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The Future of Premium Subsidies under the Affordable Care Act: 'Halbig v. Burwell' and 'King v. Burwell'

Both decisions addressed whether tax credits are available for residents in states that have federally-facilitated health exchanges. The District of Columbia Court of Appeals said “no”; the Fourth Circuit Court of Appeals...more

How Big Is Halbig? The Viability of the ACA’s Employer Mandate Hangs in the Balance

For employers with employees in the 36 states with a federally facilitated exchange, the question arises how the Halbig decision impacts their decision and strategy to provide health coverage to their employees when the...more

I Can’t Get No SATISFACTION-- In the Eleventh Circuit, Is Discretionary Language Still "Satisfactory to Us"?

Ever since the United States Supreme Court addressed the question of whether a wholesale adoption of the "arbitrary and capricious" standard of review would be appropriate for judicial review of denial of benefit...more

Employee Benefit Plan is Governmental Plan, Even Though Employees are Not, says District Court in 11th Circuit.

It is a deceptively simple statement: Governmental employee benefit plans are exempt from ERISA. 29 U.S.C. § 1003(b)(1). But what about an employee benefit plan of an entity affiliated with a governmental entity, but whose...more

Australia’s High Court Denies Employee Worker’s Compensation Claim For Sex Injury

Ruling in a 4-2 decision[1], the Australian High Court denied a government employee worker’s compensation claim for an injury the employee sustained while having sex in a motel room during a business trip. The female...more

The Affordable Care Act & the Impact on the C-Suite – Interview with Alden Bianchi, Member, Mintz Levin [Video]

Attorney Alden Bianchi, Practice Group Leader of Mintz Levin's Employee Benefits & Executive Compensation Practice, discusses why the Affordable Care Act makes health care benefits something that should be top-of-mind to...more

The Affordable Care Act: The Structure of Health Plans – Interview with Alden Bianchi, Member, Mintz Levin  [Video]

Attorney Alden Bianchi, Practice Group Leader of Mintz Levin's Employee Benefits & Executive Compensation Practice, discusses how health plans will be purchased under PPACA....more

State Insurance Commissioner’s “Non-Binding” Opinion Banning Discretionary Language Has No Effect in Court

An Insurance Commissioner’s non-binding opinion banning discretionary language in an ERISA governed plan has no effect. Here’s the case of Frazier v. Life Insurance Company of North America, __ F.3d __ (6th Cir. August...more

Arizona Court Of Appeals Decision Highlights Employer’s Burden Of Proving Disqualification From Unemployment Benefits

The Arizona Court of Appeals recently issued an opinion overturning the Unemployment Insurance Appeals Board’s denial of unemployment benefits to an employee who was terminated for excessive tardiness. ...more

Subrogation Claims are “Equitable Relief” Governed by ERISA

That subrogation claim you have might be governed by ERISA, at least in some circuits… Here’s the case of Thurber v. Aetna Life Insurance Company, __F.3d__ (2nd Cir. March 13, 2013) (Insurer’s counterclaim for return...more

8th Circuit – Expressing Intent to Appeal in the Future Does Not Constitute an “Appeal.”

How does an ERISA claimant start an administrative appeal? Can a mere request for medical records, and a reference to an “appeal in the future tense,” trigger the appeal? No....more

Labor & Employment Law Update - January 2013 : New Year Employer Checklist

In This Issue: - New Health Care Mandates - I-9's for Immigration in 2013 - A Policies and Procedures Review - Classifying Employees as Exempt or Non-Exempt? - Awareness of National Labor Relations Board...more

Take 5: Views You Can Use - January 2013

In this issue: - Assess the Workforce - Choose Whether to "Pay" or to "Play" - Evaluate Existing Wellness Programs and/or Implement New Wellness Programs to Enhance Employees' Health Profiles and to Avoid or Minimize...more

Health Care Reform: Recent Guidance on "Play or Pay" Rules for Applicable Large Employers in 2014

Many important aspects of the Patient Protection and Affordable Care Act ("ACA") will go into effect in 2014, including the implementation of health insurance exchanges, and the requirement for certain employers to offer...more

Health Care Reform Update: Many Self-Insured Plans Subject to New Annual Fees This Year

New regulations have been issued under the Patient Protection and Affordable Care Act (“PPACA”) implementing annual fees and reporting requirements on self-insured health plans and indirectly on fully insured plans. The...more

Employer Alert -- January 2013: IRS Proposed Regulations On PPACA’S Shared Responsibility Provisions Full of New Year Surprises...

On December 28, 2012, the Internal Revenue Service (“IRS”) issued long-awaited proposed regulations regarding the “shared responsibility” penalty provisions of the Patient Protection and Affordable Care Act (“PPACA”). In...more

Patrick Administration Proposes Elimination of Fair Share Contribution Requirements

On Tuesday, January 8, 2013, the Deval Patrick administration filed An Act to Support Employers in the Commonwealth. This new legislation, if enacted, will repeal the Fair Share Contribution program effective June 30, 2013....more

New Health Care Reform Fees—Will You Be Required to Pay?

The Patient Protection and Affordable Care Act established two fees to be paid by insurers and self-insured plans: (1) the Transitional Reinsurance Program (TRP) fee to raise revenue for health insurance issuers that cover...more

Health Care Reform: Preparations For 2014 Pay Or Play Rules Should Begin Now

By far the most important issue for employers to consider under the Affordable Care Act (ACA) is the employer “free rider penalty,” often referred to as “pay or play.” Instead of forcing employers to provide group health...more

For Employers, Pay-or-Play Proposals Could Be Worse, Much Worse

Could employee benefits regulatory activity under the Patient Protection and Affordable Care Act (Act) be taking a turn toward common sense?...more

Impact of the PPACA Insurance Exchanges on the Marketplace for Health Coverage

The Patient Protection and Affordable Care Act (“PPACA”) creates “insurance exchanges” that will be the enrollment mechanism for Medicaid, the sole source of federally subsidized health coverage, and – possibly – a...more

IRS Releases Further Guidance on Employer Health Care Coverage Mandate and Penalties

The Internal Revenue Service has released proposed regulations and FAQs on the shared responsibility provisions of the Affordable Care Act (ACA). These rules require large employers to offer full-time employees and their...more

New IRS Rules for Employer Shared Responsibility Provisions under Health Care Reform

From an employer’s perspective, one of the most important components of the Affordable Care Act (ACA) is the employer shared responsibility provisions. The Internal Revenue Service (IRS) just issued proposed regulations...more

IRS Issues Proposed Rule on ACA Play or Pay Requirements

Full implementation of healthcare reform under the Affordable Care Act (ACA) is less than a year away. The most important aspect of the new system for employers is the "employer shared responsibility" or "play or pay"...more

Government Agencies Provide Guidance on Taxes and Fees under the Affordable Care Act

In regulations and other pronouncements issued toward the end of 2012, the government has provided further details on new taxes and fees introduced by the Affordable Care Act (ACA)....more

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