Employer Group Health Plans

News & Analysis as of

Mainstream Wellness Program Challenged in EEOC v. Honeywell

Despite promulgating a paucity of guidance on what constitutes a “voluntary medical exam” under the Americans with Disabilities Act (“ADA”), on October 27, 2014, the U.S. Equal Employment Opportunity Commission (“EEOC”)...more

The ERISA Litigation Newsletter

Editor's Overview - As it is well known, in Cigna Corp. v. Amara, 131 S. Ct. 1866 (2011), the U.S. Supreme Court identified several forms of appropriate equitable relief that may be available under Section 502(a)(3) of...more

Do You Have A Health Plan Identifier?

Do You Even Know What It Is? With great focus on healthcare reform, you may have missed a current requirement for health plans to apply for and obtain a Health Plan Identifier (HPID). This requirement does not come...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 6: Labor and Treasury Departments Play Whack-a-Mole with...

Last year, the Department of Labor and the Treasury Department/IRS (Departments) issued guidance on the application of certain of the Affordable Care Act’s insurance market reforms to health reimbursement arrangements (HRAs),...more

Final Rules for Offering Limited-Scope Dental and Vision Benefits

Under the Affordable Care Act (ACA), group health plans are prohibited from establishing any annual dollar limit on the amount of benefits for any individual. Group health plans must also provide certain preventive care...more

Agencies Come Down Hard on Various Employer Health Plans and Arrangements

As we move into 2015, employers continue to grapple with numerous Health Care Reform concepts. Employers should be cautious regarding arrangements promoted to avoid health care penalties because the agencies are cracking...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 7: IRS Puts the Kibosh on Health Plans that Fail to Cover...

In a previous post, we described an Affordable Care Act compliance strategy—referred to commercially as a “minimum value plan” or “MVP”—that involves an offer of group health plan coverage that, while similar in most respects...more

Self-Insured Group Health Plans: Two Deadlines to Note

As 2014 winds down, plan sponsors are likely thinking ahead to some of the significant changes that will take effect in 2015, most notably, the employer "pay or play" mandate under the ACA. However, there are two deadlines...more

Group health plans for same-sex spouses: Equal treatment required or not?

In our recent webinar, McAfee & Taft attorneys shared with you a number of ramifications from the recent U.S. Supreme Court decision that effectively legalized same-sex marriage in Oklahoma. One of the key questions we...more

Affordable Care Act Update: Hospitalization Services Required for Plan to Meet Minimum Value

On November 4, 2014, the Internal Revenue Service (IRS) released guidance (Notice 2014-69) clarifying that certain group health plans that do not provide for hospitalization services or physician services or both will fail to...more

Eighth Circuit Permits Employee to Maintain Age Bias Claim Based on Company's Age-Based Health Care Considerations

With the rising costs of health care benefits for both employers and employees alike, a recent case out of the Eighth Circuit provides an important reminder that even seemingly innocuous cost control measures can have a...more

Health Plan ID Program Suspended

Late on October 31, the Centers for Medicare and Medicaid Services (CMS) Office of E-Health Standards and Services announced that it was suspending the program that required all health plans to register for a health plan ID...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 8: Breaking HPID News

In a surprise move, the Centers for Medicare & Medicaid Services (CMS) announced an indefinite delay in enforcement of regulations pertaining to “health plan enumeration and use of the Health Plan Identifier (HPID) in HIPAA...more

BREAKING: EEOC Seeks Court Order To Halt Honeywell’s Biometric Testing

The Equal Employment Opportunity Commission filed a petition yesterday in federal court in Minnesota to stop Honeywell International, Inc., from requiring that employees (and spouses, if the employees have family health...more

HRAs Under the Affordable Care Act

Analysis: HRAs are employer-funded accounts designed to reimburse employees for out-of-pocket medical expenses. Employees are not permitted to contribute their own funds, so they are unlike flexible spending accounts or...more

New York’s “Emergency Medical Services and Surprise Bills” Law

Earlier this year, the New York Legislature enacted, and Governor Cuomo signed, legislation that will impact billing and reimbursement for some out-of-network health care services, require new disclosures from providers...more

Eighth Circuit Says That Considerations Of Health Care Cost Savings Could Be Proxy For Age In ADEA Suits

The Eighth Circuit recently concluded that an employer may violate the ADEA by terminating an older employee in order to reduce its health care premiums. Tramp v. Associated Underwriters, Inc., 2014 WL 4977396 (8th Cir....more

Updated Timeline of Highlights for Employer Group Health Plan Compliance with the Affordable Care Act

Since enactment of the Affordable Care Act (“ACA”), the regulators have promulgated a myriad of regulations implementing the ACA’s requirements for group health plans. Over the past several years, the Obama administration has...more

Provider Competition Matters—Even for “Reference Pricing”

In a recent blog post, three Federal Trade Commission (FTC) economists splashed some cold water on advocates of “reference pricing” that seem to imply that such pricing “will increase competition between providers.” In the...more

IRS Issues New Forms And Instructions Regarding The Employer Mandate Information Reporting Requirements Under The ACA

In order to administer and enforce the rules of the Employer Shared Responsibility Mandate, the Affordable Care Act (ACA) added Sections 6055 and 6056 to the Internal Revenue Code, which require insurance providers and...more

Legal Alert: New PPACA-related “Family Status” Changes for Cafeteria Plans

The Internal Revenue Service has issued Notice 2014-55 to permit new health plan elections in two situations where they were not previously allowed. ...more

HEALTH CARE REFORM: Time to get serious about the Affordable Care Act’s employer reporting requirements

The Affordable Care Act (ACA) has consumed us for the last four and a half years. As employers, we have spent so much time trying to figure out what the ACA requires, trying to hit the government’s moving regulatory targets,...more

IRS Issues Draft Instructions For Health Coverage Reporting

The IRS has issued draft instructions for the forms employers will use to report health coverage information required by the Affordable Care Act. The draft instructions should not be relied on, but they are indicative of the...more

IRS to Amend Cafeteria Plan Regulations to Facilitate Enrollment in Marketplace Coverage

On Thursday, September 18, 2014, the Internal Revenue Service (“IRS”) released Notice 2014-55, which expands the cafeteria plan “change in status” rules to allow plans to offer employees an option to revoke their elections...more

California Repeals 60-Day Limit on Waiting Periods

On August 15, 2014, California passed Senate Bill 1034, which repealed an insurance law (Assembly Bill 1083) that prohibited insurance companies from including waiting periods in excess of 60 days in their group health...more

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