Amy Gordon

Amy Gordon

McDermott Will & Emery

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Extension for Good-Faith Reporting and 2016 Forms 1095-C and 1094-C

On November 18, 2016, the Internal Revenue Service issued Notice 2016-70, extending both the due date for furnishing individuals with Forms 1095-C and 1095-B, in addition to certain good-faith transition relief to the 2016...more

11/22/2016 - Affordable Care Act Form 1094 Form 1095 Good Faith Internal Revenue Code (IRC) IRS Minimum Essential Coverage Reporting Requirements Section 6055 Section 6056 Time Extensions

IRS Adjusted ACA Fee Amounts for the 2017 Policy or Plan Years

The Patient-Centered Outcomes Research Institute (PCORI) fee was established under the Affordable Care Act (ACA) to advance comparative clinical effectiveness research. The PCORI fee is assessed on issuers of health insurance...more

11/21/2016 - Affordable Care Act Fees Healthcare HHS IRS PCORI Reinsurance

Affordable Care Act Whistleblower Complaint Procedures

On October 11, 2016, the Occupational Safety and Health Administration published a final rule that establishes procedures and time frames for handling whistleblower complaints under the Affordable Care Act (ACA); for hearings...more

10/17/2016 - Affordable Care Act ALJ Anti-Retaliation Provisions DOL Employment Policies Final Rules Health Insurance Hiring & Firing Interim Final Rules (IFR) Judicial Review OSHA Over-Time Retaliation Title I Wage and Hour Whistleblowers

Score on Wellness Lawsuits—Wellness Plans 3, EEOC 0?

On September 19, 2017, in the ongoing lawsuit the US Equal Employment Opportunity Commission (EEOC) brought against Orion Energy Systems Inc. (Orion) regarding its wellness program, a Wisconsin federal judge found that...more

9/28/2016 - EEOC Health and Welfare Plans Orion Energy Wellness Programs

Michigan Health Insurance Claims Assessment Act is Not Preempted by ERISA

The Sixth Circuit, has decided, on remand from the Supreme Court, that the Michigan Health Insurance Claims Assessment Act (Act) is not preempted by ERISA. The Act imposes a 1 percent tax on all paid claims by insurers or...more

8/24/2016 - Assessment ERISA Gobeille v Liberty Mutual Insurance Com. Income Taxes Remand SCOTUS Self-Insured Health Plans TPAs

Affordable Care Act Compliance: IRS Releases Draft 2016 Employer Reporting Forms and Instructions

The Internal Revenue Service recently issued revised draft Forms 1094-C and 1095-C and related instructions for use for the 2016 reporting year. ...more

8/20/2016 - Affordable Care Act Applicable Large Employers (ALE) Employer Group Health Plans Form 1094 Form 1095 IRS Reporting Requirements Self-Insured Health Plans

Guidance on Ransomware Attacks under HIPAA and State Data Breach Notification Laws

The US Department of Health and Human Services (HHS) has recently issued guidance under the Health Insurance Portability and Accountability Act (HIPAA) on what covered entities and business associates can do to prevent and...more

8/8/2016 - Breach Notification Rule Business Associates Covered Entities Cybersecurity Data Breach Data Security HHS HIPAA New Guidance PHI Ransomware Software

Responding to Marketplace Notices

Employers have begun to receive notices from the Health Insurance Marketplace Exchanges (Marketplace) notifying them that one or more of their employees is eligible for governmental subsidies under the Marketplace. Employers...more

8/4/2016 - Affordable Care Act Appeals Employer Liability Issues Full-Time Employees Health Insurance Exchanges Penalties Public Health Insurance Marketplace Shared Responsibility Rule Subsidies

New Mental Health Parity and Addiction Equity Act Guidance from the DOL

In Depth - The US Department of Labor (DOL) has provided guidance on health plan provisions that could trigger a violation of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008...more

6/14/2016 - DOL Employer Group Health Plans Health Care Providers Health Care Violations Mental Health Mental Health Parity Rule MHPAEA Notice Requirements Physicians

EEOC Releases Final Wellness Program Regulations Related to the Genetic Information Nondiscrimination Act and the Americans with...

In Depth - The US Equal Employment Opportunity Commission (EEOC) recently released final wellness plan regulations providing guidance on how employer wellness programs may comply with Title I of the Americans with...more

6/3/2016 - ADA Affordable Care Act Disability Discrimination EEOC Employer Group Health Plans GINA HIPAA Incentives Wellness Programs

HHS Issues Final ACA Nondiscrimination in Health Programs and Activities Regulation

In Depth - On Friday, May 13, 2016, the US Department of Health and Human Services (HHS) Office for Civil Rights (OCR) finalized regulations that provide explicit protections from discrimination on the basis of gender...more

5/26/2016 - Affordable Care Act Covered Entities Employer Group Health Plans Gender Identity Health Insurance HHS Non-Discrimination Rules OCR Religious Exemption Section 1557 TPAs Transgender

New FAQs Address Implementation of the Affordable Care Act, Mental Health Parity and Addiction Equity Act, and the Women’s Health...

