Monday, October 3, 2022

Compliance and Benefit News, October 3, 2022

Compliance Updates

CA Legislature Expands Pay Transparency and Data Reporting Requirements; Extends COVID Supplemental Paid Sick Leave - "If signed into law by Governor Newsom, the current amended version of SB 1162 would increase employers’ pay transparency obligations as follows: 1) upon request, all employers will be required to provide the pay scale (i.e., hourly rate or salary range) for the position in which the employee is currently employed; 2) employers will be required to maintain records of job title and wage rate history for all employees for the duration of employment plus three years; and 3) all employers with 15 or more employees will be required to disclose pay scales in all job postings.


SB 1162 also expands California employers’ current pay data reporting requirements, which were initially passed into law in 2020 as part of the nation’s first such state-imposed obligations. The current requirements mandate that private employers with 100 or more employees report annually the number of their employees by race, ethnicity, and sex in specified job categories to the Department of Fair Employment and Housing (recently renamed the Civil Rights Department (CRD))."

California Slated to Usher in New Era of Pay Transparency in 2023: What California Employers Need to Know - "The Act expands pay data reporting to all California employers with 100 or more employees regardless of whether or not they are exempted from the EEO-1 filing requirement. The Act also significantly expands the types of pay information employers must report each year. The first deadline to report is the second Wednesday of May 2023 (May 10, 2023). Covered employers must now also provide the “median and mean hourly rate” within each job category (discussed above), for each combination of race, ethnicity, and sex."

Benefit News

The Cost Of Long COVID To Employers Is Skyrocketing -"two types of claims were sorted out: those labeled long COVID, and those attributed to diabetes. When the numbers were crunched, here’s what came up: Per-member employer spend on long COVID was on average $2,654.67, more than 26% higher than the average diabetic spend....The study also finds that long COVID patients reported a 3.6 times greater likelihood of missing work for medical reasons than plan members without the symptoms. ... [T]he average predicted cost of long COVID to patients is nearly $9,500 within the first six months following a diagnosis."

Segal Trend Survey, 7.4% Plan Increases in 2023 - "The projected annual cost trend for outpatient prescription drugs is expected to be approaching double-digit levels, the highest rate observed since 2015. Double-digit specialty Rx cost trend, mostly driven by price increases and new-to-market specialty drugs, continues to be a major driver of Rx cost trends. Survey respondents project per-person cost trends for open-access PPO/POS plans to be 7.4 percent."

Yet Another Reason to Look at Reference-Based-Pricing (another hidden cost shift against employers) - Employer plans pay an average of 224% of what Medicare pays for the same hospitalizations. This cost shift away from Medicare and onto employers has led to growth in employers moving away from traditional insurance and reverence-base-pricing their plans. I spoke about it with Armstrong and Getty in September here. And I wrote about it becoming a growing trend in the 2020s hereA new study now shows that the same hidden tax/cost shift is happing with Obamacare Exchange plans.

‘Gaming’ Of U.S. Patent System Is Keeping Drug Prices Sky High, Report Says - Four pharmaceutical companies have filed hundreds of patents to keep their drugs out of the hands of generic competition and prolong their “unprecedented profits,” according to a report published Thursday. The excessive use of the patent system — by drugmakers Bristol-Myers Squibb, AbbVie, Regeneron and Bayer — keeps the prices of the medications at exorbitant levels, often at the expense of American consumers, according to the report from the Initiative for Medicines, Access & Knowledge, or I-MAK, a nonprofit organization that advocates drug patent reform. ... The U.S. patent system is meant to reward innovation by permitting drug companies to sell new medications on the market and barring other manufacturers from making generic versions for a set period of time — usually 20 years. Once the patent expires, generics are allowed on the market, often at a lower list price than the brand-name drug. But drugmakers often extend their patents by making small tweaks to the drugs, sustaining their monopolies for several years. Legal experts refer to this tactic as “evergreening...”

