Employee Benefits Employer Group Health Plans

News & Analysis as of

SCOTUS ERISA Cases, Part Two: Preemption of State Healthcare Claims Database

This is the second article of a three part series summarizing employee benefit issues that are being argued in front of the U.S. Supreme Court during the current October 2015 term. Part One provided an outline of Montanile v....more

Employer-Sponsored Health Plans Should Get Ready for HIPAA Audits

Health Insurance Portability and Accountability Act of 1996, as amended, (HIPAA) audits could be right around the corner for self-funded employee health plans. The Department of Health and Human Services' Office for Civil...more

Expected Timeline for New SBC Template

The Department of Labor has issued a new FAQ (Part 30) stating that after March 28, 2016 (the end of the comment period for the proposed changes to the Summary of Benefits and Coverage template and related documents), the...more

Supreme Court: ERISA Pre-empts Law Requiring Reporting to State Healthcare Database

In Gobeille v. Liberty Mut. Ins. Co., the U.S. Supreme Court held that the Employee Retirement Income Security Act of 1974 (ERISA) pre-empts a Vermont law that requires healthcare providers, including health insurers and...more

March and April 2016 Filing and Notice Deadlines for Qualified Retirement and Health and Welfare Plans

Employers and plan sponsors must comply with numerous filing and notice deadlines for their retirement and health and welfare plans. Failure to comply with these deadlines can result in costly penalties. To avoid such...more

U.S. Supreme Court Reaffirms ERISA’s Preemption Provisions as Applied to State Health Law Reporting Requirements

Recently, the U.S. Supreme Court, in Gobeille v. Liberty Mutual Insurance Co., 2016 U.S. LEXIS 1612, underscored the broad extent to which the preemption language of the Employee Retirement Income Security Act of 1974...more

Cybersecurity and Data Privacy: Big Win for Self-Insured ERISA Plans at Supreme Court (3/16)

On March 1, the Supreme Court issued a decision in Gobeille v. Liberty Mutual Insurance Company that delivered a big win for self-insured group health plans. The case involved a challenge to a Vermont law that required...more

Supreme Court Restricts State Medical Claims Data Reporting Law

ERISA does not allow a state to compel a self-insured group health plan to compile and report medical claims data for inclusion in a state-wide all-payer health care database, the U.S. Supreme Court has ruled in a landmark...more

EEOC Loses Another Wellness Case, Part 2 – Beware the ACA Penalties

In my last blog post, I discussed a recent loss by the EEOC in its efforts to limit the ability of employers to require employees to complete health risk assessments (HRAs) or biometric screenings in order to enroll in the...more

EEOC Loses Another Wellness Case, Part 1

The EEOC has been bringing lawsuits against employers challenging wellness programs. A recent case involved a company that had previously provided a credit to employees enrolled in the health plan who participated in a health...more

DOL Issues Proposed Updates for Summaries of Benefits and Coverage

The U.S. Department of Labor (DOL) has issued an updated template Summary of Benefits and Coverage (SBC), Glossary of Coverage and Medical Terms, and related materials. The revised materials remain in proposed form, but have...more

Issue 99: Transition Relief for Student Health Plans and Other ACA Issues Impacting Student Employees

This is the ninety-ninth issue in our health care reform series of alerts for employers on selected topics in health care reform. This series of Health Care Reform Management Alerts is designed to provide a more in-depth...more

IRS Reduces Voluntary Compliance Program Filing Fees for Most Plans

The IRS recently published its annual update on user fees, Revenue Procedure 2016-8, which now includes fees for Voluntary Compliance Program (“VCP”) applications filed with the IRS pursuant to the Employee Plans Compliance...more

DOL and Treasury Update 2015-2016 Regulatory Agendas for Employee Benefits

The principal regulators of U.S. employee benefits have recently published updates to their guidance plans for the coming months. On November 19, 2015, the U.S. Department of Labor (DOL) updated its Semi-Annual...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

Employee Benefits Developments - October 2015

The Internal Revenue Service (IRS), consistent with prior regulations from the Department of Health and Human Resources (HHS), issued supplemental proposed regulations requiring employer sponsored health plans to provide...more

President Obama Signs ACA Change Into Law

While Republican efforts to effectively repeal the Affordable Care Act (ACA) through the budget reconciliation process have garnered attention, Congress's recent passage of a bipartisan bill making targeted changes to the law...more

Same-Sex Marriage is Legal – Are Your Employee Benefit Plans Up to Date?

What is the Supreme Court’s holding in Obergefell v. Hodges? LB: The U.S. Supreme Court ruled that all states must license a marriage between two people of the same sex and all states must recognize a lawful same-sex...more

IRS Provides Updated Guidance on Electronic Filing of ACA Information Returns

As 2016 approaches, the IRS is issuing more detailed guidance on how employers will need to comply with the upcoming ACA information reporting requirements. As a reminder, the ACA information reporting rules require employers...more

Employee Benefits Developments August 2015

Certain Closely Held For-Profit Employers Need Not Provide Women’s Contraceptive Services. Under the ACA, non-grandfathered group health plans must cover specified preventive services, including certain women’s preventive...more

Limiting an Employee’s Hours to Avoid Offering Group Health Plan Coverage Under the Affordable Care Act: Evaluating the Risks...

Business leaders and human resources and employee benefits professionals are well aware of potential minefields for employer group health plan sponsors under the Affordable Care Act (ACA). Large employer plan sponsors are...more

Be Alert Middle East: New Dubai and Qatar Health Insurance Laws

Qatar, and most recently Dubai, have introduced a compulsory health insurance scheme. The scheme, which applies to all residents and visitors, stipulates that it is mandatory for employers to provide employees with health...more

IRS Issues Second Guidance on Cadillac Tax

The Internal Revenue Service has issued a new notice addressing issues relating to future rules governing the calculation and payment of the so-called “Cadillac tax” under the Affordable Care Act. Beginning in 2018, the ACA...more

What Does the Supreme Court's Same-Sex Marriage Ruling Mean for Employee Benefit Plans?

On June 26, 2015, the U.S. Supreme Court ruled in Obergefell v. Hodges that states must license and recognize a marriage between two people of the same sex. Despite being a landmark decision affecting same sex couples whose...more

Benefits Litigation Update – July 2015

Welcome to the new, rejuvenated version of the Benefits Litigation Update, which we bring you jointly with the law firm of Epstein Becker Green. Our goal is to provide a concise and, we hope, insightful glimpse into recent...more

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