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Cyber Criminals Seeking to Capitalize on Coronavirus

Criminals prey on unfortunate circumstances, seeking to capitalize on victims during times of panic and hardship. Unfortunately, the coronavirus disease 2019 (COVID-19) pandemic is no exception. The Cybersecurity and Infrastructure Security Agency (CISA), part of the U.S. Department of Homeland Security, told individuals to be vigilant about scams related to COVID-19. Cybercriminals have been known…

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COVID-19 News

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2020

National Public Health Emergency Extension Benefit Plan Impact

On July 23, 2020, the Secretary of Health and Human Services (“HHS”), Alex Azar, declared the Public Health Emergency, scheduled to end on July 25, 2020, will once again be extended for an additional 90 days. As a result, numerous temporary benefit plan changes remain in effect.   Important Definitions  Emergency Period. HHS Secretary Azar issued…

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DOL Issues RFI on Paid Family and Medical Leave

The U.S. Department of Labor (DOL) seeks information from the public about the effectiveness of paid employee family and medical leave. In a Request for Information (RFI) issued July 15, 2020, the DOL said it intends to gather information about the effectiveness of current state- and employer-provided paid leave programs, and how access (or lack…

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DOL Issues Revised Optional FMLA Forms

The Wage and Hour Division (WHD) of the U.S. Department of Labor (DOL) has revised the forms employers and employees may use to meet their notification and certification obligations under the federal Family and Medical Leave Act (FMLA).   In a July 16, 2020, statement announcing the changes, the DOL said the forms were revised…

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IRS Issues FFCRA W-2 Reporting Guidance

July 17, 2020 | FFCRA Update   The IRS issued Notice 2020-54 to help employers properly report 2020 emergency paid sick leave and expanded family medical leave wages paid to employees under the Families First Coronavirus Response Act (“FFCRA”). Employers with less than 500 employees who provided benefits under either leave program will need to…

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FFCRA Benefit Eligibility Updates for Summer Program Closures

July 13, 2020 | FFCRA Update With the summer season officially upon us, the Department of Labor’s Wage and Hour Division (“the Department”) has issued Field Assistance Bulletin (“FAB”) 2020-4 to clarify when benefits under the Families First Coronavirus Response Act (“FFCRA”) may be available due to a summer camp or enrichment program being closed…

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Departments Issue FAQ Part 43 on COVID-19

On June 23, 2020, the Departments of Labor, the Treasury, and Health and Human Services (“HHS”) (collectively, “the Departments”) issued FAQ Part 43, which includes certain guidance on the Families First Coronavirus Response Act (“FFCRA”) and the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”), as well as other COVID-19 health plan issues.  …

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5 Tips for Onboarding Employees Remotely During the Coronavirus Pandemic

The coronavirus disease 2019 (COVID-19) pandemic has caused employers to make significant changes to their business practices, including onboarding. Managers and new hires across the country are navigating the unchartered waters of remote onboarding.  The onboarding process—which is designed to cultivate a long-term relationship between the employer and the employee while fostering a feeling of…

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Return to Work Plans Following the COVID-19 Pandemic

The coronavirus (COVID-19) pandemic has interrupted many businesses across the country. While it’s unclear how long COVID-19 will continue to affect organizations, many employers are looking to the future of employees returning to work. Echoing public health officials’ sentiments, a return to normalcy won’t be like flipping a switch, but rather a continuous effort. In…

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CDC Guidance for Employees Following a COVID-19 Diagnosis or Exposure

On April 4, 2020, the Centers for Disease Control and Prevention (CDC) issued guidance for discontinuing home isolation following a COVID-19 diagnosis. The CDC also issued guidance for what essential workers should do following exposure to COVID-19.   CDC Guidance for Discontinuing Isolation Following a COVID-19 Diagnosis  The decision to discontinue isolation should be made…

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COVID-19 Relief Extends Certain Employee Benefit Plan Deadlines

On April 28, 2020, the Departments of Labor (DOL) and the Treasury (Departments) issued deadline relief to help employee benefit plans, plan participants, and plan service providers impacted by the COVID-19 outbreak. This Compliance Overview summarizes the participant deadline extensions affecting COBRA continuation coverage, special enrollment periods, claims for benefits, appeals of denied claims, and…

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EEOC Updates Employer Guidance on Coronavirus and the ADA

On June 17, 2020, the Equal Employment Opportunity Commission (EEOC) issued an additional answer to frequently asked questions (FAQs) about how employers should comply with the Americans with Disabilities Act (ADA) while also observing all applicable emergency workplace safety guidelines during the coronavirus pandemic. The new FAQ, which addresses antibody tests (see A.7), was added…

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OSHA Guidance for Reopening Nonessential Businesses