Health care spending for mental health disorders increases between 2013 and 2020 -

  • Overall spending on mental health services increased from 6.8% to 8.2% between 2013 and 2020, according to a new study published by the Employee Benefit Research Institute (EBRI).
  • The percentage of the population under the age of 65 with employment-based health coverage diagnosed with a mental health disorder increased from 14.2% in 2013 to 18.5% in 2020.
  • Among enrollees with a mental health diagnosis, average annual spending on mental health care services increased from $1,987 to $2,380 between 2013 and 2020 — an average of 3% per year.

Physician Burnout Has Reached Distressing Levels, New Research Finds - "Results released this month and published in Mayo Clinic Proceedings, a peer-reviewed journal, show that 63 percent of physicians surveyed reported at least one symptom of burnout at the end of 2021 and the beginning of 2022, an increase from 44 percent in 2017 and 46 percent in 2011. Only 30 percent felt satisfied with their work-life balance, compared with 43 percent five years earlier."

The perks that work to retain employees now - "Among employed adults, 56% say that the work schedule attracts them most in their current role ­— a factor valued more by women (61%) than men (51%). Almost half of the workers surveyed say that colleagues (48%), fair pay (46%), and work-life balance (43%) are most appealing, with 34% also appreciating their health benefits. In fact, 58% of Gen Z are attracted to their job because of colleagues and work friends, while men (52%) are more likely than women (39%) to be drawn to their job because they are paid fairly."

Health and Wellness

Antidepressants Work Better Than Sugar Pills Only 15 Percent of the Time - "Five years ago Mark Horowitz seemed an unlikely skeptic of psycho-pharmaceuticals. He had been taking the popular antidepressant Lexapro virtually every day for 15 years. He was so fascinated by the drugs that he spent three years hunched over a dish of human brain cells in a laboratory at King's College London, measuring the effect of human stress hormones and drugs like Prozac and Zoloft. Then, when he tried to wean himself off the medication, he suffered panic attacks, sleep disruptions, and depression so debilitating that he had to move back to his parents' house in Australia—symptoms that he says were far worse than anything he experienced prior to going on the drugs. He went online and found thousands of others in a similar pickle. They had been unable to kick one of the psychiatric drugs known as Selective Serotonin Reuptake Inhibitors, or SSRIs, which include Lexapro, Zoloft, and Prozac, among others. Since withdrawal symptoms were thought to be mild and temporary, many of them, like him, had been told by doctors that they were experiencing a relapse of their depression. ..."

How to maintain peak brain health: Scientists say it comes down to these 3 factors - "The three identified keys to strong brain health are:

  1. Physical exercise
  2. Social activity
  3. Strong, passionate interests and hobbies

Simple, right? Let’s break down each factor a bit further. ..."

CDC no longer recommends universal masking in health facilities - "The Centers for Disease Control and Prevention no longer recommends universal masking in health care settings, unless the facilities are in areas of high COVID-19 transmission. The agency quietly issued the updates as part of an overhaul to its infection control guidance for health workers published late Friday afternoon [Sept. 23rd]. It marks a major departure from the agency’s previous recommendation for universal masking."

Being unhappy or lonely speeds up aging — even more than smoking - "Being unhappy or experiencing loneliness accelerates the aging process more than smoking, according to new research. An international team says unhappiness damages the body’s biological clock, increasing the risk for Alzheimer’s, diabetes, heart disease, and other illnesses. The team reports that they detected aging acceleration among people with a history of stroke, liver and lung diseases, smoking, and in people with a vulnerable mental state. Interestingly, feeling hopeless, unhappy, and lonely displayed a connection to increasing a patient’s biological age more than the harmful impact of smoking."

Wednesday, September 21, 2022

Reducing Employer Healthcare Costs via RBP with Armstrong and Getty

 I spent a couple of segments on the air with Joe Getty this morning discussing the very latest healthcare cost increases in and out of the exchanges, as well as how employers are fighting back by option out of the Government-Insurer-Complex madness with reference-based pricing.  


