On 2/23/22, Judge Jeremy Kernodle of the Eastern District of Texas issued a final judgment setting aside key parts of the NSA that creates a new federal independent dispute resolution (IDR) process in order to protect patients from certain types of surprise out-of-network bills. The lawsuit, led by the Texas Medical Association (TMA), argued that parts of the IDR rule are inconsistent with the NSA and should be invalidated. Judge Kernodle agreed and vacated these provisions on a nationwide basis.
Court Ruling »
Interim Final Rule of the No Surprises Act, Part II »

California Governor Newsom signs COVID-19 Supplemental Paid Sick Leave (CSPSL)
02.19.2022 — SB 114 requires employers with 26 or more employees to provide up to 80 hours of supplemental paid sick leave for certain COVID-19 related reasons. CSPSL is effective from February 19, 2022, and will expire on September 30, 2022 offering leave to both full-time and part-time employees with both fixed and variable weekly schedules. One significant change is that SB 114 permits up to 40 hours to be used in two batches of time in increments of 40 hours, in which qualifying reasons could allow an eligible EE to use some or all of their CSPSL.
SB 114 »
Morgan Lewis »

President Biden Releases Notice of Continuation of the National Emergency Concerning the Coronavirus 2019 (Covid-19) Pandemic
02.18.2022 — On 2/18/22, President Biden again formally extended the COVID-19 National Emergency, which was set to expire on March 1, 2022. This most recent extension means that certain deadlines pertaining but not limited to COBRA election and payments, claim submission and requests for HIPAA special enrollments continue to be paused for one year (or, if earlier, 60 days from the end of the National Emergency). This National Emergency declaration is different from the Public Health Emergency declaration, which is tied to the COVID-19 testing requirements in the FFCRA and the CARES Act.
White House Announcement »
Federal Register »

Departments Issue FAQ Part 52 Enhancing Coverage and Access to COVID-19 Tests
02.04.2022 — The new guidance provides additional flexibility that plans, and issuers can provide the “free” test kits either upfront or through reimbursement. Additionally, plans will also need to provide at least one of each: a direct-to-consumer shipping mechanism and an in-person mechanism. The amount of reimbursement can be limited to $12 per test (or full cost, if lower) and includes shipping and sales tax. The coverage mandate has not changed and still provides tests without a prescription, cost-sharing or preauthorization for at least 8 FDA-approved OTC at-home COVID-19 tests per 30-day period per covered individual.
FAQ Part 52 »
Groom Law Group »

Reminder: San Francisco HCSO “Top-Off” Payment Deadline is February 28
02.01.2022 — The Health Care Security Ordinance (HCSO) requires covered employers to pay an “Expenditure” toward their covered employees’ healthcare costs. In 2022, when an employer is assessing the cost of its 2021 health plan, the employer must determine whether the 2021 average hourly Expenditures meet or exceed the 2021 Expenditure rate. Where the calculations show that the employer’s average Expenditures for a self-insured plan fall short of 2021’s “$3.18 per hour” Expenditure requirement, the employer must make a “top-off” payment by the end of February 2022.
San Francisco’s HCSO Page »
Self-insured Plans’ “Top Off” Payment Instructions »

IRS Releases Publications 502, 503 and 15-B for Use in 2022 on 2021 Tax Returns
01.31.2022 — The IRS recently released a series of publications for use in preparing 2021 tax returns: Publication 15-B explains employer tax treatment of fringe benefits, including rules for tax treatment of accident and health, group term life, HSAs and others; Publication 502 explains usage, calculation, and reporting of deductions for medical and dental expenses; and Publication 503 explains eligibility, calculation and claiming tax credit for child and dependent care expenses on individual tax returns.
Publication 15-B »
Publication 502 »
Publication 503 »

Two New Laws Delay and Modify Washington’s Long Term Care Program
01.27.2022 — Governor Jay Inslee signed two bills into law, making key improvements to delay and modify Washington’s Long Term Care Act (WA Care Fund). Changes include: workers near retirement (born before 1968) can qualify for partial benefits on a pro-rated basis; workers who live out of state and work in Washington, military spouses, workers on non-immigrant visas, and certain veterans with disabilities may opt out of the program; and payroll taxes for workers now start July 1, 2023, with benefits not available until July 1, 2026.
House Bill 1732 »
House Bill 1733 »
WA Cares Fund Employer Information »

OSHA Withdraws its Private Employer Vaccine-or-Test Mandate
01.26.2022 — Following the Supreme Court’s decision to stay the implementation of the OSHA Emergency Temporary Standard (ETS) regulation, OSHA has withdrawn the ETS. The ETS required private employers with 100 or more employees to require vaccination or weekly testing. Under the OSH Act, OSHA intends to use the ETS as a proposal for a permanent standard.
OSHA ETS Withdrawal »
Littler »

Agencies’ MHPAEA Report to Congress Reinforces Plan Sponsors’ Responsibility to Conduct NQTL Comparative Analyses
01.25.2022 — Federal agencies have submitted their 2022 MHPAEA Report to Congress. Effective February 10, 2021, the MHPAEA, as amended by the CAA, requires plans to perform and document a comparative analysis of their benefit plans’ NQTLs to demonstrate parity between mental health/substance use disorder benefits and medical/surgical benefits. The Report highlights noncompliance and enforcement activities, including 86 investigations covering 156 plans and issuers. The comparative analyses reviewed were all initially insufficient. The Report highlights the need for plans and issuers to meet their responsibility to conduct the comparative analyses required.
2022 MHPAEA Report to Congress »

