Employer Group Health Plans

News & Analysis as of

Well Well: Court Sides with Employer in Latest Wellness Program Battle (Part 1)

Here’s one for you: Did you hear the one about the employee that turned down the opportunity to have his annual health insurance premiums waived? Not a joke, unfortunately. And there’s not much of a punch line either....more

Wisconsin Court Rejects Employer’s Argument That Wellness Programs Are Insulated from Disability Law

Trial to Be Scheduled on Retaliation Claim - MILWAUKEE - A federal court has ruled in favor of the U.S. Equal Employment Opportunity Commission (EEOC) in a disability discrimination case involving wellness programs filed...more

Just What The Doctor Ordered: Court Denies The EEOC’s Motion For Summary Judgment In ADA Suit Regarding Employer’s Wellness...

Seyfarth Synopsis: After the EEOC brought an action under the Americans With Disabilities Act against an employer who implemented a wellness program requiring employees to take a health assessment to participate, the Court...more

The Latest Win for Wellness Programs May Be More of a Win for the EEOC

Although the U.S. District Court for the Eastern District of Wisconsin held that the employer wellness program at issue in EEOC v. Orion Energy Systems did not violate the ADA, the EEOC may find much it likes in this court’s...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

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

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

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

[Webinar] 28th Annual Employee Benefits Seminar - September 21st, 8:20am Central / 9:20am Eastern

Program Highlights Please join the Locke Lord Employee Benefits and Executive Compensation Group for our 28th annual employee benefits seminar via webinar.  Our attorneys will provide an overview of current developments...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

Cybersecurity and the Role of ERISA Fiduciaries

The Employee Retirement Income Security Act of 1974, as amended (ERISA), protects plan participant benefits and account balances by imposing high standards of care on the plan’s fiduciaries. Fiduciaries who do not follow...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

Recognition of Same-Sex Marriage Officially the Tax Law of the Land

Effective tomorrow, September 2, 2016, new IRS final regulations will take effect which provide that for federal tax purposes, the terms “spouse,” “husband,” and “wife” mean an individual lawfully married to another...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

Check Your Neutral Policies: The EEOC Joins the ACLU’s Challenge to Dignity Health’s Exclusion of All Care Related to Sex...

The ACLU filed a complaint against Dignity Health, claiming that the total exclusion of care related to “sex transformation surgery” in Dignity’s employee health insurance plan is unlawful sex discrimination. Now the EEOC...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

ERISA Preempts State Law Requiring Insurer “Prompt Payment”

Alaska’s prompt pay statute—which requires insurers to pay benefit claims within 30 days of submission—is preempted by federal laws governing employer-provided benefits and benefits for government workers, a federal judge...more

Penalties Increased for Employee Benefit Plan Violations

Recently-enacted legislation has increased many penalty amounts for certain employee benefit plan violations. The new penalties – some of which are more than double previous amounts – were adjusted to catch up with inflation...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

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