Roundup of selected state health developments, third-quarter 2023 

November 15, 2023

More than a dozen jurisdictions focused on leave issues during the third quarter of 2023, with Maine becoming the latest state to mandate paid family and medical leave (PFML). Several states announced 2024 PFML rates. Illinois, New Jersey and Puerto Rico passed laws affecting pharmacy benefit managers (PBMs) and prescription drugs. States passing health insurance coverage mandates included California, Illinois, New Jersey and Oregon. Court decisions affected an Oklahoma PBM law and a Puerto Rico paid leave law. A new commuter benefit mandate will apply to many Chicago-area employers next year. San Francisco and Seattle announced 2024 rates for each jurisdiction’s health coverage mandates.

Download the 17-page print-friendly PDF to read details on changes in states and other jurisdictions. Here is an overview of the topics covered.

Maine became the 13th state (plus Puerto Rico and Washington, DC) to require paid leave for an employee’s own serious health condition or disability. Alabama passed a voluntary family leave insurance (FLI) law. Colorado, Delaware and Oregon finalized PFML regulations. Maryland, Massachusetts, New Jersey, New York and Washington have announced 2024 PFML rates.

California increased — and New York City clarified — paid sick leave (PSL) benefits. New Illinois laws address bereavement and organ donation leaves. A federal appellate court halted changes to Puerto Rico’s paid leave law. Massachusetts guidance clarifies differences between the Parental Leave Act and the PFML program. Bloomington, MN, revised last year’s earned sick and safe time (ESST) ordinance, aligning the city’s requirements with a similar state law (2023 Ch. 53, SF 3035) enacted earlier this year; see Minnesota adopts paid sick and safe leave requirement, Sept. 27, 2023.

Rx costs and PBMs continue to be a focus on legislative, judicial and regulatory fronts. Illinois and New Jersey each passed three Rx/PBM laws. An appellate court cited ERISA preemption as the reason for striking down several provisions of a 2019 Oklahoma PBM law A Puerto Rico law requires third-party financial assistance to apply to a fully insured plan’s cost sharing.

California expanded behavioral health coverage and will require dental coverage disclosures. Maine capped insurance reimbursement of ambulance services. An Illinois law broadens off-label use of some medications. Massachusetts has published its 2024 minimum creditable coverage (MCC) rates. A new Oregon law applies gender-affirming care and reproductive healthcare protections to fully insured plans. Washington, DC, added an infertility coverage mandate. A New Hampshire case against a Tennessee insurer upheld the extraterritorial reach of the state’s insurance laws. New Jersey regulations establish parity rules for abortions and related drugs covered by fully insured plans. Colorado’s COVID-19 vaccine coverage mandate expired.

Temporary employees in Illinois are now entitled to pay and benefit parity with comparable employees at client companies. Many Chicago-area employers will soon have to offer commuter benefits. San Francisco and Seattle have posted 2024 benefit rates under each jurisdiction’s health benefit mandates. A California law broadens the scope of confidential medical information protections. A Missouri law expands the use of telehealth.

• Transportation plans offer valued benefits but pose compliance issues (Nov. 14, 2023)
• Minnesota adopts paid sick­­­­ and safe leave requirement (Sept. 27, 2023)
• Massachusetts sets 2024 individual-mandate coverage dollar limits (Sept. 18, 2023)
• Maine paid family and medical leave overview (Sept. 12, 2023)
• Maine law requires paid family and medical leave (Sept. 11, 2023)
• San Francisco posts 2024 Health Care Expenditure rates (Aug. 25, 2023)
• Maryland paid family and medical leave overview (July 25, 2023)
• Maryland revises paid family and medical leave (May 25, 2023)
• Roundup of selected state health developments, first-quarter 2023 (May 19, 2023)
• Is ERISA preemption at risk of being preempted? (Feb. 23, 2023)
• Roundup of selected state health developments, fourth-quarter 2022 (Feb. 17, 2023)
• 2023 state paid family and medical leave contributions and benefits (Feb. 1, 2023)
• Roundup of selected state health developments, third-quarter 2022 (Nov. 4, 2022)
• Roundup of selected state health developments, second-quarter 2022 (Aug. 22, 2022)
• Delaware enacts paid family and medical leave law (July 7, 2022)
• Oregon’s paid family and medical leave contributions delayed to 2023 (Aug. 5, 2021)
• Massachusetts readies for paid family and medical leave (Jan. 13, 2020)
• New Jersey updates, expands family and disability benefits (March 26, 2019)

• Life, absence and disability benefits
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