Court Rules that Employer Breached Fiduciary Duty with Misleading SPD Language
01.24.2022 — A federal district court in Tennessee has ruled that an employer breached its fiduciary duty under ERISA to ensure that accurate information is detailed in its summary plan description (SPD). The court’s decision serves as an important reminder to employers to have SPDs reviewed regularly to ensure accuracy. In this case, the employee had enrolled in the employer’s long-term disability (LTD) plan providing 40% of her earnings, and also, its “buy-up” benefit described in the SPD as “additional coverage” of 60% of her earnings. The employee believed she was entitled to 100% of her salary, but when the buy-up plan only provided an additional 20% (for a total of 60% of her salary), she filed suit against her employer and the LTD insurer. The employer was held liable for breaching its ERISA fiduciary duty to communicate accurately in its SPD about the plan’s coverage and required to pay the employee 100% of the LTD benefit.
Johnson vs. Ballad Health »
DOL Guidance on SPDs »

Federal Court Blocks Biden Administration’s Vaccine Mandate for Federal Workers
01.21.2022 — The U.S. District Court for the Southern District of Texas blocked the enforcement of President Biden’s vaccine mandate for federal employees on 1/21/22, enjoining Executive Order 14043, which mandated that all federal employees consent to vaccination against COVID-19 or lose their jobs. The Court enjoined the mandate for being beyond the scope of the President’s authority, citing the recent Supreme Court decision on the OSHA Emergency Temporary Standard (ETS) regulation (requiring vaccination of employees of private sector employers with 100 or more employees).
Southern District of Texas Court Order »
Executive Order 14043 »

CMS Issues Guidance and Deadlines for Texas Healthcare Facilities to Comply with its Vaccine Mandate
01.20.2022 — Following SCOTUS’ decision to permit the CMS vaccine mandate, CMS has issued guidance and timelines for Texas healthcare facilities subject to the mandate. When the Court issued its ruling, Texas healthcare facilities were still under an injunction against the CMS Rule by an order from the U.S. District Court for the Northern District of Texas. Due to the Court’s ruling, the Texas District Court lifted the injunction and dismissed the case.
CMS guidance »
McGuire Woods »

Biden Administration’s Federal Contractor Vaccine Mandate Remains Blocked
01.20.2022 — Executive Order (EO) 14042 requiring employees of federal contractors and subcontractors to be fully vaccinated by 1/18/2022 continues to get blocked by federal courts. On 12/7/2021, the U.S. District Court for the Southern District of Georgia issued a nationwide injunction against the enforcement of the mandate. The 5th, 6th, 8th and 11th Circuit Courts of Appeal have all declined to grant expedited review, and at this time, the earliest that any of these cases could be argued is April 2022, and a final decision could take several more months.
Executive Order 14042 »
Southern District of Georgia Court’s Order »
Littler article »

DC Mayor Reminds Washingtonians of Indoor Establishment Vaccine Mandate for the District beginning January 15
01.14.2022 — DC’s Mayor Muriel Bower reminded Washingtonians that individuals age 12 and over must show proof of one dose of the COVID-19 vaccine beginning 1/15/22, and be fully vaccinated by 2/15/22, to enter certain indoor venues for a city-wide vaccination entry requirement (VaxDc). It includes medical or religious exemptions, with documentation and provision of a negative PCR or antigen test within the last 24 hours.
DC Mayor’s announcement »
VaxDc Guidance and FAQs »

HHS Renews the COVID-19 Public Health Emergency
01.14.2022 — HHS Secretary Xavier Becerra renewed the determination that the COVID-19 pandemic is a “public health emergency (PHE).” The PHE designation, in effect since January 27, 2020, and renewed multiple times, will continue for an additional 90 days. This means that certain telehealth and other health and welfare plan-related rules’ flexibility will remain in effect until at least April 16, 2022.
Public Health Emergency Declaration »

HRSA Updates the Affordable Care Act Preventive Health Care Guidelines to Improve Care for Women and Children
01.11.2022 — Health Resources and Services Administration (HRSA) has updated guidelines to expand women’s preventive benefits effective for plan years beginning in 2023. These benefits now include, but are not limited to, comprehensive lactation services, supplies and maintenance, contraceptive screenings, supplies and counseling, counseling on sexually transmitted infections and more. These guidelines do not address the requirement of coverage or payments for contraceptive services for organizations that have religious beliefs or moral convictions.
HRSA Guidelines »
Religious Accommodation Regulation »

NY State Releases 2022 Health Care Reform Act (HCRA) Covered-Lives Assessment Rates
01.07.2022 — NY released 2022 HCRA Covered-Lives Assessment Rates (CLA) requiring third-party payors, including self-funded plans and health care service providers, to help fund health care initiatives, effective 1/1/22. Payors pay the CLA per covered individual to the Professional Education Pool or percentage surcharges to in-state hospitals for certain healthcare services. Costs vary regionally based on individuals’ level of coverage.
NY HCRA »
Covered Lives/Assessments/Surcharges chart »

CMS Guidance Addresses Review of Claims Involving Surprise Billing Matters
12.30.2021 — CMS issued a memorandum providing guidance for group health plans (beginning on or after 1/1/22), insurers, and states, regarding an expanded scope of external review requirements under the No Surprises Act. The guidance explains that states are expected to modify their existing ACA-required external review processes to accommodate surprise billing matters for certain out-of-network services and cost sharing limits, and that the HHS-administered process may be used if a state’s process cannot yet accommodate these matters. Alternatively, an Independent Review Organization may be used for dispute resolution.
CMS memorandum »