  On June 18, 2020, the Occupational Safety and Health Administration (OSHA) released guidance to help employers plan how to reopen nonessential businesses. The guidance also addresses issues employers should consider as they ask their employees to return to work during the COVID-19 pandemic. OSHA’s publication of guidelines for reopening nonessential businesses includes charts, examples,…

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Common Employment Practices Claims Arising Out of COVID-19

The uncertainty wrought by COVID-19 has left employers at an increased risk of exposure to employment-related claims alleging wrongful termination, discrimination, retaliation, and harassment, among others.   As COVID-19 continues to spread throughout the United States, there has been a massive upheaval of the American workplace. Employers have found themselves drafting and implementing policies and…

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Prevent Worker Exposure to Coronavirus (COVID-19)

The novel coronavirus (officially called COVID-19) is believed to spread from person-to-person, primarily through respiratory droplets produced when an infected person coughs or sneezes. The virus is also believed to spread by people touching a surface or object and then touching one’s mouth, nose, or possibly the eyes. Employers and workers should follow these general…

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DOL Issues Regulations for FFCRA Paid Leave

  The U.S. Department of Labor (DOL) has issued temporary regulations to implement the paid leave mandates of the Families First Coronavirus Response Act (FFCRA). The regulations provide direction for administration of the Emergency Paid Sick Leave Act (EPSLA) and the Emergency Family and Medical Leave Expansion Act (EFMLEA).   This action is intended to…

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DOL Guidance on Employers Covered by FFCRA Paid Leave

The U.S. Department of Labor (DOL) has issued frequently asked questions (FAQs) that address which employers are covered by the paid leave requirements of the Families First Coronavirus Response Act (FFCRA). The FFCRA requires covered employers to provide their employees with paid sick leave and expanded family and medical leave for specified reasons related to…

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DOL Issues Corrections to FFCRA Regulations

The regulations, published April 6, 2020, clarify and explain the employee leave provisions under the FFRCA’s Emergency Family and Medical Leave Expansion Act (EFMLEA) and Emergency Paid Sick Leave Act (EPSLA). While the corrections mainly address minor drafting errors in the regulations, some of the changes may impact employers’ implementation of the law. Substitution of…

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Unemployment Benefits for Coronavirus Under the CARES Act

The Coronavirus Aid, Relief, and Economic Security (CARES) Act, enacted on March 27, 2020, provides federal funding to expand the availability of unemployment insurance (UI) benefits during the coronavirus (COVID-19) public health emergency. Under this law, virtually all types of workers, even those who otherwise would not qualify for UI benefits, may receive payments for…

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DOL Regulations for Families First Coronavirus Response Act

The U.S. Department of Labor (DOL) has issued temporary regulations under the Families First Coronavirus Response Act (FFCRA). The FFCRA created new employer requirements to provide paid sick leave and partially compensated, expanded FMLA leave for reasons related to the COVID-19 pandemic. The regulations include important clarifications to the law and earlier DOL guidance on…

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IRS FAQs: Employee Retention Credits under the CARES Act

Under the Coronavirus Aid Relief and Economic Security Act (CARES Act), eligible employers that keep employees on their payroll for specified reasons related to COVID-19 are eligible for employee retention tax credits. This Compliance Bulletin provides the Internal Revenue Service’s (IRS) answers to frequently asked questions (FAQs) on how the CARES Act retention tax credits…

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DOL Issues Guidance on COVID-19 and the FMLA

The U.S. Department of Labor has issued Q&As on the federal Family and Medical Leave Act (FMLA) and COVID-19 (the disease caused by the new coronavirus) and other health emergencies. The Q&As explain that under the FMLA, covered employers must provide eligible employees with job-protected, unpaid leave for specified family and medical reasons, which may include…

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CMS Reporting to Include Prescription Drug Information

  Background Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007 created reporting requirements for group health plans to CMS. These requirements were effective January 1, 2009. In most cases, the insurance carrier and TPA are the RREs. An employer may be the RRE when it both sponsors and administers the group…

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HHS Increases Civil Penalties for HIPAA Violations

  On Jan. 17, 2020, the Department of Health and Human Services (HHS) published a final rule increasing the civil monetary penalties for violations of laws enforced by HHS, including the HIPAA privacy and security rules. HHS is required to adjust these penalties for inflation each year to improve their effectiveness and maintain its deterrent…

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Overtime Pay Consequences of Common Employee Benefits

On December 16, 2019, the Wage and Hour Division of the U.S. Department of Labor (DOL) published final regulations on “regular rate of pay” for overtime pay purposes under the Fair Labor Standards Act (“FLSA”). The final regulations address common employer-provided benefits as well as other workplace practices, which were not specifically addressed in previous…

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Proposed Rules Clarify Individual Coverage HRAs

