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An Interesting Intersection: No Surprises Act Claims and the New Fee Disclosure Requirements for Group Health Plans

As reported in our January 7, 2022 SW Benefits Blog “The DOL Asks and Answers Questions About the New Welfare Plan Fee Disclosure Rules,” group health plans must now comply with the ERISA Section 408(b)(2) disclosure...more

Free COVID-19 Vaccine and Testing Update

On November 30, Moderna announced that it is seeking FDA authorization for its COVID-19 vaccine.  In addition, on November 17 the FDA issued an emergency use authorization for the first COVID-19 diagnostic test for...more

Congress Giveth and They Taketh Away — Recent Health Plan Changes

In enacting the Further Consolidated Appropriations Act, 2020, (the “Act”), Congress, among other changes, enacted the following key changes affecting employer group health plans...more

Preventive Care Can Now Be Covered for Specified Chronic Conditions Before HDHP Deductible

On July 17, 2019 the IRS released Notice 2019-45 resolving a preventive care problem that has been plaguing many high deductible health plans (“HDHPs.”). The Affordable Care Act’s free preventive care mandate appears to be...more

Texas Judge Declares the Affordable Care Act Unconstitutional – What’s Next?

As reported in our “2018 End of Year Plan Sponsor “To Do” List (Part 1) Health & Welfare,” the Tax Cuts and Jobs Act repealed the individual mandate, which spawned a lawsuit challenging the whole of the Affordable Care Act...more

Zombie Benefits – Are Health Reimbursements Arrangements (“HRAs”) Back From the Dead?

The Affordable Care Act (“ACA”) has not been kind to health reimbursement arrangements (“HRAs”). Many employers got rid of HRAs, or integrated them with a major medical plan, in order to avoid significant penalties under the...more

Congress Kicks the Can Down the Road Again – Cadillac Tax On High Cost Employer Health Coverage Delayed to 2022

Section 4980I, which was added to the Internal Revenue Code by the Affordable Care Act, was originally supposed to take effect in 2018. This tax is commonly called the “Cadillac tax” because it imposes a 40% excise tax on...more

Why Isn’t My “Free” Preventive Health Care Free?

In my opinion, one of the best changes made by the Affordable Care Act is the mandate that requires health plans to provide certain specified preventive services without imposing any cost sharing. This is sometimes referred...more

If You Blinked You Might Have Missed Important Affordable Care Act Guidance

Notice 2015-87 issued by the IRS on December 16, 2015, provides guidance on numerous Affordable Care Act provisions. Below are some of the highlights....more

King v. Burwell – Supreme Court Confirms Tax Subsidies are Available in All States

In an earlier blog post this year, I discussed the King v. Burwell case and the possible ramifications if the United States Supreme Court did not uphold the Internal Revenue Service position that residents in states with...more

Wellness Programs: Agencies Issue Helpful Guidance but Look Before You Leap

Recent studies indicate that wellness programs significantly improve the health of workers. If only it were so easy to implement a wellness program . . . As explained in our July 17, 2013 Benefits Update – Final...more

IRS Issues More Guidance On Employers That Pay For Individual Health Insurance Policies for Employees – Gives Limited Relief to...

I have blogged more on the topic of how the Health Care Reform Act applies to employers that reimburse employers for individual health insurance policies than any other topic in the last year....more

When Did You Last Amend Your Section 125 Cafeteria or Flexible Benefit Plan? Now May Be A Good Time to Dust It Off and Update It

Section 125 Plans, which are commonly referred to as either cafeteria plans or flexible benefit plans, are much loved, and needed, if you want to allow employees to pay health insurance and other premiums on a pre-tax basis....more

Rethinking COBRA After Health Care Reform

The Health Care Reform Act made many changes to health plans, but one thing it did not do was expressly eliminate or change the COBRA rules. Although health care reform does not expressly change COBRA, it does, in many ways,...more

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