DOL Issues Temporary Enforcement Guidance on CAA Service Provider Fee Disclosures
12.30.2021 — The DOL issued guidance regarding broker and consultant (and other service providers’) required fee disclosures under ERISA, as amended by the Consolidated Appropriations Act, 2021 (CAA). These requirements apply to anyone providing brokerage or consulting services to ERISA group health plans, and who is reasonably expected to be compensated, directly or indirectly, $1,000 or more. The new guidance provides good faith compliance relief for the disclosing and reporting requirements applicable to both plan service providers and plan sponsors’ fiduciaries. All group sizes of fully and self-insured plans, as well as dental and vision plans, must comply. The effective date of the new disclosure rules was for contracts entered into or renewed on or after December 27, 2021.
DOL FAB 2021-03 »

CMS Issues Process Guide for Surprise Billing Independent Dispute Resolution
12.29.2021 — The DOL, IRS and HHS jointly issued a process guide (“Guide”) for certified independent dispute resolution (IDR) entities, detailing IDR processes under the No Surprises Act (part of the Consolidated Appropriations Act, 2021 [CAA]), effective 1/1/2022. The Guide addresses IDR process initiation, payment determination rules, confidentiality standards, fees, record-keeping, reporting requirements, timelines, notice requirements, and how to request deadline extensions for extenuating circumstances.
CMS IDR process guide »

Centers for Medicare & Medicaid Services (CMS) Reinstates COVID-19 Vaccine Mandate
12.28.2021 — CMS, in a policy reversal, announced that it would start enforcing its vaccine mandate for healthcare workers in half of states. The other half of the states are judicially enjoined. The mandate’s first phase requires a first vaccine dose by 1/27/22. The second phase requires a second dose, if applicable, by 2/28/22. Any facility with less than 100% compliance will be deemed noncompliant and could face enforcement action.
CMS Memorandum »

Connecticut Paid Family Leave Payments and State FMLA Changes Coming January 1
12.27.2021 — Several Connecticut Family and Medical Leave Act (CT FMLA) changes become effective and payments will begin on 1/1/22. CT FMLA will expand to cover employers with one or more employees in CT (it currently requires 75+), cover more family members, and significantly increase the total leave entitlement. With regard to CT PFML, the benefits will begin for employees taking covered leave on or after 1/1/2022. For 2022, employers will be responsible for payroll deductions of 0.5% of covered employees’ wages (up to the Social Security contribution limit of $147,000).
Connecticut Paid Leave »
Jackson Lewis article »

Washington Governor Announces Enforcement Pause on New Long-Term Care Law
12.23.2021 — On 12/17, WA Gov. Jay Inslee and legislative leaders delayed premium assessments for the state’s new long-term care (LTC) law to allow time for legislation to extend implementation time frames and make refinements. Then, on 12/23, Gov. Inslee clarified that while his decision to put a pause on the law’s enforcement would remain in effect, some employers (including WA state itself) are voluntarily complying with the law until amended or rescinded. While Gov. Inslee has paused enforcement, given that the law remains on the books until the legislature can convene, some employers may want to voluntarily comply.
WA Gov 12/23 announcement »
WA Gov 12/17 announcement »
Davis Wright Tremaine article »

Supreme Court to Hold Hearings on Federal Vaccine Mandates in Early January
12.22.2021 — The U.S. Supreme Court has announced that it will hear oral arguments on 1/7/22, on whether the OSHA Emergency Temporary Standard (ETS) regulation (requiring vaccination of employees of private sector employers with 100 or more employees) and the Centers for Medicare & Medicaid Services (CMS) emergency rule (requiring vaccination of certain health care workers), are enforceable while legal appeals are in process.
OSHA ETS regulation »
CMS regulation »
SCOTUS Announcement »

IRS Announces Updated PCORI Fees for 2022
12.21.2021 — The IRS has updated the Patient-Centered Outcomes Research Institute (PCORI) fee for all plan years ending on or after 10/1/21 and before 10/1/22. The updated amount is $2.79 per covered life, up from $2.66. Self-insured plans are required to pay this fee to the IRS and to file Form 720 (to be filed by July 31 every year).
Form 720 »
IRS Guidance »

California Amends State Vaccine Mandate with Tightened Restrictions
12.17.2021 — California’s CAL/OSHA Standards Board readopted the state’s COVID-19 Prevention Emergency Temporary Standards (ETS) regulation to include more restrictive requirements. This includes new definitions for “COVID-19 testing,” “fully vaccinated,” and “face coverings,” as well as new exemption requirements, return to work criteria and other items. Starting 1/14/22, employers must make COVID-19 testing available for free and with paid time off to employees who had close contact with a positive case at work.
California ETS »
Morgan Lewis »

Update on State of Vaccine Mandate for Healthcare Workers
12.15.2021 — The 5th Circuit Court of Appeals has clarified that the previously issued nationwide injunction by a federal district court against the federal vaccine mandate (applicable to healthcare workers for Medicare and Medicaid-certified providers and suppliers) only applies to the 14 states mentioned in that case. For those 14 states, along with the 10 more covered by a stay of the mandate issued by another federal district court, the mandate remains on hold. However, the mandate is still in effect for the other 26 states.  
5th Circuit’s Decision »
CMS Guidance »

New York City Council Passes COVID-19 Child Vaccination Leave Law
12.15.2021 — New York City’s (NYC) Council recently voted (and the Mayor is expected to sign) to add 4 hours of paid leave per injection to Earned Safe and Sick Time Act for parents taking their children to get vaccinated against COVID-19 and caring for them if there are side effects. This applies to employees of all private employers subject to the act. Once signed, the effective date will be retroactive to November 3, 2021, and it will expire on December 31, 2022.
NYC Consumer and Worker Protection Dept. »
Proposed Legislation (Intro. 2448) »