If you want to read more about reference-based pricing, I wrote about it over at Think Adviser, here.  

Tuesday, September 20, 2022

Compliance and Benefit News Updates, Sept. 20, 2022

Tools You Can Use

How Employers Should Handle MLR Rebates - The Affordable Care Act (ACA) established medical loss ratio (MLR) rules to help control health care coverage costs and ensure that enrollees receive value for their premium dollars. The MLR rules require health insurance issuers to spend 80-85% of premium dollars on medical care and health care quality improvement rather than administrative costs. Issuers that do not meet these requirements must provide rebates to consumers. Rebates must be provided by September 30 following the end of the MLR reporting year. For the 2021 reporting year, issuers are required to pay rebates by Sept. 30, 2022. Employers that expect to receive rebates should review the MLR rebate rules and decide how they will administer the rebates. For assistance with rebates, please contact your Fantastic McGriff representative.

The affordability percentage for “Pay or Play” purposes under the Affordable Care Act will be decreased for 2023 to 9.12% of household income (from 9.61% in 2022). As a result, some employers will have to contribute more heavily toward the cost of individual coverage in order to avoid penalties. 

Compliance Updates

California Set to Extend COVID-19 Supplemental Paid Sick Leave Until End of Year - California is expected to extend COVID-19 Supplemental Paid Sick Leave (SPSL) through the end of 2022, but the leave-extending bill does not require employers to provide a new bucket of leave and establishes a relief grant for small businesses and non-profits who incur costs for SPSL. 

Court Allows GINA Claims to Proceed Against Wellness Program Sponsor - A recent case should remind employer plan sponsors that the Genetic Information Nondiscrimination Act may limit the information they are allowed to request from employees as part of a wellness program.  

How A Facebook Messenger Chat Can Become a “Usual and Customary” FMLA Notice Procedure For a Company - A Fourth Circuit case highlights the importance of abiding by the company’s written absence policies and call-in procedures. "Because the terminated employee’s manager accepted previous messages regarding absences via Facebook Messenger, the Company’s position that using Facebook Messenger was not its “usual and customary” notice practice for reporting FMLA absences was called into question. The Court found that previous utilization of Facebook Messenger to communicate absences raised a question of material fact for a jury to determine if a Facebook Messenger Chat satisfied the FMLA’s notice requirements."

California Passes Bill Protecting Employees’ Off-Duty Marijuana Use - California’s legislature recently passed AB 2188, a bill that would “make it unlawful for . . . employer[s] to discriminate against a person in hiring, termination, or any term or condition of employment . . .” for cannabis use while off the job and away from the workplace. 

Benefit News

Employers Project 7.5% Rise in Health Care Costs for 2023 - "As industry experts predict that organizations should brace for increased health care costs in 2023, the International Foundation of Employee Benefit Plans launched a survey of U.S employers to identify the considerations they are contemplating for the coming year. Results show that corporate employers project a median increase of 7.5% for medical plan costs."


Healthcare Pricing Protected So Far From Inflation, BLS Data Shows - "In July 2022, overall prices grew by 8.5% from the previous year, while prices for medical care increased by only 4.8%. While that’s a reversal from the typical trend, the relatively high rate of inflation seen in the rest of the economy may eventually translate to higher prices for medical care, the analysis found. This may lead to steeper premium increases in the coming years.... Since 2000, the price of medical care, including that of services provided, insurance, drugs and medical equipment, has risen faster than prices in the overall economy. Medical prices have grown 110.3% since 2000, while prices for all consumer goods and services rose by 71% in the same period."

The FDA Is Helping Millions Of Americans Hear Better. Finally - "The FDA finalized a rule that would allow people with mild to moderate hearing loss to buy hearing aids over the counter — no prescription, no haggling with insurance, which usually does not cover the devices, and no audiologist visit. This move will also allow people to bypass complex and unnecessary state-level restrictions, which often limit who can sell hearing aids and when, inhibiting patients from shopping around for the best products and discouraging manufacturers from competing on cost and quality."

