Amy Gordon

Amy Gordon

McDermott Will & Emery

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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

Agencies Clarify Cost-Sharing Limits Under the Affordable Care Act

The U.S. Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (collectively, the Departments) have issued a set of Frequently Asked Questions (FAQs) clarifying the limitations on cost sharing under...more

6/11/2015 - Affordable Care Act Cost-Sharing DOL Employer Group Health Plans Health Insurance Health Insurance Exchanges HHS Public Health Insurance Marketplace

IRS Issues Q&As on Information Reporting under Code Section 6055 and 6056

Thursday, the U.S. Internal Revenue Service issued new Questions & Answers regarding the Affordable Care Act’s reporting rules under Code Section 6055 and 6056. The categories under the guidance include: Basics of the...more

5/26/2015 - Affordable Care Act Employer Mandates IRS Reporting Requirements

EEOC Issues Guidance on Employer Provided Wellness Programs

The Equal Employment Opportunity Commission (EEOC) has released long-awaited proposed guidance (the proposed rule) relating to employer wellness programs. The proposed rule amends regulations implementing Title I of the...more

4/22/2015 - ADA Affordable Care Act DOL EEOC GINA Health Insurance Healthcare Proposed Regulation Wellness Programs

Employers with Group Health Plans: Have You Notified State Regulators of the Breach?

Data security breaches affecting large segments of the U.S. population continue to dominate the news. Over the past few years, there has been considerable confusion among employers with group health plans regarding the...more

2/20/2015 - Breach Notification Rule Covered Entities Cybersecurity Data Breach Data Breach Plans Data Protection Employer Group Health Plans ERISA HIPAA Third-Party Service Provider

IRS Publishes Final Forms and Instructions on Information Reporting Under the Affordable Care Act

The Internal Revenue Service (IRS) published final forms and instructions addressing information reporting requirements applicable to employers and insurers under Internal Revenue Code Sections 6055 and 6056. The reporting...more

2/13/2015 - Affordable Care Act Employer Group Health Plans Employer Mandates Health Insurance Insurance Industry IRS Minimum Essential Coverage Reporting Requirements Self-Insured Health Plans

Changes to IRS Form for Qualified Adoption Expenses

The Internal Revenue Service (IRS) has released the 2014 version of Form 8839 (Qualified Adoption Expenses), as well as updated instructions. Taxpayers use Form 8839 to claim the adoption credit, an exclusion for...more

1/20/2015 - Adoption IRS

Upcoming Health and Welfare Plan Requirements Checklist for Employers #2

As 2014 draws to a close, employers should turn their attention to several upcoming compliance obligations for the health and welfare benefit plans they sponsor. Below is a list of upcoming health and welfare compliance...more

12/18/2014

View From McDermott: A New Type of ERISA-Based Hold-Up—The Rise of Out-of-Network Provider Suits Against Self-Funded Health Care...

Over the past decade, there has been a significant increase in the number of physicians who have dropped out of Preferred Provider Organization (‘‘PPO’’) and Health Maintenance Organization (‘‘HMO’’) networks and attempted to...more

12/4/2014 - ERISA Health Insurance HMOs Physicians PPOs Self-Funded Health Plans

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