New Guidance from EEOC on COVID-19 and ADA Protections
12.14.2021 — The EEOC has issued 14 new FAQs about what employers may or may not do to comply with federal employment laws during COVID-19 pandemic. These FAQs expand ADA protections to cover many COVID-19 cases as an “actual” disability, a “record of disability,” or being “regarded as” having a disability. The EEOC states that COVID-19 will be an actual disability if it causes a physical or mental impairment that “substantially limits one or more major life activities.”
EEOC guidance »

Philadelphia Mayor Announces Vaccine Mandate for Food Establishments
12.13.2021 — The City of Philadelphia has announced that, beginning January 3, 2022, patrons of all restaurants, bars, and sports and entertainment venues serving food will be required to show proof of COVID-19 vaccination to enter, except for individuals with medical and religious exemptions who test negative within 24 hours and children under age 5 and three months.
City of Philadelphia announcement »

Judge Issues Nationwide Injunction Halting Federal Contractor Vaccine Mandate
12.07.2021 — The U.S. District Court for the Southern District of Georgia has issued a nationwide preliminary injunction blocking Executive Order 14042, the vaccine mandate applicable to federal contractors and subcontractors. This follows a Nov. 30 preliminary injunction by the Eastern District of Kentucky blocking enforcement of the mandate for Kentucky, Ohio and Tennessee.
Court Order »
Executive Order 14042 »
Safer Federal Workforce Guidance »

New York City Mayor Announces Vaccine Mandate for Private Employers
12.06.2021 — Mayor Bill De Blasio announced that a vaccine mandate for all New York City (NYC) private-sector employers will take effect Dec. 27, an expansion of the existing mandate for city employees. The mayor also announced children ages 5-11 will have to show proof of vaccination to dine indoors and to enter fitness/entertainment centers starting Dec. 14, an expansion of the existing requirement for children 12 and older.
The Hill »

IRS has Released Updated Form 2441 for Reporting Child and Dependent Care Expenses
12.02.2021 — Form 2441 and its instructions have been updated for the 2021 tax year. Updates include: attestation of eligibility for the refundable DCTC, separate reporting of 2020 expenses paid in 2021, separate lines for refundable and nonrefundable credit amounts and more. Taxpayers should pay close attention to each line and checkbox on the Form to ensure compliance. Employers should also be prepared to assist employees with their questions.
IRS Form 2441 »
IRS Form 2441 Instructions »

Connecticut Paid Family and Medical Leave Benefits Starting in January 2022
12.02.2021 — The Connecticut Paid Leave Authority (“Leave Authority”) is accepting applications for the paid family and medical leave program (PFMLA), with benefits beginning Jan. 1, 2022. Employees may take up to 12 weeks of leave annually for medical reasons, bonding, caregiver leave, military/exigency leave or family violence.
Connecticut Paid Leave »
CT Paid Leave HR Toolkit »
Ogletree Deakins »

Federal Court Blocks Vaccine Mandate for Federal Contractors in Three States
12.01.2021 — The U. S. District Court of the Eastern District of Kentucky has blocked the implementation and enforcement of President Biden’s COVID-19 vaccine mandate for federal government contractors and subcontractors in Kentucky, Ohio and Tennessee, based on the court’s opinion that the Biden administration has likely exceeded its authority. Covered employers in other states must still comply with the vaccine mandate by December 8, 2021.
Court Decision »
AP News »

Federal Court Blocks Vaccine Mandate for Healthcare Workers in Ten States
11.29.2021 — The U.S. District Court for the Eastern District of Missouri issued an injunction for ten states, blocking the Biden administration from enforcing vaccine mandates requiring health care workers to be vaccinated by January 4, 2022. The injunction is effective December 1, 2021.
Court Decision »
Bloomberg Law »

Proposed Regulations Allow Permanent 30-Day Extension to Furnish Forms 1095-C/1095-B for 2021 and Beyond
11.24.2021 — The IRS has issued proposed regulations (which can be relied on for 2021) allowing applicable large employers subject to the ACA’s information reporting requirements automatic 30-day extensions to furnish covered individuals the Forms 1095-C/1095-B for 2021 and future years. However, the deadlines for filing the forms remain February 28, 2022 for paper filings and March 31, 2022 for electronic filings.
IRS Proposed Regulations »

Utah Passes Law Restricting Employer Vaccine Mandates
11.19.2021 — Utah recently passed a law, effective 11/16/21, which requires most Utah employers to waive any COVID-19 vaccine requirement if an employee or prospective employee submits a statement objecting to the vaccine for health reasons, religious reasons, or based on personal beliefs.
Utah S.B. 2004 »
McGuire Woods »

Florida Passes Laws Restricting Employer Vaccine Mandates
11.18.2021 — FL Gov. DeSantis has signed legislation that significantly restricts Florida employers’ ability to impose vaccine mandates on their workers. Under the new laws, private employers cannot impose COVID-19 vaccine mandates unless employees can choose from numerous exemptions, including health or religious concerns, pregnancy, and past recovery from COVID-19. Large employers with 100 or more employees can face fines of $50,000 per violation.
Governor’s Press Release »
Local ABC News »