On September 30, 2019, the IRS published proposed regulations to clarify the application of the employer mandate under the Affordable Care Act (“ACA”) and certain nondiscrimination rules under the Internal Revenue Code (“Code”) Section 105(h) to health reimbursement arrangements (“HRAs”) integrated with individual health insurance coverage (individual coverage HRAs, or “ICHRAs”). Notably, the proposed regulations…

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CMS Disclosure Requirement for Employer Health Plans

Background The Centers for Medicare and Medicaid Services (CMS) is a federal agency that collects data and administers various federal programs. The agency utilizes the CMS online tool to  collect information from employers about whether their group health plan’s prescription drug coverage is creditable or non-creditable. Creditable coverage means the group health plan’s prescription drug…

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2019

Make Sure You Aren’t Grounded by the Real ID Act

Don’t miss an important meeting or family gathering, and don’t be that person who makes everyone else wait in line. Real IDs are set to become a new requirement in the security process for flying in the United States, and if you don’t take the necessary steps to prepare for the changes, you won’t be…

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HHS Moves for More Drug Price Transparency

Beginning in May of last year, the Trump administration began searching for ways to curb out- of-control prescription drug costs—referring to the initiative as American Patients First. This effort is finally seeing some traction, with the administration publishing its first final rule on the matter. Drug companies will now be “… required to disclose to…

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Proposed Rules Would Require Hospitals to Publish Retail Prices for Health Care Services

On Monday, July 29, 2019, the Centers for Medicare and Medicaid (CMS) proposed rules that would require all Medicare-participating hospitals to post their negotiated prices for standard health care services. The Outpatient Prospective Payment System (OPPS) & Ambulatory Surgical Center (ASC) proposed rule is intended to increase pricing transparency and help consumers understand the charges…

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Final Rule on Hospital Price Transparency Released

On Friday, Nov. 15, 2019, the Trump administration released its final rule regarding hospital price transparency. This final rule will take effect Jan. 1, 2021, a year later than originally proposed. The Centers for Medicare and Medicaid Services (CMS) had been listening to feedback on a proposed version of the rule for the past four…

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New Executive Order Addresses Healthcare Issues

On June 24, 2019, President Trump issued an Executive Order (“EO”) directing the relevant federal agencies to issue regulations or other guidance to make available more meaningful information related to the price and quality of healthcare. This summary highlights aspects of the EO that may be relevant to employer-sponsored group health plans and their covered…

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New Jersey Small Employer Stop Loss Bill

A bill has been introduced in New Jersey in both the Senate and Assembly that, if passed, would prohibit insurance carriers or other insurers subject to the insurance laws of New Jersey or any other state from offering, issuing or renewing any stop loss insurance policy of any kind to small employers. Stop loss insurance…

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Court Strikes Down Association Health Plan Rules

On March 28th, 2019, a Federal District Court in the District of Columbia struck down significant portions of the Department of Labor’s (DOL’s) Association Health Plan (AHP) Final Rule. Specifically, the Court found the DOL “failed to reasonably interpret” ERISA when issuing these rules by: expanding the definition of “employers” to include disparate groups of…

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Court Provides Fiduciary Duty Guidance to Health Plans

While ERISA fiduciaries have often been challenged for allowing an ERISA retirement plan to pay excessive fees and expenses (such as in the context of a 401(k) plan), such claims have rarely been raised against ERISA fiduciaries of a group health plan. However, the Department of Labor (“DOL”) recently sued a group health plan raising…

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ACA Legal Challenges Continue

Apr 2019 – This article is intended to provide you with an update on current legal challenges to invalidate the ACA. There is no immediate impact to employer-sponsored health plans or other requirements under the ACA.   In 2018, a Texas Court ruled in favor of 20 Republican state attorneys general (“AGs”) to invalidate the…

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Court Strikes Down Association Health Plan Rules

On March 28th, 2019, a Federal District Court in the District of Columbia struck down significant portions of the Department of Labor’s (DOL’s) Association Health Plan (AHP) Final Rule. Specifically, the Court found the DOL “failed to reasonably interpret” ERISA when issuing these rules by: expanding the definition of “employers” to include disparate groups of…

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2018

Almost ‘all modern computers’ affected by cold boot attack

Researchers warn the attack would allow potential hackers to steal sensitive information stored on your RAM. Security researchers have discovered a flaw with nearly all modern computers that allow potential hackers to steal sensitive information from your locked devices. The attack only takes about five minutes to pull off, if the hacker has physical access…

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Would States Eliminate Key Benefits if AHCA Waivers are Enacted?