Thursday, July 14, 2022

Employer-sponsored Health Insurance Yields 47% ROI for U.S. Businesses

A new report from Avalere Health analyzing the return on investment (ROI) of employer-sponsored health insurance (ESI) estimated a 47% ROI for U.S. employers in 2022—increasing to a predicted 52% return in 2026. The report was commissioned by the U.S. Chamber of Commerce and focused on employers with 100 or more employees.  

Avalere Health analyzed various benefits of offering ESI, such as reduced direct medical costs, productivity, recruitment, retention, short- and long-term disability, and tax benefits. Consider the following analysis of key drivers and their ROI:
  • Productivity—$275.6 billion in 2022 ($346.6 billion in 2026)
  • Tax benefits—$119.2 billion in 2022 ($139.7 billion in 2026)
  • Recruitment—$141 billion in 2022 ($167 billion in 2026)
  • Reduction in direct medical costs—$101 billion in 2022 ($108 billion in 2026)
The ROI growth is attributed to various factors, including growing employment, anticipated wage increases, a projected rise in per-employee spending on wellness programs, and relatively flat employee turnover rates.
 
Share of Benefits by Component, as % of ROI

Employer Takeaway

Companies offering such insurance could anticipate receiving an average of $1.47 back in financial benefits for every dollar invested in ESI. The report also demonstrated that employers offering higher quality coverage and wages could likely expect a higher return on their ESI programs. Additionally, industries in which employers generally made more significant investments in ESI, such as wellness programs, tended to result in larger ROI. Since costs associated with turnover and recruitment are positively associated with wages, a higher ROI is expected in higher-wage industries.

Full report, here.  
 

Friday, June 24, 2022

Managers Saying Stupid Stuff in Response to an Employee’s Request for FMLA Leave

He said, what?  From Jeff Nowak at FMLA Insights

Over the course of 27 years working for the Sheriff, Sal developed a number of health conditions, including work-related post-traumatic stress disorder. Sal took quite a bit of FMLA leave over time, and as of September 2016, he already had used more than two-thirds of the 12 weeks he was allotted for FMLA. So, when he lined up to take FMLA leave yet again, the benefits manager overseeing FMLA benefits allegedly told Sal this time around:

'You’ve taken serious amounts of FMLA . . . don’t take any more FMLA. If you do so, you will be disciplined.' 

Ouch.   

As the story goes, Sal retired days later, and he did what former employees are oft inclined to do — he sued his former employer.

Cost to Bring New Drugs to Market Inflating at 20% ANUALLY

From Bob Langreth at BenefitsPro

The median launch price of a new drug in the US soared from $2,115 in 2008 to $180,007 in 2021, a 20% annual inflation rate over the period, researchers at Harvard-affiliated Brigham and Women’s Hospital in Boston found. Even after adjusting for factors such as drugmakers’ focus on expensive disease categories like cancer and estimated discounts that manufacturers give some purchasers, the annual inflation rate in launch prices over the period was still almost 11%.  

How Doctor Offices Harvest Your Personal Health Information and Circumvent HIPAA Protection

Here is a great summary of a nefarious HIPAA circumvention from Geoffrey Fowler writing at the Washington Post

The doctor will sell you now.

Your intimate health information may not be as private as you think if you don’t look carefully at the forms you sign at the doctor’s office.

There’s a burgeoning business in harvesting our patient data to target us with ultra-personalized ads. Patients who think medical information should come from a doctor — rather than a pharmaceutical marketing department — might not like that.

But the good news is, you have the right to say no. I’ll show you what to be on the lookout for.

Several Washington Post readers recently wrote to Ask Help Desk about a consent form they were asked to sign while checking in for a doctor’s appointment. Most of us just hurriedly fill out whatever paperwork is put in front of us, but these eagle-eyed readers paused at this:

'I hereby authorize my health care provider to release to Phreesia’s check-in system my health information entered during the automated check-in process … to help determine the health-related materials I will receive as part of my use of Phreesia. The health-related materials may include information and advertisements related to treatments and therapies specific to my health status.'