Agencies Release Rule on Prescription Drug and Health Care Spending Transparency
11.17.2021— Federal agencies, including HHS, DOL, and Treasury, issued an interim final rule that implements several provisions of the Consolidated Appropriations Act, 2021 designed to increase transparency by requiring group health plans and health insurance issuers in the group and individual markets to begin submitting certain cost information about prescription drugs and health care spending to the agencies by 12/27/2021.
Federal Register »

Illinois DOL Releases FAQ Guidance on new Healthcare Disclosure Law
11.16.2021 — This guidance explains how employers can comply with the Consumer Coverage Disclosure Act (CCDA), a new law requiring employers to notify employees of which state-determined “essential health benefits” (EHBs) are (or are not) covered by their group health plan. Employers must provide to employees upon hire, annually thereafter, and upon request the plan’s covered benefits and a comparison of those benefits to the state’s EHBs.
CCDA FAQ Guidance »
Consumer Coverage Disclosure Act »

OSHA Suspends ETS Vaccination or Testing Mandate for Large Employers
11.16.2021 — OSHA has temporarily suspended implementation and enforcement of their Emergency Temporary Standard (ETS) regulation that would have required employees of large employers to get vaccinated or submit to weekly testing by January 4. OSHA has indicated that this is “pending future developments in the litigation,” and comes in response to the 5th Circuit Court of Appeals’ decision to stay the ETS on November 12 (see our eAlert on that decision here).
OSHA »

D.C. Council Adopts Paid Leave for Vaccination and Recovery
11.15.2021 — The D.C. Council has passed (and the Mayor is expected to sign) the Covid Vaccination Leave Emergency Amendment Act of 2021, effective 30 days following Congressional review. The Act will require D.C. employers to provide paid leave for employees who are receiving or are accompanying their children to receive the COVID-19 vaccination. Employers also must provide paid leave for employees experiencing side effects or whose child is experiencing side effects and requires care.
COVID Vaccination Leave Emergency Amendment Act of 2021 »
Jackson Lewis »

Tennessee and Alabama pass new laws restricting Employer COVID-19 Vaccination Mandates
11.12.2021 — Tennessee and Alabama Governors recently signed legislation restricting employers’ ability to impose COVID-19 vaccine mandates. The Tennessee law prohibits employers, with certain exceptions, from requiring employees, job applicants and customers to provide proof of COVID-19 vaccination, and employers cannot deny a person employment, privileges, or otherwise discriminate against an employee if proof is not provided. The Alabama law requires employers to follow specific processes allowing employees to claim medical and religious exemptions from the COVID-19 vaccine mandates and appeal if the request is denied.
Tennessee Law »
Alabama Law »
McGuire Woods »

5th Circuit Affirms its Decision to Stay OSHA Vaccine Mandate for Large Employers
11.12.2021 — The U.S. 5th Circuit Court of Appeals has affirmed its stay on the OSHA emergency temporary standard (ETS) regulation that would have required vaccination or weekly testing for employees of larger employers. The court ruled that the ETS was “fatally flawed” and that it failed to take into account the needs of different workplaces and workers. The decision prohibits OSHA from enforcing the ETS “pending adequate judicial review” of a motion for permanent injunction.
5th Circuit Decision »
The Hill »

Appeals Court Temporarily Halts OSHA’s Vaccine Mandate ETS Rule
11.08.2021 — The U.S. Court of Appeals for the Fifth Circuit issued a stay to pause OSHA’s Emergency Temporary Standard rule following Texas’ challenge claiming an unconstitutional overreach. The DOL maintains that OSHA has legal authority to act quickly to protect workers. Given the temporary nature of the ruling and DOL plans to appeal, employers should still prepare to comply by the rule’s Jan. 4, 2022 deadline.
Reuters »

DOL Publishes Vaccine Rule for Larger Employers
11.04.2021 — The Department of Labor has published the final emergency temporary standard regulation on the federal vaccine mandate applicable to private sector employers with 100 or more employees. The rule sets a January 4 deadline for employees to be fully vaccinated or submit to regular testing.
OSHA ETS Fact Sheet »

EEOC Issues Updated Guidance on Religious and Pregnancy Vaccine Accommodations
10.25.2021 — The update clarified that employers: do not need to accommodate requests based on social, political, personal preference or nonreligious concerns about the possible effects of the vaccine; may inquire about the nature or sincerity of religious accommodation requests and ask for supporting documentation; and may choose the accommodation, even if different from the requested accommodation. Additionally, the EEOC reiterated its position that the Americans with Disabilities Act (ADA) and the Pregnancy Discrimination Act (PDA) may trigger accommodation requirements for pregnant employees in certain circumstances.
EEOC guidance »
Morgan Lewis »

Arkansas Law Requires Employers to Accept Alternatives to COVID-19 Vaccination
10.13.2021 — The law requires employers must allow employees to be exempt from vaccination if they can produce either: a negative antigen or diagnostic test result; or proof of immunity for the virus that causes COVID-19, including antibody test results. The law will take effect on January 13, 2022, and expire on July 21, 2023, unless it is extended.
Arkansas Senate Bill 739 »
Morgan Lewis »

EEOC Updates Guidance on COVID-19 Vaccine Incentives
10.13.2021 — The update clarifies that, so long as the healthcare provider administering the vaccine is not the employer or its agent, (1) the ADA does not limit incentives an employer may offer to encourage employees to voluntarily receive a COVID-19 vaccination or provide confirmation of vaccination; and (2) GINA does not limit the incentives an employer may offer to employees to encourage them or their family members to receive a COVID-19 vaccine or provide confirmation of vaccination. While this update provided clearer wording on these rules, it did not substantively change the EEOC’s prior guidance.
Updated EEOC Guidance »

