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House Narrowly Passes American Health Care Act

On Thursday, May 4, 2017, the US House of Representatives passed the American Health Care Act by the slimmest of margins with no Democrats voting in favor of the bill. Amendments to the original bill attracted more support...more

Manager Amendments to the American Health Care Act

On Monday March 20, 2017, technical and policy amendments to the American Health Care Act of 2017 (AHCA) were introduced to address concerns by more conservative Republicans. The House is expected to vote on the AHCA as early...more

American Health Care Act: Considerations for Employers

On Monday March 6, 2017, the House Republican leadership in the Energy and Commerce and Ways and Means Committees unveiled their signature bill to “repeal and replace” the Affordable Care Act (ACA). The “American Health Care...more

The Challenges of the Trump Administration’s Vow to “Repeal and Replace” the Affordable Care Act

In the presentation “ACA Repeal/Replace Under the Trump Administration,” Susan Nash discusses the implications of President Trump and the GOP’s immediate vow to “repeal and replace” the Affordable Care Act (ACA), which was...more

DOL Finalizes New Disability Claim Rules for Welfare and Retirement Benefit Plans

The US Department of Labor’s Employee Benefit Security Administration recently released final rules on claims adjudication of disability claims under welfare and retirement plans (the Final Rule). The purpose of the Final...more

Northern District of Texas Blocks Enforcement of the Non-Discrimination Regulations of the ACA

On December 31, 2016, the US District Court for the Northern District of Texas issued an opinion and order in Franciscan Alliance, Inc. et al v. Burwell, which preliminarily enjoins the US Department of Health and Human...more

Legal Update on Select Health and Welfare Plan Issues

In a presentation to the Silicon Valley Employers Forum, Susan M. Nash discussed recent updates to select health and welfare plans while outlining some potential issues. The agenda included changes to exchange notices,...more

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

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

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

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

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

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

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

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

'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

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

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

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

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

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

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

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

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

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