But Phreesia doesn’t just make money by selling its software to doctor’s offices. It also has a business in selling ads to pharmaceutical companies that it displays after you fill in your forms. And it wants to use all that information you entered — what drugs you take, what illnesses you’ve had in the past — to tailor those ads to your specific medical needs.

I can understand why pharmaceutical companies might want this. The ads remind you to ask your doctor about whatever drug they’re pushing right before you go into the exam room. With access to your data, Phreesia can ensure that its advertising messages are shown to the most receptive audience at the moment they’re seeking care....

 

Monday, June 6, 2022

Compliance and Benefit Updates, June 6, 2022

Compliance Updates

The California Supreme Court unanimously ruled that an employee’s meal and rest period "premium pay is subject to the same wage statement and final pay requirements as other wages earned by employees. 

  • Employers must pay all wages, accrued vacation earned and other premium pay immediately upon termination.
  • Employers cannot withhold final paychecks to induce employees to return tools or equipment, pay back money owed or turn in forms or reports.
  • Final paychecks or deposits must be delivered at the time of termination. Employers should be conscious of possible delays caused by delivery or deposit."

FDA: Pharmacists and wholesalers can import drugs from Canada - "Pharmacists and drug wholesalers can import prescription medicines from Canada for up to two years as part of state programs aimed at bringing down drug costs, according to final FDA guidance released Thursday.

  • Why it matters: With President Biden's drug pricing agenda still stalled, the FDA is further clarifying how states could take advantage of lower drug costs abroad without the need to limit prices in the U.S.
  • Background: Both the Biden and Trump administrations embraced limited importation to bring down health costs, though experts view the policy as having limited impact."

Newsom Signs Compromise Law Raising The Limit On Medical Malpractice Damages - "California’s $250,000 limit on damages for pain and suffering caused by medical malpractice, a ceiling enacted by lawmakers in 1975 at the insistence of doctors and insurers, will be lifted next year. Gov Gavin Newsom signed compromise legislation Monday, sponsored by consumer advocates and supported by medical groups, that will not remove all limits on malpractice damages but will raise them to account for some of the inflation in the past 47 years. Under AB35 by Assembly Majority Leader Eloise G√≥mez Reyes, D-Colton (San Bernardino County), the new limits for noneconomic damages in 2023 will be $350,000 for nonfatal medical malpractice by a physician and $500,000 for malpractice causing death. The maximum will rise gradually over the next decade, to $750,000 for non-death cases and $1 million for fatal cases, and increase by 2% a year thereafter for inflation."

Pandemic Fatigue Dooms California’s Excessive Covid Vaccine Mandate Aspirations - "In January, progressive California Democrats vowed to adopt the toughest covid vaccine requirements in the country. Their proposals would have required most Californians to get the shots to go to school or work — without allowing exemptions to get out of them. Months later, the lawmakers pulled their bills before the first votes. One major vaccine proposal survives but faces an uphill battle. It would allow children ages 12 to 17 to get a covid-19 vaccine without parental permission. At least 10 other states permit some minors to do this. Democrats blamed the failure of their vaccine mandates on the changing nature and perception of the pandemic. They said the measures became unnecessary as case rates declined earlier this year and the public became less focused on the pandemic. Besides, they argued, the state isn’t vaccinating enough children, so requiring the shots for attendance would shut too many kids out of school."

Benefit News

HR managers are more burned out than ever. Who is supporting them? "Ninety-eight percent of HR professionals have felt burned out at work in the last six months, according to a recent survey conducted by workplace communication app Workvivo, and nearly 4 in 5 are open to leaving their jobs. ... HR teams and managers should work in tandem to share and clearly outline any mental health benefits their company offers"

Will the Pandemic’s Missing Workers Ever Return to the Labor Force? "Looking at those who have exited the labor force and are not retired:

  • 23 percent said that available jobs are not in their field of work interest.
  • 17 percent said they haven't been able to find a job that pays enough.
  • 9 percent said they have chosen to learn new work skills or want to pursue a different career path.
  • 27 percent said that if their savings ran out or ran low, it would motivate them to return."