Texas Executive Order Creates Broad Exemptions to Vaccine Mandates
10.11.2021 — Texas Gov. Greg Abbott issued an executive order permitting broad exemptions to any vaccine mandate, including if someone objects to the vaccine for "any reason of personal conscience." The Texas Order applies to vaccine mandates by any “entity in Texas,” including private sector employers.
Executive Order »
Axios »

D.C. Enacts Expanded Paid Family Leave Rights
10.08.2021 — The expanded employer-funded D.C. paid family leave (DCPFL) includes an additional two weeks of leave for an individual’s serious medical condition, including prenatal care. Beginning October 1, 2021, the amendment applies to leaves of absence beginning on or after September 26, 2021.
DCPFL law »
Epstein Becker Green »

IRS Guidance Clarifies Application of COVID-19 Relief to COBRA Rules
10.06.2021 — The IRS has issued guidance clarifying the application of certain COBRA deadline extensions under prior relief that was issued as a result of the COVID-19 outbreak (the “Outbreak Period Rules”). The guidance also addresses the interaction of the Outbreak Period Rules with the COBRA subsidies that were made available for certain eligible individuals under the American Rescue Plan Act.
IRS Guidance »

Agencies Issue Guidance on COVID-19 Vaccine-Related Premium Surcharges and Discounts
10.04.2021 — The Departments of Labor, Treasury and Health and Human Services (“Agencies”) issued FAQ guidance regarding the application of the HIPAA wellness rules and ACA affordability rules to vaccine-related premium surcharges and discounts. The Agencies confirmed the permissibility of implementing COVID-19 vaccination discounts and surcharges under employer-provided group health plans to incentivize employees to become vaccinated assuming applicable HIPAA requirements are satisfied.
FAQ Guidance »

IRS Issues Draft 2021 ACA Information Reporting Forms and Instructions
09.30.2021 — With some exceptions, the draft forms are mostly unchanged from 2020. The draft instructions no longer mention an automatic extension to furnish the forms to individuals, and simply note the normal January 31, 2022 due date. The instructions remove references to “good faith” penalty relief which had been available for reporting incomplete or incorrect information. The threshold for mandatory electronic filing with the IRS remains at 250 returns, which differs from the recently proposed regulations reducing the filing thresholds and aggregating different return types (see our e-Alert here) and suggests that the IRS may not be able to finalize the proposal in time for the March 31, 2022 electronic filing deadline.
Draft Forms:
Draft Form 1094-C »
Draft Form 1095-C »
Draft Form 1094-B »
Draft Form 1095-B »
Draft Instructions:
Draft C Form Instructions »
Draft B Form Instructions »

HHS/OCR Issues COVID-19-Related HIPAA Guidance
09.30.2021 — HHS/OCR FAQ guidance helps consumers, businesses and health care entities understand when the HIPAA Privacy Rule applies to disclosures and requests for information about whether a person has received a COVID-19 vaccine. The guidance provides common workplace examples which clarify that the HIPAA Privacy Rule applies only to covered entities and business associates, and does not include employers in the context of employment related questions and disclosures.
HHS/OCR FAQ guidance »

Part II of the No Surprises Act Regulations Issued—Focus is on IDR Process
09.30.2021 The agencies implementing the No Surprises Act have issued Part II of their three-part interim final regulations (IFRs) under the new statute intended to prevent most forms of surprise billing (see our eAlert here on Part I). These Part II IFRs establish a federal independent dispute resolution (IDR) process that nonparticipating providers, group health plans and insurers can use to resolve disputes regarding the appropriate out-of-network rate for certain services.
Part II IFRs »

U.S. Government Issues Vaccine Mandate Guidance for Federal Contractors and Subcontractors
09.24.2021 — The Safer Federal Workforce Task Force issued guidance explaining the necessary COVID-19 safety protocols for covered federal government contractors and subcontractors, including their remote workers (“covered contractors”) to comply with Executive Order 14042, Ensuring Adequate Covid Safety Protocols for Federal Contractors. Among other requirements, covered contractors will have until December 8, 2021 to be fully vaccinated or qualify for a medical or religious accommodation.
Federal Guidance »
Executive Order 14042 »
Morgan Lewis Article »

Agencies Issue Proposed Rules under No Surprises Act
09.10.2021 — The proposed rule focuses on 1) the submission of information about air ambulance services; 2) the process that HHS will take to investigate and enforce violations of federal insurance law (including the NSA and CAA); and 3) implementation of a CAA provision that requires insurers to disclose direct and indirect compensation to agents and brokers for enrollment in individual market coverage and STLDI.
Proposed Regulation »
Health Affairs »

ACA Affordability Percentage Set to Decrease in 2022
08.27.2021 — The IRS has updated the required contribution percentage for purposes of determining whether an employer’s offer of coverage will be “affordable” under the Affordable Care Act’s (ACA) Employer Shared Responsibility rules (“Employer Mandate”). For plan years beginning in calendar year 2022, the new affordability percentage will be 9.61%, which is down from the 2021 percentage of 9.83%.
IRS Rev. Proc. 2021-36 »

CAA Healthcare Price Transparency Rules Delayed
08.20.2021 — FAQ guidance issued by the agencies implementing the Consolidated Appropriations Act, 2021 (CAA) delays enforcement of some of the CAA’s most challenging health plan transparency requirements. The FAQ guidance delays enforcement of the following rules: the requirement to disclose new “advanced explanations of benefits” providing good-faith estimates of the out-of-pocket costs for scheduled medical services; a “price comparison tool” to enable participants to compare cost-sharing amounts for specific network providers; extensive drug cost information that was required to be reported to federal regulators in December 2021; and health plan pricing disclosures (required to be disclosed to the public) related to in-network rates, out-of-network allowed costs, and prescription drug prices.
DOL/HHS/IRS FAQ Guidance »

