Affordable Care Act, Premiums

You May be Able to Increase Health Plan Premiums and Stay Affordable in 2025

Bricker Graydon LLP on 9/17/2024

For the first time in four years, the IRS adjusted the affordability percentage used for the shared responsibility penalties. The IRS recently announced that the affordability percentage for 2025 will be 9.02%....more

You May Need to Lower Employees’ Premiums to Keep Your Plan Affordable Under the ACA

Bricker Graydon LLP on 9/7/2023

For the third year in a row, the IRS adjusted the affordability percentage used for the shared responsibility penalties down. The IRS recently announced that the affordability percentage for 2024 will be 8.39%. This is down...more

Innovative 1332 Waivers Proceed in Colorado and Washington

Manatt, Phelps & Phillips, LLP on 6/29/2022

The Biden administration gave its stamp of approval last week to Colorado’s novel waiver under Section 1332 of the Affordable Care Act (ACA) to require premium reductions in a public option program, a first-of-its-kind plan...more

House Passes Build Back Better Act

Roetzel & Andress on 11/22/2021

Early Friday morning, the U.S. House of Representatives approved President Biden’s sweeping social and climate spending proposal known as the Build Back Better Framework. Key provisions in the approximately $2 trillion bill...more

Don’t Pay a Premium: Texas Solicits Comments Regarding Major Changes to Health Plan Rating

Foley & Lardner LLP on 10/22/2021

Since the passage of the Affordable Care Act (the “ACA”) in 2010, Texas has deferred to the federal government with respect to certain aspects of health plan rate review. That’s about to change. On October 19, 2021, the...more

Federal Agencies Issue FAQ on Health Plan Premium Discounts for COVID-19 Vaccinations

Parker Poe Adams & Bernstein LLP on 10/15/2021

The federal Centers for Medicare & Medicaid Services (CMS) issued a set of Frequently Asked Questions about the interaction of HIPAA, the Affordable Care Act, and various group health plan issues relating to the COVID-19...more

Department of Labor Responds to COVID-Related Medical Premium Discounts and Surcharges

Maynard Nexsen on 10/13/2021

Over the past few months, many employers have announced plans to encourage COVID-19 vaccination among their workforce by implementing either medical premium discounts for the vaccinated or surcharges for the unvaccinated. ...more

What To Consider Before Implementing A Health Insurance Surcharge For Unvaccinated Employees

Amundsen Davis LLC on 9/8/2021

The recent announcement that Delta Airlines will begin imposing a $200 per month health insurance surcharge on unvaccinated employees has prompted many employers to consider whether a similar surcharge may be an alternative...more

Can Employers Charge Higher Group Medical Insurance Premiums for Unvaccinated Employees?

Parker Poe Adams & Bernstein LLP on 8/30/2021

As many companies continue to struggle with low employee COVID-19 vaccination rates, some employers are evaluating imposing higher premiums for unvaccinated employees under their group medical plans. These employers see this...more

[Webinar] COVID-19: The Road Ahead for Commercial Health Insurance - April 23rd, 2:00 pm - 3:00 pm ET

Manatt, Phelps & Phillips, LLP on 4/10/2020

Examine the Evolving Challenges That Lie Ahead for Healthcare Stakeholders and State Regulators—and What You Can Do Now to Prepare and Protect Your Organization—at a New Manatt Webinar. Effective health insurance...more

Health Reimbursement Arrangement Update

Williams Mullen on 9/18/2019

On this episode of Williams Mullen's Benefits Companion, Brydon DeWitt reviews the final health reimbursement regulations that go into effect on January 1, 2020....more

Podcast: Health Reimbursement Arrangements

Williams Mullen on 4/26/2019

[co-author: Claire Pollock, Paralegal] In this episode of Williams Mullen's Benefits Companion, Brydon DeWitt and Claire Pollock discuss proposed health reimbursement arrangement regulations that may provide welcome relief...more

No Longer in Suspense: CMS Issues Final Rule Announcing that Risk Adjustment Program Transfers for 2017 will be Distributed in...

Sheppard Mullin Richter & Hampton LLP on 7/27/2018

The Final Rule. In a Final Rule posted by CMS last Tuesday, July 24, 2018, CMS announced that $10.4 billion in “risk adjustment transfers” (“Risk Transfers”) for benefit year 2017 (as calculated pursuant to the Affordable...more

Insurers Not Entitled to Full ACA Risk Corridors Payments Says the United States Court of Appeals for the Federal Circuit

King & Spalding on 6/21/2018

Resolving a split in the lower courts, the Federal Circuit issued two decisions on June 14, 2018, wherein the Court held that health insurers Moda Health Plan Inc. (Moda Health) and Land of Lincoln Mutual Health (Land of...more

Latest Challenge to Affordable Care Act Arises in Idaho

Mitchell, Williams, Selig, Gates & Woodyard,... on 2/16/2018

The decision of Blue Cross of Idaho to offer health insurance plans that appear to violate federal law begins the latest chapter in the continuing saga of the Affordable Care Act’s increasingly tenuous existence. Blue Cross...more

Fractal Geometry, Actuarial Risk, and §1332 Waivers—The Role of the States in Reforming Health Care

Mintz - Employment Viewpoints on 9/25/2017

At this writing, the prospects for success of the latest Republican effort to replace the Affordable Care Act appear bleak — but the Graham-Cassidy bill on which the GOP has pinned its last-ditch hopes highlights a major...more

Updated Health Care Reform Legislation Comparison Chart

Proskauer - Employee Benefits & Executive... on 7/15/2017

The chart below compares key provisions of the Affordable Care Act (ACA), the American Health Care Act (AHCA) and the Better Care Reconciliation Act (BCRA). This chart is current as of July 13, 2017, and as of that date,...more

Manatt on Medicaid: Maine Releases Draft Waiver Request Proposing New Eligibility Requirements

Manatt, Phelps & Phillips, LLP on 5/2/2017

On April 25, 2017, the Maine Department of Health and Human Services released for public comment a draft Section 1115 waiver application to implement new eligibility and coverage requirements for MaineCare, the State’s...more

Stabilizing the Exchanges: CMS Issues Final Rule

Bass, Berry & Sims PLC on 4/29/2017

On April 18, 2017, the Centers for Medicare & Medicaid Services (CMS) published in the Federal Register a final rule (the "Final Rule") aimed at stabilizing the individual and small group health insurance markets...more

House Amends the American Health Care Act: Where Will It Lead?

Perkins Coie on 4/13/2017

On the last day before the U.S. Congress began its spring recess, the U.S. House of Representatives amended the now consolidated bill H.R. 1628, known as the American Health Care Act (the AHCA). We previously discussed the...more

ACA Repeal and Replace Update: House Vote Expected This Week; CBO Estimates Impact of Repeal and Replace Legislation; CMS...

King & Spalding on 3/30/2017

After narrowly passing the Budget Committee, the Republican-sponsored health reform repeal and replace bill, the American Health Care Act (AHCA), is scheduled for a floor vote for Thursday, March 23, 2017, seven years to the...more

Patient Protection and Affordable Care Act (PPACA) › Premiums