News & Analysis as of

Consolidated Omnibus Budget Reconciliation Act Employer Group Health Plans

Telemedicine: Proceed With Caution

by Fisher Phillips on

One of the hottest benefit trends in 2017 is the adoption of free or low-cost “telemedicine” programs to provide employees easy and affordable access to medical care. However, you need to proceed with caution when introducing...more

Health Care Reform Weekly Roundup – Issue 3

Below are key health care reform developments from the week of May 22nd. CBO/JCT Estimate for AHCA Released. The Congressional Budget Office (CBO) and Joint Committee on Taxation (JCT) released an updated cost estimate...more

Issues for Employers as Health Care Legislation Moves to the Senate

by Jones Day on

ABSTRACT - Although the American Health Care Act, as passed by the U.S. House of Representatives, mainly affects the individual and small group health insurance markets, it has implications for large employers. The repeal of...more

Changes to Stabilize HealthCare.gov Have Implications for Employer Sponsored Health Plans

by Winstead PC on

We learn early on that for any action there is a reaction. On Friday, the Department of Health and Human Services released “Market Stabilization” final regulations that will impact group health plans as they plan for 2018....more

ACA Brief: Path to Repeal—The American Health Care Act Unveiled

This ACA Brief is the fourth in a series of installments that will closely track congressional and administrative actions relating to ACA provisions that affect large employer-sponsored plans. On March 6, 2017, the U.S....more

American Health Care Act – Key Takeaways for Employers and Plan Sponsors

On March 6, 2017, the House of Representatives’ Ways and Means Committee and Energy and Commerce Committee released budget reconciliation recommendations that will, after mark-up beginning on March 8th, form the American...more

A New Employer Healthcare Plan: Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)

by Fisher Phillips on

Until very recently, employers were at risk of receiving steep fines if they reimbursed employees for non-employer sponsored medical care – the Affordable Care Act (ACA) included fines of up to $36,500 a year per employee for...more

Avoiding COBRA’s Bite: Measures to Counter COBRA Class Actions

by Perkins Coie on

With the filing of a class action complaint in late 2016 in the U.S. District Court for the Southern District of Florida, Wal-Mart Stores, Inc. became the latest large company accused of failing to provide adequate notices as...more

Caution: Non-Compliant COBRA Election Notices may be Costly

by Bryan Cave on

Earlier this year, an employer was sued in a class action in Federal District Court for the Southern District of Florida for violating the notice provisions of the Consolidated Omnibus Budget Reconciliation Act of 1985...more

Plan Sponsors – It’s That Time Of Year Again! Medicare Creditable Coverage Notices Must Be Sent By October 15th

by Tucker Arensberg, P.C. on

If prescription drug coverage is offered under your group health plan, you must provide an annual notice by October 15th to plan participants (and their dependents) who are Medicare eligible, whether they are active...more

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

by Snell & Wilmer on

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

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

Waves of Guidance and Benefit Plan Developments Worth Watching

by Winstead PC on

Notices on Second Round of Privacy and Security Audits are Out, Expat Plans, OON Surgery Center Billing Issues, and New Nondiscrimination Rules for Federal Contractors, New ERISA Civil Monetary Penalties, COBRA Notices and...more

COBRA Notices May Include Additional Information on Exchanges

The Department of Labor (DOL) recently issued an FAQ addressing the inclusion of information about the Health Insurance Exchanges (Marketplace) in COBRA notices. The guidance could be very helpful for employers in directing...more

The ERISA Litigation Newsletter - May 2016

by Proskauer Rose LLP on

Editor’s Overview - In this issue of Proskauer's ERISA Litigation Newsletter, we review a recent ruling by the Tenth Circuit Court of Appeals concerning the application of controlled group principles to the building...more

Cadillac Tax: A Levy in Limbo

by Best Best & Krieger LLP on

The future of the Cadillac tax, a key cost-control mechanism and federal revenue source enacted as part of the Patient Protection and Affordable Care Act (ACA), is unclear. Though initially set to take effect in 2018,...more

Vague COBRA Notices Could Prove Venomous

by Cozen O'Connor on

A recent class action settlement serves to remind employers that the Consolidated Omnibus Budget Reconciliation Act, commonly referred to as COBRA, has real fangs in the hands of the plaintiffs’ bar. A large financial...more

Beware of Traps for the Unwary in Preparing ACA Information Returns (Part 3)

by Miles & Stockbridge P.C. on

This is the third and final part of a series on traps for the unwary in preparing information returns required under the Affordable Care Act (ACA). Part one of the series included the information-return deadlines. Part two...more

No Surprises in the Final Rules Issued Under ACA

Final rules have been issued regarding grandfathered plans, pre-existing conditions, rescissions, dollar limits, claims and appeals procedures, and patient protections. These rules, effective on the first day of the plan year...more

Checklist for Group Health Plan Participant Disclosure Requirements

by Poyner Spruill LLP on

There has been an explosion of participant disclosure requirements for group health plans in recent years. While health care reform created some of these new requirements, many of them became effective years earlier. For busy...more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 15 of 24): Coding Form 1095-C, Part II for...

As we noted in a previous post, the recently issued final 2015 Instructions for Forms 1094-C and 1095-C changed certain of the rules relating to the reporting for offers of COBRA coverage where the COBRA qualifying event...more

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

by McDermott Will & Emery on

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

IRS Releases Final Forms for Health Care Reform Reporting

by Thompson Coburn LLP on

With required reporting under the Affordable Care Act (ACA) looming, employers should be aware of the latest guidance from the IRS. As a reminder, information reporting requirements apply to all employers who are members of...more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 10 of 24): IRS Issues Final Form 2015...

The IRS recently issued final instructions for Forms 1094-B and 1095-B and Forms 1094-C and 1095-C . The 2015 Instructions for Forms 1094-B and 1095-B implement a suggestion we made in a previous post relating to the...more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 7 of 24): Mergers and Acquisitions

When it comes to mergers and acquisitions involving at least one applicable large employer (ALE), the substantive rules governing employer shared responsibility (under Internal Revenue Code § 4980H) and the corresponding...more

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