IRS Information Letters Clarifies Health FSA Issues under COBRA and COVID-19 Relief
08.19.2021 — The IRS has issued guidance clarifying how employers can claim the tax credit for the 100% COBRA premium subsidies available under the American Rescue Plan Act of 2021. Employers and plan sponsors may need to make last-minute changes to (or amend) their Form 941 IRS filings for claiming these tax credits, due on August 2, 2021.
IRS Information Letter: 2021-0004 »
IRS Information Letter: 2021-0005 »

In The News

Airline Travel Mask Mandate Decision Appealed by the Department of Justice (DOJ)
04.20.2022 — Following a ruling by a federal district court in Florida vacating the CDC-mandated mask requirements for airlines, airports, mass transit and taxis, the U.S. Department of Justice (DOJ) filed an appeal on April 20, 2022. While there is no current timeline on a decision, if the 11th Circuit Ct. of Appeals upholds the ruling, the matter may potentially go to the Supreme Court. After the decision, the Transportation Security Administration (TSA) released a statement stating that it will no longer enforce mask use.
Ruling »
DOJ appeal »
TSA Statement »

Biden Administration Warns Health Insurers on Birth Control Coverage and Joint Departments FAQs Released to Address Complaints
01.18.2022 — Health insurers could face increased scrutiny and enforcement actions following Biden Administration guidance to comply with ACA-required birth control. In response to reports of potential violations of the contraceptive coverage requirement, DOL, HHS and Treasury jointly released FAQs, effective 1/10/22, that make clear that all FDA-approved or granted contraceptive products that are determined by an individual’s medical provider to be medically appropriate for such individual must be covered without-cost sharing.
Axios »
Agency FAQs »

Biden Administration Offers Free COVID-19 Tests
01.18.2022 — The Biden Administration increased access to free COVID-19 testing by launching www.COVIDtests.gov. U.S. households can order up to 4 antigen (rapid) tests. The U.S. Postal Service will deliver the tests, expected by late January. These 4 tests will not limit the 8 monthly tests that insured individuals will be able to get through their group health plan or insurer at no cost.
White House Fact Sheet »

Supreme Court asked to evaluate ERISA pre-emption for City of Seattle Ordinance for Hotel Worker’s Insurance
01.14.2022 — SCOTUS has been asked to review this case pertaining to the Seattle Ordinance which requires large hotels and related businesses to give workers either health insurance coverage or additional compensation and whether it is preempted by ERISA. This case presents the question of whether ERISA’s preemption provision permits state and local governments to place insurance mandates on private employers. The question whether ERISA preempts state law is an issue of frequent litigation, finding its way to the Supreme Court almost two dozen times. As seen with the San Francisco Health Care Ordinance, it was allowed to proceed.
EBSA Memo »
Seyfarth Shaw »
Petition »

Biden Calls on Employers to Implement Vaccine Mandates Despite SCOTUS Block of OSHA COVID-19 ETS
01.13.2022 — After SCOTUS’s block of OSHA’s Emergency Temporary Standard (ETS) that would have required employers with 100 or more employees to adopt mandatory COVID-19 vaccination for their employees or weekly testing, President Biden urged business leaders to immediately join those companies, including 1/3 of Fortune 100 companies, who have instituted vaccine requirements to protect employees, customers and communities.
White House Statement »
The Hill »

FDA Approves Pfizer Vaccine Boosters for 12- to 15-Year-Old Children
01.03.2022 — The FDA has authorized a single dose booster of the Pfizer-BioNTech COVID-19 vaccine for 12- to 15-year-old children in a revised Emergency Use Authorization (EUA). The EUA also authorizes a booster for certain immunocompromised 5- to 11-year-old children.
FDA news release »

CDC Cuts COVID-19 Isolation Period Recommendation in Half
12.27.2021 — The CDC has shortened its recommended isolation time for people who test positive for COVID-19 from 10 days to five days if they're asymptomatic. This will have an immediate benefit to employers and HR managers across the country who have been dealing with the negative impact of increasing numbers of employees in quarantine as Omicron cases surge.
CDC announcement »

Omicron Surge Challenges Definition of “Fully Vaccinated”
12.21.2021 — The U.S. may be getting closer to redefining what “fully vaccinated” means. Officials are considering requiring boosters as part of the full vaccination regimen. Other countries have already made this change. Changing definitions could cause additional challenges for employers and businesses.
Politico »
White House Press Release »

CDC Recommends COVID-19 Vaccine Boosters for All Adults
11.19.2021 — The FDA has authorized, and the CDC has recommended, COVID-19 vaccine boosters for all adults. As a result, all individuals age eighteen or older are now eligible for a single dose of the Moderna or Pfizer-BioNTech booster if it has been at least six months since they completed their second vaccination. The booster provides continued protection against the virus and serious consequences such as hospitalization or death.
CNN Health »

6th Circuit Court of Appeals to Decide on Challenges to the Vaccine Mandate for Large Employers
11.16.2021 — Challenges to the recent OSHA ETS regulation will be consolidated and heard by the conservative-leaning 6th Circuit Court of Appeals. While the 6th Circuit tends to rule in favor of conservative positions, it’s possible that its decision could modify or lift the 5th Circuit’s stay of the ETS (see our eAlert).
CNN »

