On July 28, 2022, the federal regulators (referred to as the “Departments”) released a new set of FAQs (Part 54) under the Affordable Care Act (“ACA”) to clarify the scope of the preventive care mandate, in particular, with...more
On November 22, 2021, the IRS released a draft version of proposed regulations that have been submitted for publication to the Federal Register (but not yet formally published) which would permanently extend the annual...more
The Supreme Court released its opinion today in a highly anticipated third challenge to President Obama’s signature health care law, the Patient Protection and Affordable Care Act (“ACA”).
The 7-2 majority opinion,...more
The Internal Revenue Service (IRS) released Notice 2020-76 on October 2, 2020, announcing a delay in the deadline for distribution of Forms 1095-B and Forms 1095-C to participants by employers, health insurers and other...more
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Today the Internal Revenue Service issued guidance and transitional rules regarding the Patient-Centered Outcomes Research (“PCOR”) fee for plan years ending on or after October 1, 2019 and before October 1, 2020...more
The Internal Revenue Service (IRS)’s Office of Chief Counsel recently issued a memorandum (the “CCM”) announcing that the Employer Shared Responsibility Payment (“Employer Penalty”) under Code Section 4980H is effectively not...more
The Supreme Court announced yesterday that it would grant certiorari with respect to two petitions relating to a challenge to the constitutionality of the Affordable Care Act....more
Yesterday, language to eliminate the Cadillac and other ACA taxes was included in must pass spending legislation. The Consolidated Spending Bill is set to be voted on by the House and Senate and signed by the President by...more
In ACA FAQ Part 40, HHS, IRS and DOL (the "Departments") delayed the implementation of the controversial rule in HHS 2020 Notice of Benefit and Payment Parameters requiring health plans to credit to the out-of-pocket maximum...more
In our last blog past, we discussed the recent rule finalized by Health and Human Services regarding the calculation of the annual cost-sharing limits for health plan participants who receive financial assistance from drug...more
The Notice of Benefit and Payment Parameters for 2020 released by the Department of Health and Human Services (HHS) finalizes a proposed rule regarding the calculation of the annual cost-sharing limits for health plan...more
Health Reimbursement Accounts (HRAs) are employer funded, account-based health plans which, by design, reimburse up to a fixed dollar amount of medical expenses. The Affordable Care Act (ACA) has severely limited their use...more
The Department of Labor has issued a final rule that adopts a new regulation at 29 CFR 2510.3-5 that will allow an expansion of Association Health Plans (AHPs) by revising the definition of who can qualify as an “employer”...more
The stopgap funding bill passed by Congress and signed by President Trump yesterday keeps the government open for another three weeks. It also funds the Children’s Health Insurance Program (“CHIP”) for the next six years....more
A newly issued proposed rule significantly relaxes the Department of Labor requirements that currently limit the availability of association health plans (AHPs) and if finalized in its currently form will profoundly affect...more
Substantial new guidance has been issued on QSEHRAs, the new type of health reimbursement arrangement described in Code Section 9831(d) that is exempt from ERISA’s requirements that apply to group health plans. If an employee...more
On December 19, 2016, the DOL issued final regulations modifying the claims procedures for adverse determinations relating to disability claims under ERISA. Most of the changes mirror the additional disclosure requirements...more
The new SBC templates released last year are required for open enrollment periods beginning on and after April 1, 2017. For health plans and employers with calendar year plans, this means the updated SBC templates and...more
Unless you recently were stranded on an uninhabited island, or do not own a mobile phone, computer or television, you likely have not heard that the House released the Affordable Care Act repeal and replace bill. This new...more
This afternoon the Internal Revenue Service issued IRS Notice 2016-70 extending the distribution due date for ACA reporting purposes. Specifically, the notice extends by 30 days the due date for distributing the 2016 Form...more
Unlike the forms for the 2015 calendar year, the 2016 Forms 1095-C must be provided to employees by January 31 and must be submitted to the IRS electronically by March 31 (for those with under 250 forms submitting on paper,...more
Newly proposed IRS regulations seek to clarify certain aspects of reporting of minimum essential coverage by employers and issuers under Code Section 6055. Here, we focus on proposals that impact employer reporting (Part III...more
If adopted, the changes would be effective for plan years beginning on or after January 1, 2019. The revisions affecting pension plans, and details regarding changes to Schedules H and I that affect funded plans (such as...more
Newly proposed regulations address the application of the Affordable Care Act to expatriate health plans (whether insured or self-insured), travel insurance and certain other excepted benefits, effective for plan years...more
Earlier this week, the Southern District of New York denied a motion to dismiss a case against Dave & Buster’s, Inc. – a development that is sure to concern many employers around the country. This case, Marin v. Dave &...more