Compliance Bulletin | July 2024

Welcome to the July 2024 edition of the Baldwin Bulletin, a compliance newsletter by the Baldwin Regulatory Compliance Collaborative (BRCC).

The Baldwin Bulletin serves as a monthly guide to important regulatory developments, legal news, and employee benefits-related industry happenings designed to keep you abreast of the latest developments.

This month’s issue focuses on important upcoming compliance deadlines and includes our timeline of upcoming compliance requirements, in addition to providing information regarding certain hot-button compliance issues significantly impacting employers.

Upcoming Compliance Deadlines. For information regarding upcoming compliance deadlines for employer-sponsored group health plans, read more here.

2024 HIPAA Privacy and Security Rule Training Calendar. This year’s BRCC HIPAA training calendar is available here.

2024 Baldwin Professional Education Connection Educational Webcast Calendar. The BPEC’s monthly educational webinar series calendar for 2024 is available here.

San Francisco HCAO Rates Increase Effective 7/1. Effective July 1, 2024, the HCAO Fee Rate will increase to $6.75 per hour with a weekly maximum cap of $270.  Read more here.

Compliance Considerations for Domestic Partner Eligibility. Recent trends among young adults show that the younger generations are foregoing traditional marriage and entering other forms of sharing relationships and partnerships. To appeal to these new partnerships, employers are looking to expand who may be eligible to participate in the group insurance plans they sponsor. These non-traditional arrangements are often difficult to define and can place additional administrative burdens on already over-taxed Human Resources staff. Read more here.

ACA’s Free Preventive Services Mandate Stands, U.S. 5th Circuit Appeals Court Rules. The lawsuit, Braidwood Management Inc. v. Xavier Becerra, 4:20-cv-00283, (N.D. Tex.), was brought by two Christian-owned Texas businesses opposed to covering the HIV-prevention drug, PrEP. That portion of the case — specifically the scope of a panel’s authority — has been sent back to a lower court for review. Read more here.

Updated Resources Available for Next Gag Clause Prohibition Compliance Attestation Due December 31, 2024. On May 24, 2024, the U.S. Department of Labor (“DOL”) issued updated annual submission instructions, user manual and Excel template to assist health plans and health insurance issuers in submitting their annual attestation of compliance with the Consolidated Appropriations Act’s (“CAA”) gag clause prohibition. Section 4 of the updated instructions has a list of the changes made since 2023.  These resources can be used to submit the next gag clause attestation due by December 31, 2024. Read more here.

Risks for Employers Administering Supplemental Life Coverage. On June 11 and 12, 2024, the DOL announced a recent settlement with Unum Life Insurance Company of America (“Unum”) and Lincoln Financial Group (“Lincoln”) following an investigation into the carriers’ group supplemental life insurance claims practices. The DOL investigation found that Unum routinely accepted premiums (via employer payroll deductions) for many years without verifying if participants satisfied an evidence of insurability (EOI) standard. Read more here.

Managing MLR Rebates: A Guide for Employers. The Affordable Care Act (“ACA”) implemented medical loss rebates (“MLR”) regulations to control costs of health care coverage and ensure policyholders (typically the employer who sponsors the group health plan) get value from their premiums. These regulations require that health insurance providers spend between 80 to 85% of premium funds on medical care and improvements to healthcare quality instead of administrative expenses. Every year by July 31st, insurers must submit a report detailing their premium expenditure from the prior year to the Department of Health and Human Services (HHS). Read more here.

Question of the Month. Our “Question of the Month” concerns the ACA’s impact on interns and seasonal employees. Read more here.