Employers Pay 224% Of Medicare Prices For Hospital Services - Employer-sponsored health plans paid on average 224% of what Medicare paid to hospitals for the same services at the same facilities, according to a new study from RAND Corporation. The report covers billing for hospital inpatient and outpatient services in 2020. The study said that there were significant variances in prices across states or geographic areas and added that the difference in cost seemed to be linked to hospital market share rather than hospitals’ share of Medicare and Medicaid patients.

  • The researchers found that in Hawaii, Arkansas, and Washington, relative prices were under 175% of Medicare.
  • Other in states, such as Florida, West Virginia, and South Carolina, relative prices were at or above 310% of Medicare.
  • Prices for COVID-19 hospitalization were similar to prices for overall inpatient admissions and averaged 241% of what was paid for Medicare patients.

Note from Craig: This is why I wrote that "America Will Dramatically Change the Way It Provides Health Care by 2030." This trend cannot continue. The federal government controls prices by arbitrarily slashing what it will pay for services in Medicare and Medicaid. This forces hospitals to inflate what they charge for all services to private employer plans. Hence, the tax subsidy is really a cost shift to employers that far exceeds anything any of us pay in FICA. In short:

  1. Companies that are large enough (over 300 employees) will self-fund and reference base price their plans. Why pay 224% of Medicare when you can pay 140% and have 97% of your claims sail through without pushback. This saves an employer 20% to 30% on healthcare in the first year alone.
  2. Smaller companies will be forced into some sort of defined contribution scheme where the employee is punished for the year over year 6% to 9% increases. Perhaps, as I wrote in the above article this will be done mainly through individual HRAs.
  3. Lastly, I believe we'll end up with some sort of Medicaid (not Medicare, that is too expensive) safety net for all who are not fortunate enough to end up in numbers one or two above.

Ninth Circuit Rules That a Temporary Impairment Can Qualify as a “Disability” Under the ADA - "The U.S. Court of Appeals for the Ninth Circuit, the federal appellate court with jurisdiction over much of the western United States (including Washington, Oregon, California and Idaho), ruled last week that an employee’s temporary impairment can qualify as a disability under the Americans with Disabilities Act (“ADA”). The Ninth Circuit’s decision resolves an important question under federal disability law and could signal a significant change in how employers are required to address employees’ short-term medical limitations.


In Shields v. Credit One Bank N.A., plaintiff Shields was employed by Credit One Bank ('Bank') as a human resources generalist. Shields underwent biopsy surgery. The biopsy revealed that Shields did not have cancer, but she had a number of post-surgery limitations (e.g., unable to use her right arm to lift, pull, push, type, write, tie her own shoes or use a hair dryer), and these limitations indisputably precluded Shields from performing the essential functions of her position. The Bank put Shields on a short-term leave of absence, but when she was not ready to return to work after two months the Bank terminated her employment. Shields’ lawsuit alleges the Bank violated the ADA by terminating her rather than offering her a reasonable accommodation, specifically, extending her leave of absence to allow her additional recuperation time. The Bank defended on the grounds that Shields did not have a disability under the ADA because her post-surgery limitations, while significant, were not sufficiently 'permanent or long-term' to meet the law’s requirements. The District Court agreed and dismissed Shields’ claim. The Ninth Circuit reversed. Under the ADA, a disability is defined in relevant part as 'a physical or mental impairment that substantially limits one or more major life activities,' without any reference to how long the 'substantial[] limit[]' might last."

