Employer Group Health Plans

News & Analysis as of

It Was the Economy, Stupid!

Remember Bill Clinton’s 1992 campaign mantra, “It’s the economy, stupid!” A study released today by the Robert Wood Johnson Foundation indicates those four words are the best answer to the question, “Why are so many...more

Supreme Court Rejects Sixth Circuit's Approach to Retiree Medical Benefits

Ordinary contract principles govern disputes about collectively bargained retiree medical benefits. A Morgan Lewis team secured a major victory for employers when the U.S. Supreme Court, in M&G Polymers USA, LLC v....more

Supreme Court Dispenses With the Yard-Man Inferences

In a decision watched closely by both employers and unions, a unanimous Supreme Court has resolved a thirty-plus year split among the circuit courts on the standards governing claims for retiree health-care benefits arising...more

Ding-Dong, Yard-Man Is Dead! Supreme Court Decision in Tackett a Huge Win for Employers in the Retiree Healthcare Arena

On Monday, a unanimous United States Supreme Court issued its decision in M & G Polymers USA, LLC v. Tackett, Supreme Court Case No. 13-101, vacating and remanding the Sixth Circuit’s holding that a group of retirees was...more

Supreme Court Rejects Analysis of Duration of Retiree Benefits As Contrary to Contract Law

On January 26, 2015, the Supreme Court of the United States resolved a long-standing dispute between the Sixth Circuit Court of Appeals and the remainder of the federal judiciary in a case concerning the extent to which...more

U.S. Supreme Court Rejects the Yard-Man Inference Vesting Lifetime Benefits for Union Retirees

In M&G Polymers USA, LLC v. Tackett, the U.S. Supreme Court overturned three decades of precedent by the U.S. Court of Appeals for the Sixth Circuit, unanimously ruling that, when no specific provision in a...more

Supreme Court Rejects Yard-Man: Ordinary Contract Principles Apply When Interpreting Retiree Medical Promises

The Supreme Court has unanimously vacated a Sixth Circuit ruling that a collective bargaining agreement (CBA) vested retirees with lifetime medical benefits. M&G Polymers USA, LLC v. Tackett, No. 13-1010, 2015 U.S. LEXIS 759...more

Decision Alert: US Supreme Court Potentially Shifts the Balance in Healthcare Employee Benefits Litigation

Justice Clarence Thomas and a unanimous US Supreme Court decided to vacate a Sixth Circuit decision and hold that the federal courts cannot assume from silence in a union’s collective bargain agreement that retiree group...more

Agencies Green Light Pilot Program to Allow Limited Wrap-Around Coverage for Health Insurance Policies Purchased on an Exchange

Under proposed rules recently issued by the Departments of Treasury, Labor, and HHS, employers may participate in a pilot program where they offer certain wraparound coverage as an “excepted benefit” to part-time employees,...more

New Proposed Rules Streamline ACA Summary of Benefits and Coverage (SBC) Disclosure Requirement

In a very welcome development for health insurance issuers and employers who sponsor self-funded group health plans, the Departments of Treasury, Labor, and HHS have issued joint new proposed regulations that will streamline...more

2015 Health Care Reform Compliance Checklist for Employers

The United States has entered a new era of health care reform. Until now, United States employers were generally not required to provide health care coverage to employees (although many did so for employee relations and...more

Caution: Big Penalties for Reimbursing Health Care Premiums

Even if you are a small employer who is not required to provide your employees with health insurance under the Affordable Care Act (ACA), if you reimburse your employees for health insurance premiums, you run the risk of...more

Illinois District Court Holds That a Plan Maintained by a Religiously Affiliated Organization Is Not a Church Plan

The United States District Court for the Northern District of Illinois recently had the opportunity to weigh in on the issue of whether a religiously affiliated employer was exempt from federal regulation of its employee...more

Administration Issues Proposed Rules on ACA Summary of Benefits and Coverage, Excepted Benefits/Wraparound Coverage

On December 30, 2014, the Internal Revenue Service (IRS), the Employee Benefits Security Administration (EBSA), and the Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would revise Affordable...more

Health Headlines: Also in the News - January 2015 #2

House Passes Bill to Redefine Full-Time Employee Under ACA – On January 8, 2015, the House of Representatives in a 252-172 vote approved a bill that would redefine a full-time worker under the ACA employer mandate from one...more

In Florida, Recognition of Same-Sex Marriage Will Impact Employers

On January 6, Florida became the 36th state to recognize same-sex marriage. This development came as the result of several recent state and federal court decisions finding Florida's ban on same-sex marriage an...more

A Reminder for Small Businesses in Need of a Tax Credit

Although the Patient Protection and Affordable Care Act does not require small businesses to purchase group healthcare insurance for their employees, there is a tax credit available if they choose to do so. Specifically, a...more

Employing Veterans May Help Avoid the ACA’s Employer Mandate

The new Republican Congress began its session with an attempt to narrow the Affordable Care Act’s (ACA) employer mandate by exempting certain veterans and their families from counting toward the number of employees at small...more

Obama Administration Seeks Comments on Proposed Changes to Summary of Benefits and Coverage Document and Requirements

On December 30, 2014, the Departments of Health and Human Services, Labor, and the Treasury (collectively, “Departments”) issued a proposed rule (“Proposed Rule”) regarding the summary of benefits and coverage (“SBC”) for use...more

Want to Reimburse Your Employees for Healthcare Coverage?

Fine, but make sure that you do so correctly. Many employers prefer to reimburse employees for healthcare insurance premiums rather than hassle with providing coverage under a group healthcare plan. In so doing, these...more

EAPs That Meet Four Requirements May Avoid Application of Health Care Reform

Benefits provided through an employee assistance program (“EAP”) may be considered group health plan coverage, which would subject the EAP to the health care reform requirements mandated by HIPAA and the Health Care Reform...more

Heads Up – The ACA Employer Mandate Is Now In Effect: Beware of Actions that Could Result in ACA Whistleblower Liability

Effective January 1, 2015, certain employers became subject to the employer mandate of the Patient Protection and Affordable Care Act (ACA), and thus subject to liability under the ACA Employer Shared Responsibility...more

Expatriate Plans Exempted from Many Affordable Care Act Provisions

In the Consolidated and Further Continuing Appropriations Act (the recently enacted federal budget bill often known as the “CRomnibus” legislation), Congress has exempted health plans designed to cover expatriates from most...more

A Quick Look at Healthcare Issues Expected to Make News in 2015

As we look into our crystal balls, we do not expect a lot of new issues in 2015. Rather, we believe that most of the significant issues will be a continuation of issues that arose in 2014 or earlier. ...more

Distant Cousins, not Twins: Some Key Differences between the Massachusetts and Federal Health Care Reform Laws

On January 1, 2015, the Affordable Care Act’s (ACA) employer shared responsibility mandate took effect. Up until July 1, 2013, most employers doing business in Massachusetts were required to comply with an employer mandate...more

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