Susan M. Nash

Susan M. Nash

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

Wellness Incentive Programs: Navigating Legal Landmines and Designing Effective Employee Communication Strategies

This year’s Employer Healthcare & Benefits Congress featured a presentation by Susan Nash that addressed the many shapes and sizes of wellness programs today. Programs are typically designed to promote health and to educate...more

10/18/2016 - ADA Affordable Care Act Anti-Discrimination Policies Disability EEOC GINA HIPAA Internal Revenue Code (IRC) Wellness Programs

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

EEOC Model Wellness Program Notice

On June 16, 2016, the EEOC issued its model notice to be used in conjunction with wellness programs that ask disability related inquiries or require medical examinations. The notice requirement applies prospectively to...more

6/17/2016 - ADA Disability Discrimination EEOC Employer Group Health Plans HIPAA Medical Examinations Notice Requirements Wellness Programs

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

Phase 2 HIPAA Audits Are Underway

In Depth - The US Department of Health and Human Services Office for Civil Rights (OCR) announced on March 21, 2016, that it would soon begin a second phase of audits (Phase 2 Audits) of compliance with Health Insurance...more

4/26/2016 - Covered Entities ERISA HIPAA Audits HITECH OCR

'Right-Sizing' Full-Time Employees to Reduce ACA Obligations May Lead to ERISA Class Action Exposure

Compliance with the Affordable Care Act (ACA) has resulted in increased health benefit costs for many employers. A recent court decision demonstrates that while programs to reduce the number of full-time employees may lower...more

2/16/2016 - Affordable Care Act Class Action Corporate Counsel Employer Healthcare Costs ERISA Full-Time Employees Health Insurance Motion to Dismiss Popular Section 510 Shared Responsibility Rule

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

Cadillac Tax Delayed to January 1, 2020; Extension of ACA Health Plan Information Reporting Due Dates

After employer and other stakeholder opposition to the “Cadillac Tax” grew into bipartisan support from Congress, President Obama signed into law a two-year delay of the Cadillac Tax on December 18, 2015. This two-year delay...more

12/30/2015 - Affordable Care Act Cadillac Tax Filing Deadlines IRS Reporting Requirements Time Extensions

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

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

Navigating Legal Issues in Connection with Employer Sponsored On-Site Health Clinics

Employers are increasingly concerned with the high cost of health care and executives in the C-Suite are beginning to take notice. The Affordable Care Act (‘‘ACA’’) required employers who sponsor group health plans to adopt a...more

10/13/2015 - Affordable Care Act C-Suite Executives Cadillac Tax COBRA Employer Group Health Plans Employer Healthcare Costs Employer Mandates ERISA HDHP Health Savings Accounts Healthcare HIPAA Income Taxes Internal Revenue Code (IRC) Minimum Essential Coverage Reporting Requirements Wellness Programs

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

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