Health & Wellness

The caregiver crisis: How employers can support workers in this new reality - "America faces a caregiving crisis. Whether it’s caring for an aging parent, a sick spouse or a child, more than 50 million Americans are unpaid caregivers for family members and loved ones. Tens of millions of those caregivers are also balancing work with caregiving responsibilities. And while caregiving is a rewarding experience, recent data show that 71% of family caregivers with full-time jobs suffer from mental health challenges and more than half of caregivers say they are too burned out to do their job well. It’s no wonder so many family caregivers are thinking about leaving their jobs."

Half-cup of blueberries a day could keep dementia away, scientists say - "An apple a day may keep the doctor away, but a new study finds blueberries may be better for your brain. Researchers from the University of Cincinnati have found that a half-cup of blueberries can keep middle-aged adults from developing dementia as they get older. Moreover, the study finds adding the fruit to your diet lowers insulin levels and improves metabolic function — making it easier to burn fat for energy."


Friday, May 6, 2022

Compliance and Benefit News Updates, May 6, 2022

 Compliance Updates

IRS Information Letter Explains Requirements for Expenses to Qualify as Medical Care - “The IRS has released an information letter regarding the requirements for expenses to qualify as medical care under Code § 213. The letter responds to a request for guidance on when the cost of health and wellness coaching is medical care that can be reimbursed under health FSAs, HSAs, and other tax-favored accounts.”

Work From Home – SOS! Post-Pandemic Legal Hazards - “A Gallup poll last fall indicated that 61 percent of workers expect to work remotely at least part of the time in the future, and just 9 percent expect to work from home only minimally or not at all. With that in mind, employers and HR professionals must consider how to properly navigate the legal hazards stemming from our new normal. The following provides some key considerations in successfully managing a remote workforce.”

Cal/OSHA Approves Third Revised ETS and Clarifies Position on Some Lingering Questions - “California’s Division of Occupational Safety and Health (Cal/OSHA or “the Division”) Standards Board met on April 21, 2022, and formally approved the third readoption of its COVID-19 Emergency Temporary Standard (“3rd Revised ETS”)… Under Governor Newsom’s previous executive order that paved the way this readoption, the 3rd Revised ETS will become effective when the Office of Administrative Law completes its review and files it with the secretary of state, which is anticipated to occur before the end of the first week of May 2022, and will remain in effect through December 31, 2022.”

Which Federal Employment Laws Apply to My Company - There are a number of different federal employment laws that have their own rules for covered employers. Employers should be aware of the federal employment laws that may apply to their company. An employer’s size, or the number of employees, is a key factor in determining which federal employment laws the employer must comply with. Some federal laws, such as the Equal Pay Act (EPA), apply to all employers, regardless of size. However, other laws, such as the Family and Medical Leave Act (FMLA), only apply to employers that reach a certain employee count. Also, some federal laws, such as COBRA, include exclusions for certain types of employers (for example, churches). This Compliance Overview provides a high-level overview of key federal employment laws and explains which employers they apply to. Most states also have their own labor and employment laws. This summary does not address state labor laws, and it also does not address additional compliance requirements for companies that contract with the federal government or businesses in specific industries.


Benefit News

U.S. Hospitals Struggle to Absorb Pandemic-Era Rising Costs - "Labor costs per patient jumped by 19% in 2021 from 2019, and supplies rose by over 20% per patient during that period, according to the report. Nursing expenses shifted heavily toward travel nurses. The travelers’ share of nursing budgets rose to 39% in 2022 from 5% in 2019."

Spending on U.S. Medicines Rose 12% in 2021 Due to COVID-19 Vaccines and Therapies, Says IQVIA Institute for Human Data Science - Spending on medicines in the United States, at estimated net manufacturer prices, reached $407 billion in 2021, up 12% over 2020, as COVID-19 vaccines and therapeutics became widely available and added $29 billion in related spending. That’s according to a new U.S. Medicines Trends 2022 Report, released today by the IQVIA Institute for Human Data Science. In the same year, the non-COVID medicines market grew more slowly, at 5%, from the growing impact of biosimilars, which increased significantly, offsetting increased use of branded medicines.

