Departments Propose Rule on Limited Duration Insurance and Fixed Indemnity Excepted Benefits Coverage
Reminder: COVID-19 National Emergency Outbreak Period Has Ended
Based on DOL FAQ guidance and subsequent commentary, the COVID-19 National Emergency Outbreak Period ended on July 10, 2023. This means that the tolling of certain ERISA plan deadlines (e.g., COBRA elections, payments and certain notices, HIPAA special enrollments, and claims and appeals filings) will no longer be required.
Accordingly, employers should work with legal counsel, TPAs, COBRA vendors and other service providers to ensure related plan documents, procedures and systems have been updated to accommodate the Outbreak Period end and subsequent reversion to pre-pandemic election, notice and payment timelines after July 10, 2023. PPI has amended our COBRA QE Notice to reflect the applicable deadlines.
For further information, download a copy of End of COVID-19 Emergency Declarations: A Guide for Employers.
Paid Sick Leave Law Expanded
July 18, 2023
Gov. Polis signed into law an amendment to the Colorado Healthy Families and Workplaces Act (HFWA), which broadens the scenarios under which employees may take paid leave beyond those involving the health or caregiver needs of the employee and their immediate family members.
Effective August 7, 2023, Colorado employees will also be able to use accrued sick pay to:
- “Grieve, attend funeral services or a memorial,” or address “financial and legal matters that arise after the death of a family member.”
- “Care for a family member whose school or place of care has been closed due to inclement weather, loss of power, loss of heating, loss of water, or other unexpected occurrence or event that results in the closure of the family member’s school or place of care.”
- “Evacuate the employee’s residence due to inclement weather, loss of power, loss of heating, loss of water, or other unexpected occurrence or event that results in the need to evacuate the employee’s residence.”
Colorado employers must notify employees of their right to take paid leave under the HFWA and should consider updating both their sick leave policies and posters to reflect the new grounds for which employees may take HFWA leave on or before the law’s effective date.
Telehealth Reimbursement Requirements Temporarily Expanded
July 18, 2023
On June 22, 2023, Gov. Green signed HB907 into law. The law temporarily requires reimbursement parity for telehealth services and allows reimbursable mental health services to be provided via audio-only.
Specifically, reimbursement for telehealth services provided via audio and video must be equivalent to reimbursement for the same services provided via in-person contact. With respect to audio-only mental health services, the law requires reimbursement equivalent to 80% of the reimbursement for the same services provided via in-person contact. However, for audio-only mental health services, the healthcare provider must first conduct an in-person visit or an audio and video telehealth visit six months prior to the initial audio-only visit or twelve months prior to any subsequent audio-only visit.
The requirements are effective immediately for policies issued or renewed in Hawaii and sunset on December 31, 2025. Employers sponsoring health plans in Hawaii should be aware of this development and contact their carrier for further information.
Behavioral Health Access and Crisis Intervention Trust Fund Surcharge
July 18, 2023
Massachusetts enacted the new Behavioral Health Access and Crisis Intervention Trust Fund surcharge, which is a surcharge on certain payments made to Massachusetts acute hospitals and ambulatory surgical centers (ASCs). The surcharge requirement is applied to both fully insured and self-insured plans. The insurers for fully insured plans and TPAs for self-insured plans where a TPA makes payments to ASCs are directly responsible for administering the payments with the Massachusetts Executive Office of Health and Human Services. If a self-insured plan pays claims directly to hospitals and ASCs, then the plan sponsor (generally, the employer) is the surcharge payer.
For further information, the Surcharge FAQ below outlines the details of the surcharge requirement.
Employers sponsoring a health plan that covers individuals in Massachusetts should be aware of the surcharge and work with their carrier or TPA to ensure compliance.
State Expands Pregnancy and Parental Leave
July 18, 2023
On May 24, 2023, Gov. Walz signed a bill expanding pregnancy and parental leave to employees in the state. Under Minnesota's Pregnancy and Parenting Leave Act (PPLA), an employer with one or more employees working in MN must provide eligible employees with up to 12 weeks of unpaid leave for the birth or adoption of a child, prenatal care, or incapacity due to pregnancy, childbirth or related health conditions.
Similar to federal FMLA, the employer must continue to make insurance coverage available to employees and their dependents under any group insurance policy, group subscriber contract or healthcare plan during this leave on the same basis as if the employee was not on leave. However, employees may be required to pay the full cost of coverage.
The bill amends the PPLA so that, effective July 1, 2023, it has expanded in the following ways:
- It covers employers with one or more employees working in MN. It used to cover employers with 21 or more employees.
- Businesses and trusts are now included in the PPLA’s definition of employer. The term employer also includes:
- Nonprofit organizations
- Groups of persons
- Governmental bodies and subdivisions
- The PPLA no longer includes length-of-service and hours-worked requirements for employee eligibility. Employees are eligible if they work for one of the employers listed above and are either the natural parent or adoptive parent of a child.
- Employers cannot terminate, discipline, penalize, interfere with, threaten, restrain, coerce or otherwise discriminate against employees for requesting or using leave under the law.
The amended PPLA is more generous in its eligibility requirements than federal and state FMLAs, but its focus is narrower. The PPLA covers more employers and employees, but the state and federal FMLAs provide leave for more qualifying reasons. Employers in the state should be aware of the expanded scope of PPLA.
Paid Leave and WA Cares Fund Webinars Scheduled
July 18, 2023
Two employer webinars have been scheduled for the second half of July in conjunction with the launch of Washington’s long-term care program (“WA Cares”) on July 1, 2023. Entitled “Paid Leaves and WA Cares,” the first webinar is scheduled for Thursday, July 20, at 11:00 a.m. PT, and the encore is scheduled for Thursday, July 27, at the same time.
More information about the WA Cares webinar series, including a registration link for the upcoming session and access to previous webinar recordings, is available here.
This material was created by PPI Benefit Solutions to provide accurate and reliable information on the subjects covered but should not be regarded as a complete analysis of these subjects. It is not intended to provide specific legal, tax or other professional advice. The service of an appropriate professional should be sought regarding your individual situation. PPI does not offer tax or legal advice. "PPI®" is a service mark of Professional Pensions, Inc., a subsidiary of NFP Corp. (NFP). All rights reserved.