As the debate over amending health insurance market rules continues, proponents of changing the law have proposed reducing the health benefits provided by non-group plans as a potential way to lower premiums in the market.  The Affordable Care Act (ACA) prescribes 10 categories of essential health benefits that non-group and small-group policies must cover, and…

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Short-Term Limited Duration Health Insurance Analysis

A new Kaiser Family Foundation analysis of short-term, limited duration (STLD) health plans for sale through two major national online brokers finds big gaps in the benefits they offer. Through an executive order and proposed new regulations, the Trump Administration is seeking to encourage broader use of short-term, limited duration health plans as a cheaper…

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The ACA Undergoes a New Legal Challenge

Several states have lodged a legal challenge to the entire Affordable Care Act (“ACA”) on the basis that the lack of an Individual Mandate tax makes the remaining provisions unconstitutional. While the Administration is not intervening, several other states are, defending the ACA’s sustainability without the Individual Mandate tax. No resolution to the legal questions…

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DOL Penalties Increase for 2018

In 2015, Congress passed the Federal Civil Penalties Inflation Adjustment Act of 2015 (the “Inflation Adjustment Act”) to direct federal agencies to adjust the civil monetary penalties for inflation every year. Civil penalties ensure compliance with federal regulation by incentivizing employers not to violate federal regulation and providing federal agencies the power to ensure compliance.…

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House Passes Legislation to Improve HSAs

The House of Representatives passed two pieces of legislation that, among other things, purport to improve and “modernize” health savings accounts (“HSAs”).     While the bills call for significant changes to the current rules affecting HSAs, the specific details are very different.   Summary of Proposed Changes   H.R. 6199 would: Exclude a direct…

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New Jersey Out-of-Network Bill

On June 1, 2018, New Jersey Gov. Murphy passed the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act (the “OON Act”). In general, the OON Act applies to emergency services and other care provided by out- of-network physicians in in-network settings (i.e. hospital-based physicians). It takes effect on September 1, 2018.   The Act…

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New FAQs Address Tax Credit for Paid Family and Medical Leave

On April 9, 2018, the IRS released its first round of guidance in the form of FAQs concerning the new employer credit for paid family and medical leave (FML) under Code Section 45S.   Background Added by the Tax Cuts and Jobs Act, Code Section 45S provides that for tax years 2018 and 2019, eligible…

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FBI Urges Consumers to Reset Their Routers to Prevent a Malware Attack

Recently, researchers at Talos—a cyber intelligence unit of Cisco—warned consumers of malware (malicious software) that specifically targets networking devices. The malware, which is known as VPNFilter, impacts an estimated 500,000 routers worldwide, particularly targeting devices from the following manufacturers: Linksys MikroTik Netgear QNAP TP-Link         Once on your equipment, the malware could…

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AmeriHealth New Jersey Lab Update for May 2018

AmeriHealth New Jersey Laboratory Network Update   As a reminder, effective May 1, 2018, LabCorp Corporation of America® Holdings (LabCorp) will become the exclusive outpatient lab for all AmeriHealth HMO, Inc. and AmeriHealth Insurance Company of New Jersey (collectively AmeriHealth New Jersey) commercial HMO, HMO Plus, POS, POS Plus, PPO, EPO, and self-funded business. As…

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Aftermath of WannaCry Ransomware

The WannaCry ransomware that has spread across 150 countries since Friday has appeared to slow down, but employees starting the workweek should be careful, as the effects in the United States are yet to be determined.   WannaCry locks users out of their computers by exploiting a vulnerability in outdated versions of Microsoft Windows. It…

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2017

DOL Sues Health Plan Alleging Compliance Failures

On August 16, 2017, the Department of Labor (“DOL”) led a lawsuit against Macy’s Inc. Health and Welfare plan (and its third party administrators) under ERISA Title I.   Specifically, the complaint alleges: The health plan and its fiduciaries failed to follow the written terms of the health plan’s Summary Plan Description (SPD) when reimbursing…

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CMS Final Regulations Issued for 2018 Individual Market Stabilization

On April 13, 2017, the Department of Health and Human Services (HHS) issued final regulations to help stabilize the individual and small group markets. These final regulations, effective June 19, 2017, do not significantly differ from the proposed regulations issued February 16, 2017. They do not directly impact large group or expatriate health plans, but…

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Independence and University of Pennsylvania

Independence Blue Cross (Independence) and University of Pennsylvania Health System (UPHS) have signed an innovative, five-year contract that strengthens both organizations’ emphasis on coordinated patient care, exchange of critical data, and shared accountability for both quality and cost of care. Independence Blue Cross

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Aetna to Withdraw from NJ Small Employer ACA Market in 2018

Aetna has decided to leave the individual market in New Jersey. Due to New Jersey law, this decision also impacts their New Jersey small employer ACA insured medical products. Health insurance coverage for each of your New Jersey small employer clients with commercial (fully insured) medical plans, will end at midnight on the day before…

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