In Depth - The US Departments of Labor (DOL), Health and Human Services (HHS) and Treasury (collectively, the Departments) published frequently asked questions (FAQs) on April 20, 2016, clarifying the implementation of...more

5/7/2016 - Affordable Care Act Clinical Trials Cost-Sharing DOL Employer Group Health Plans HHS Mental Health Parity Rule MHPAEA Popular Rescission U.S. Treasury

IRS Announces Limits for Health Savings Accounts and High-Deductible Health Plans for 2017

In Depth - Recently the Internal Revenue Service (IRS) announced (see Revenue Procedure 2016-28) cost-of-living adjustments to the applicable dollar limits for health savings accounts (HSAs) and high-deductible health...more

5/3/2016 - Benefit Plan Sponsors Cost-of-Living Adjustment (COLA) Deductibles HDHP Health Savings Accounts IRS

Recent Government-Issued FAQs Clarify ACA Employer Mandate, Market Reforms

Notice 2015-87 (the Notice) provides recent government guidance on the Affordable Care Act (ACA) employer mandate and market reforms. The Notice contains 26 frequently asked questions (FAQs) from the Internal Revenue Service...more

4/2/2016 - Affordable Care Act COBRA DOL Employer Mandates Flexible Spending Accounts HHS HRA IRS Popular Public Health Insurance Marketplace

Flambeau Inc. Wellness Program Testing Falls Within ADA Safe Harbor

On December 30, 2015, a federal judge in the Western District of Wisconsin ruled in favor of Flambeau, Inc. (Flambeau) and against the Equal Employment Opportunity Commission (EEOC) in holding that Flambeau’s medical exams as...more

1/8/2016 - ADA EEOC Employer Group Health Plans Medical Examinations Safe Harbors Wellness Programs

Final Regulations on Affordable Care Act Market Reforms

Throughout 2010, the U.S. Departments of Health and Human Services, Labor and the Treasury (collectively, the Departments) issued interim final regulations (IFR) implementing ACA market reforms applicable to grandfathered...more

12/23/2015 - Affordable Care Act Claims Appeal Procedures Dependent Coverage Grandfathered Obligations Lifetime Limits Preexisting Conditions Rescission

New Transit Benefit Requirements for D.C. and New York Employers Effective January 1, 2016

Two new laws require employers in Washington, D.C. (D.C.) and New York City (NYC) to offer pre-tax transit benefits, effective on January 1, 2016. Employers with employees in these cities must take action quickly to ensure...more

12/11/2015 - Employee Rights Fringe Benefits Full-Time Employees Local Ordinance Proposed Regulation Transit Benefits

DOL’s New Disability Claim Rules Add to a Plan Administrator’s Duties under Welfare and Retirement Benefit Plans

Now, faced with an aging baby-boomer generation and increased costs related to disability litigation, the U.S. Department of Labor’s Employee Benefit Security Administration (DOL) has proposed new rules that would revise and...more

12/1/2015 - Corporate Counsel Disability Benefits DOL ERISA Plan Administrators Proposed Regulation Retirement Plan

EEOC to Clarify and Expand Wellness Program Incentives Related to the Genetic Information Nondiscrimination Act

On October, 30, 2015, the Equal Employment Opportunity Commission (EEOC) issued a proposed rule that would amend regulations implementing Title II of the Genetic Information Nondiscrimination Act of 2008 (GINA), as they...more

11/10/2015 - Comment Period EEOC GINA Incentives Proposed Regulation Wellness Programs

Automatic Enrollment for Health Plans Has Been Repealed

Budget legislation signed into law by President Barack Obama on November 2, 2015, the Bipartisan Budget Act of 2015, repeals the controversial automatic enrollment provision under the Affordable Care Act (ACA). Section 18A of...more

11/3/2015 - Affordable Care Act Automatic Enrollment Barack Obama Employer Group Health Plans Employer Liability Issues Federal Budget FLSA Health Insurance New Legislation Pensions Popular Premiums

IRS Adjusted ACA Fee Amounts for the 2015/2016 Policy or Plan Years and Additional Payment Options

The Patient-Centered Outcomes Research Institute (PCORI) fee was established under the Affordable Care Act (ACA) to advance comparative clinical effectiveness research. The PCORI fee is assessed on issuers of health insurance...more

10/22/2015 - Affordable Care Act Fees Filing Deadlines Health Insurance HHS Insurance Industry Medical Research PCORI Public Health Insurance Marketplace Self-Insured Health Plans Third-Party Transitional Reinsurance Program

Further Guidance on the ACA’s Cadillac Tax

The Affordable Care Act (ACA) added Code Section 4980I to the Internal Revenue Code. Effective for tax years beginning on or after January 1, 2018, an excise tax of 40 percent will be imposed on the cost of employer-sponsored...more

9/30/2015 - Affordable Care Act Cadillac Tax Comment Period Employer Group Health Plans Excise Tax Health Insurance Health Savings Accounts IRS Multiemployer Plan New Guidance Plan Administrators

Affordable Care Act Reporting Penalties Significantly Increased

On June 29, 2015, President Barack Obama signed the Trade Preferences Extension Act (the Act) into law. In addition to containing several revenue offsets, the Act significantly increased penalties for incorrect information...more

7/24/2015 - 1099s Affordable Care Act Corporate Counsel Employer Liability Issues Good Faith IRS Popular Reporting Requirements Section 6722 Tax Penalties Trade Preferences Extension Act (TPEA) W-2

Supreme Court Rejects Latest Challenge to Affordable Care Act: What Are Employers' Obligations Going Forward?

On June 25, 2015, the Supreme Court of the United States upheld one of the main pillars of the Affordable Care Act (ACA): the tax credits that allow millions of Americans to afford health care insurance on the public...more

6/29/2015 - Affordable Care Act Corporate Counsel Employer Group Health Plans Employer Mandates Health Insurance Health Insurance Exchanges King v Burwell Public Health Insurance Marketplace State Health Insurance Exchanges Subsidies Tax Credits

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