Patient Protection and Affordable Care Act (PPACA) Employer Group Health Plans

The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal... more +
The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal subsidies to reduce the number of uninsured citizens. less -
News & Analysis as of

Half a Loaf: Court Rejects ADA "Safe Harbor" But Approves Pre-Regulations Wellness Program as "Voluntary"

The EEOC’s attack on employee wellness programs as unlawful under the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA) that began in 2014 with three lawsuits, and continued with...more

A Deeper Dive: Employers Receiving Federal Funding May Be Subject to ACA’s Nondiscrimination Rule and Need to Cover Transgender...

In recent months, we have written a fair amount about providing transgender benefits in light of the nondiscrimination provisions of the Affordable Care Act. Our blogs of March 30, 2016 and June 22, 2016 highlight the key...more

Nondiscrimination Standards Under ACA Section 1557: Now Is the Time to Act

Health insurers and group health plan sponsors must closely review the final rule titled “Nondiscrimination in Health Programs and Activities” (“Final Rule”) implementing Section 1557 of the Affordable Care Act (“ACA”) that...more

Changing Legal Landscape in Transgender Health Coverage

Gender identity and transgender rights have come to the forefront in the news over the past few years. While the case law is more settled with respect to transgender discrimination in the workplace, not much guidance is...more

IRS Addresses ACA Reporting Requirements Self-Funded Plans, HRAs

As promised in Notice 2015-68, the IRS has proposed clarifications to the regulations under IRC Section 6055 relating to information reporting rules for minimal essential coverage providers. These rules affect employers...more

[Webinar] Hot Topics in Welfare Benefits - September 20th, 12:00pm CST

Ever since the passage of health care reform, the applicable government agencies (IRS, DOL, EEOC and HHS) have been actively working to provide new and updated regulations and other guidance governing various aspects of...more

The ERISA Litigation Newsletter - August 2016

Editor's Overview - This month’s newsletter features an article on the DOL’s recently published interim final rule that increases penalties for notice and disclosure violations, which generally became effective on...more

Where to Draw the Line: Who Gets to be Exempt?

Legal challenges to controversial provisions in the Affordable Care Act (ACA) continue to work their way though the courts. In a follow-on to the Supreme Court’s decisions in Burwell v. Hobby Lobby and Zubik v. Burwell...more

ACA Non-Discrimination Rules May Apply to Certain Healthcare Employers' Benefits Practices

In May, the Department of Health and Human Services (DHHS) issued final regulations implementing Section 1557 of the Affordable Care Act. This legislative provision, which has been in effect since 2010, prohibits health...more

What is Telemedicine? A Cool Benefit or a Hot Mess?

We’ve had numerous inquiries lately about telemedicine benefits. My clients most typically ask either “is this a group health plan?” or “is it just access to another provider?” Clearly, there is much confusion surrounding...more

Hospital and Fixed Indemnity Policies; Excepted Benefits; Supplemental Coverage under Recently Proposed Treasury Regulations; and...

We reported in a recent post on proposed regulations dealing with, among other things, the treatment of hospital indemnity or other fixed indemnity insurance products in the group market. This post takes a closer look at the...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

You Received a Health Insurance Marketplace Notice from HHS – Now What?

Take a deep breath. The HHS Health Insurance Marketplace Notice (the “Notice”) may seem to be a nuisance, but it does not necessarily mean that you will be subject to employer shared responsibility penalties....more

Are You Down With O.O.P.s?: Opt-Out Payments Under the Affordable Care Act

In Notice 2015-87, the IRS addressed the impact of employer opt-out payments — payments made to employees who decline enrollment in an employer’s group health plan — on affordability for ACA purposes. Employers who do not...more

IRS Issues Drafts of Forms 1094-C, 1095-B and 1095-C for 2016

Last month, the IRS issued proposed changes to the ACA reporting and disclosure forms for 2016. As a reminder, Forms 1094-B and 1095-B are used by insurance providers to report on the number of individuals enrolled in health...more

Client Alert: The Physics of Wellness at Work

Newton’s Third Law of Motion states that for every action, there is an equal and opposite reaction, and that Law is evident in the workplace wellness environment. Employers believe they are doing right by their employees by...more

Departments Finally Publish Updated SBC Template and Instructions

On April 6, 2016, the Departments of Health and Human Services, Labor and Treasury (the “Departments”) issued an updated Summary of Benefits and Coverage (“SBC”) template. The latest template represents an effort by the...more

The Contraceptive Saga Continues

In Zubik v. Burwell, the justices vacated and remanded six federal appellate judgements on whether an accommodation (described below) for employers with religious objections to providing coverage for some or all contraception...more

ACA Reporting Update – 2016 Draft Forms & Instructions Released

Since our last ACA Reporting Update, the extended deadlines to distribute Forms 1095-B and 1095-C to covered individuals and employees and to file the forms with the IRS have passed. The IRS has stated, however, that late...more

Government Requests Information on ACA Contraceptive Mandate

In a recent Supreme Court case, Zubik v. Burwell, the justices vacated and remanded six federal appellate judgements on whether an accommodation (described below) for employers that object to providing contraceptive coverage...more

IRS Proposes Adjustments in Individual Mandate Reporting

The IRS has issued proposed regulations on the individual mandate reporting requirements under section 6055 of the Internal Revenue Code. To a significant degree, the new regulations reflect guidance previously published by...more

Manatt on Health Reform: Weekly Highlights - August 2016

Oregon’s hospitals see improved financial performance following the ACA; CMS denies Indiana’s request for an additional lockout period in the Medicaid expansion program; and a new Manatt Health report details Medicaid funding...more

Proposed Changes to Form 5500 Would Significantly Increase Reporting Obligations for Health and Welfare Plan Sponsors

Summary - On July 11, 2016, the Department of Labor (DOL) and Internal Revenue Service (IRS) announced a proposal to implement significant changes to the forms and regulations that govern annual employee benefit plan...more

The EEOC's View of Wellness Programs

The EEOC’s regulations allayed many concerns over the permissible level of incentives/penalties, as well as the challenge of dealing with inconsistent requirements under the various laws. Originally published in The HR...more

Final ACA Nondiscrimination Rules Under Section 1557 Now Effective

This is the one hundred and first issue in our series of alerts for employers on selected topics on health care reform. (Click here to access our general Summary of Health Care Reform and other issues in this series.) This...more

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