Florida Governor Convening Special Session to Pass Bills to Block COVID-19 Vaccine Mandates
11.14.2021 — Florida Governor Ron DeSantis has called a special legislative session to review four bills aimed at blocking employer COVID-19 vaccine mandates. The bills increase fines for local businesses, governments and other companies requiring workers to be vaccinated and schools requiring mask wearing.
The Hill »

FDA Authorizes “Mix and Match” Booster Vaccinations
10.20.2021 — The FDA has authorized boosters that differ from the vaccine originally used to immunize a person against COVID-19 (often referred to as the “mix and match” approach). So, for example, a person who received a Johnson & Johnson vaccine could receive one from Moderna or Pfizer-BioNTech as a booster.
NPR »

Florida Dept. of Health Fines County $3.5M for Implementing Vaccine Mandate
10.12.2021 — The Florida Department of Health fined Leon County $3.5 million for requiring its employees to get vaccinated against the coronavirus, saying it violated the state's ban on "vaccine passports."
Axios »

Twenty-four States Threaten to Challenge OSHA Vaccine Mandate
09.16.2021 — Recently, 24 state attorneys general submitted a letter strongly opposing President Joe Biden’s proposed COVID-19 vaccine mandate among private sector employers. The President’s proposed mandate would require that all such employers with 100 or more employees require their employees to be vaccinated or submit to weekly testing. These states have threatened legal action should the mandate’s efforts move forward.
Attorneys General Letter »

DeSantis threatens $5K fine against Florida cities with vaccine mandates
09.13.2021 — Florida Gov. Ron DeSantis threatens to fine cities and counties thousands of dollars if they impose vaccine requirements on their employees. It’s not clear how quickly the state will put in new rules that would call for these fines. At least three Florida counties and cities have required their workers to be vaccinated or tested.
Politico »

Biden Lays Out Plan To Mandate Vaccines Or Testing For Millions Of Workers
09.09.2021 — President Biden announced new federal rules requiring all businesses with 100 or more employees to ensure that every worker is either fully vaccinated for COVID-19 or submits to weekly testing for the coronavirus. Biden said the new emergency rule for private sector employers, which will be issued by the Department of Labor's Occupational Safety and Health Administration, would apply to 80 million workers.
WhiteHouse.gov »
NPR »

Delta Airlines Imposes Premium Surcharge on Unvaccinated Employees
08.25.2021 — On August 25, Delta Airlines announced that as of November 1, unvaccinated staff will pay up to $200 a month more for their company health insurance, depending on the coverage. It will also limit the number of sick days unvaccinated employees are allowed to take if they contract Covid-19.
CNN »

FDA Grants Full Approval of Pfizer COVID-19 Vaccine
08.23.2021 — On August 23, the FDA granted the first full approval of a COVID-19 vaccine. This approval will likely mean that a significantly greater number of U.S. employers will adopt mandatory vaccination policies. The vaccine remains available under emergency use authorization (EUA), including for individuals 12-15 years of age and for a third dose in certain immunocompromised individuals.
FDA News Release »

Most Private Insurers No Longer Waiving Cost-Sharing for Covid-19 Treatment
08.19.2021 — New research by the Kaiser Family Foundation (KFF) shows that most private insurers are no longer waiving cost-sharing for COVID-19 treatment. There is no federal mandate requiring insurers to waive COVID-19 out-of-pocket treatment costs. KFF finds that 72% of the two largest insurers in each state and DC (102 health plans) are no longer waiving these costs, and another 10% of plans are phasing out waivers by the end of October.
KFF Research Brief »

Biden Admin Recommends Booster Shots Beginning in September
08.18.2021 — The Biden Administration has announced that it plans to begin offering Covid-19 booster shots to all American adults starting Sept. 20, 2021, amid growing evidence that a third dose of the vaccine will be needed to maintain immunity against the virus.
Politico »

DOL Settles Lawsuit Against United Healthcare under MHPAEA
08.11.2021 — Two settlement agreements filed on August 11 provide that United Healthcare Insurance Co., United Behavioral Health, and Oxford Health Insurance Inc., will together pay more than $15.6 million to settle allegations they violated the Mental Health Parity and Addiction Equity Act (MHPAE). The settlement marks the clearest signal yet of the Biden Administration’s increased enforcement of the MHPAE.
Bloomberg »

United Airlines To Require US Employees Get Vaccinated Against COVID-19
08.06.2021 — United Airlines has announced that employees will be required to get vaccinated against Covid-19 by October 25 – the first major U.S. airline to implement such a mandate. A United executive said it was not considering a similar rule for passengers, and that any such requirement would be a decision for the government.
AP News »

ACA Survives 3rd Major Supreme Court Challenge
06.17.2021 — In California v. Texas, the U.S. Supreme Court, by a vote of 7-2, denied a challenge to the Affordable Care Act (ACA), concluding that the plaintiffs did not have standing to challenge the constitutionality of the now penalty-less individual mandate. This decision is the Court’s third rejection of a broad, global challenge to the ACA in less than a decade.
SCOTUS decision »
K&L Gates article »

White House Releases Fact Sheet on The American Families Plan (AFP)
04.28.2021 — Among other proposed provisions, the AFP would create a national comprehensive paid family and medical leave program, funded through tax increases, and paying workers up to $4,000 a month. Under that cap, it would replace a minimum of two-thirds of average weekly wages, rising to 80 percent for the lowest-wage workers. The program would be phased in over a 10-year period.
White House Fact Sheet »
SHRM »

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
09.26.2020 — 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.
NPR »

Dr. Fauci Advises Americans to Hunker Down During Flu Season
09.10.2020 — 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 »

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