HSA/HDHP limits for 2023 - HSA annual contribution limits for individual and family coverage will be $3,850 and $7,750, respectively. The HDHP minimum deductible for individual coverage will increase to $1,500, and $3,000 for family coverage. HDHP out-of-pocket maximum expense limits will be capped at $7,500 for individual coverage and $15,000 for family coverage.

Wednesday, April 13, 2022

Year Over Year Food Price Inflation

Here are the prices increases in various food categories that make up the Consumer Price Index report.

Chart
SOURCE U.S. Bureau of Labor Statistics as reported by the Detroit Free Press

Thursday, April 7, 2022

Obamacare's Twelfth Birthday, How It's Going with Armstrong and Getty

Spent a couple segments on the Armstrong and Gettys show this morning discussing Obamacare's accomplishments after twelve years. 

 

Here are my show notes for those who want to read more on the topic.  

Thursday, March 24, 2022

A Litany of COVID Vaccination, Abortion and Gun Legislation Proposed in California

Over the next few weeks, California's legislature will be voting on a myriad of newly proposed laws impacting healthcare, individual rights, and employer responsibility.  Here is a brief summary of some of them:  

From CalMatters:  

Taken together, the adoption of these bills would make California an outlier among states — and give it the country’s strictest COVID-19 regulations. Other states are considering various mandates and legislation related to COVID-19, but none appear to have the coordination of this effort, steered by some of the most powerful legislators in Sacramento.

“These bills all attempt to bring cohesion, consistency and clarity to our overall approach and response to the pandemic,” said Democratic Sen. Josh Newman of Fullerton, a member of the group.

The bills:
    • SB 871 would require all children 0 to 17 to get the COVID-19 vaccine to attend child care or school;
    • SB 866 would allow kids 12 to 17 to get the COVID-19 vaccine without parental consent;
    • SB 1479 would require schools to continue testing and to create testing plans;
    • SB 1018 would require online platforms to be more transparent about how information is pushed out to consumers;
    • SB 1464 would force law enforcement officials to enforce public health orders;
    • AB 1993 would require all employees, including independent contractors, to show proof of COVID-19 vaccine to work in California - defeated on March 29th;
    • AB 1797 would make changes to the California Immunization Record Database;
    • AB 2098 would reclassify the sharing of COVID-19 “misinformation” by doctors and surgeons as unprofessional conduct that would result in disciplinary action.  
Critics said the bills infringe on the health privacy of children, interfere with how doctors work, impose a burden on businesses and workers, and rely on vaccines that do not in many cases prevent the transmission of COVID-19.

Other legislation on tap in the Golden State:  

  • AB 1594 encourages California residents to sue gun makers, distributors of ghost guns, and "assault weapons" if they fail to "enforce reasonable controls, ... and take reasonable precautions to ensure that the [gun manufacturer] does not sell, distribute, or provide a firearm-related product to a downstream distributor or retailer of firearm-related products who fails to establish, implement, and enforce reasonable controls.  The bill would also prohibit a firearm industry member from manufacturing, marketing, importing, offering for wholesale, or offering for retail sale a firearm-related product that is likely to create a substantial and unreasonable risk of harm to public health and safety." 
  • Another bill proposed by Assembly Member Scott Wiener of San Francisco, "would render unenforceable in California any out-of-state court judgments seeking to remove children from their parents’ custody because they have received gender-affirming surgeries, hormone therapy, and other transgender medical care." 
  • Under SB 1142, taxpayer funds could be spent to help low-income California residents obtain abortions.  More significantly, the fund would be available to help out-of-state residents get abortions as well.  The legislation proposes, " the commission shall not require the submission of any identifying personal information about individuals receiving practical support services as part of an application for a grant [for an aborition] or reporting of expenditures and activities using grant [abortion] funds under this article." 

  • In order to "make capitalism more sustainable and humane," U.S. House Representative Mark Takano (CA) has proposed legislation that would reduce the standard workweek from 40 hours to 32 hours.