Employer Group Health Plans

News & Analysis as of

"Cadillac" Healthcare Tax Delayed to 2020

The so-called "Cadillac Tax" on certain high-cost healthcare plans that was scheduled to take effect in 2018 has been delayed until January 1, 2020. This legislative change, which is part of the Consolidated Appropriations...more

ERISA Plans Should Act To Reinforce Reimbursement Rights In Light Of Recent SCOTUS Decision

Group health plan administrators should take actions to address the recent U.S. Supreme Court decision holding that an ERISA plan cannot enforce its equitable lien, which had been established through the plan’s reimbursement...more

ACA Limits on Arrangements that Pay for Employee Coverage

Before the Affordable Care Act (ACA), employers had a wide variety of options when it came to paying for employee coverage. One common design, particularly for smaller employers, was to reimburse employees on a pre-tax basis...more

Integrated Health Reimbursement Accounts, Coordination with Family Coverage, and Notice 2015-87—Something’s Missing

Issued at the end of last year, Notice 2015-87 provided detailed guidance on a host of topics. The notice has been referred to colloquially in some quarters as the “pot luck” notice. Among other things, the notice, in Q&A 4,...more

Supreme Court: For ERISA Plans, Time May Be Money

A new U.S. Supreme Court decision is a reminder that Employee Retirement Income Security Act (ERISA) plans must act promptly if they want to assert a lien to secure a participant’s obligation to reimburse medical expenses or...more

Supreme Court Sends ERISA Plans Racing to the Courthouse for Subrogation Recoveries

The Supreme Court of the United States recently handed down a decision that opens the door for participants in ERISA-covered benefits plans to stop a lawsuit against them in its tracks by doing something that most people love...more

Hurry up and Spend the Money?

It’s like a simple set of facts on a law school exam with an answer that defies logic. And, yet, Supreme Court precedent has brought us to this illogical conclusion. Facts: Participant agrees to reimburse the plan money it...more

Supreme Court Limits ERISA Healthcare Plan’s Reimbursement Rights: What Montanile Really Means

Last week, the United States Supreme Court held that an ERISA healthcare benefit plan with reimbursement rights can only obtain “appropriate equitable relief” when enforcing its lien against a third-party settlement, thus...more

Reminder of the ACA Related Deadlines for 2016

This post is intended to be a brief reminder of some of the 2016 deadlines. As originally described in our December post the following are the updated dates for Forms 1094 and 1095....more

ACA Reporting Deadline Extended — But Employers Should Stay Focused To Avoid Penalties

About a month ago, and just months before the reporting deadlines required under the Affordable Care Act (ACA) were set to go into effect, the Internal Revenue Service gave us all a late Christmas present and announced that...more

Some Welcome Relief and Clarification on Affordable Care Act for Employers

As the federal agencies continue to issue more guidance on the application of various provisions of the Affordable Care Act (the “ACA”) to employer-sponsored health coverage, there are some recent developments that we want to...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

Transgender Roadmap: 10 Steps The EEOC Thinks Employers Should Take

Law360 reported yesterday morning that the Equal Employment Opportunity Commission settled a transgender discrimination and harassment lawsuit (not our Detroit-area funeral home case). Although the employer entered into the...more

Health Update - January 2016

The Megatrends Reshaping Healthcare: Managing Change and Maximizing Opportunity - Editor's Note: In 2013, Manatt Health identified 10 megatrends that would reinvent the healthcare marketplace across the next decade. In a...more

EEOC Denied in Attempt to Apply ADA Rules to Wellness Plan Tied to Group Health Plan

On the last day of 2015, the U.S. District Court for the Western District of Wisconsin ruled against the Equal Employment Opportunity Commission (“EEOC”) in its suit against an employer under the Americans with Disabilities...more

May Vermont Apply Its Health Care Database Law to the Third-Party Administrator for a Self-Insured ERISA Plan?

Vermont requires all public and private entities that pay for health care services provided to its residents to supply data to its "all-payer database." The requirements apply to insurers and third-party administrators, among...more

The Supreme Court

The Supreme Court of the United States issued decisions in four cases today: Campbell-Ewald v. Gomez, No. 14-857: Respondent Jose Gomez received Navy recruitment text messages without his consent. He filed a nationwide...more

Which Way Did Our Money Go? Supreme Court Decides ERISA Subrogation Issue

On January 20, 2016, the Supreme Court of the United States addressed the first of several ERISA-related cases on its October 2015 docket, reversing the Eleventh Circuit Court of Appeals and concluding that the trustees of...more

U.S. Supreme Court Rules on ERISA Reimbursement Case

The decision handed down today by the U.S. Supreme Court in Montanile v. Board of Trustees of National Elevator Industry Health Benefit Plan could have a great impact on health insurance plans, but also reinforces the...more

Big Employer Win in Wellness Program Case EEOC v. Flambeau

For the past couple of years, the U.S. Equal Employment Opportunity Commission (EEOC) has been challenging employer wellness programs for their alleged violations of the Americans with Disabilities Act (ADA). The most recent...more

HRA Access for Spouses and Dependents: A New Wrinkle for Form 1095-C

Imagine that you are filling out Internal Revenue Service Form 1095-Cs for 2015 for an employer that offers employees the opportunity to elect self-only or family coverage under a minimum value group health plan. The plan...more

Issue 98: Year-End Agency FAQs Address Many Unanswered ACA Concerns

This is the ninety-eighth 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

Federal Court Says Employer’s All-or-Nothing Requirement that Employees Submit to Wellness Program or Lose Health Insurance is...

Last month, a district court in Wisconsin dealt a blow to the EEOC and the future of its proposed ADA wellness program regulations. In EEOC v. Flambeau, Inc., the court held that that an employer did not violate the...more

District Court to EEOC: Leave Wellness Enough Alone

A Wisconsin federal district court dismissed (with prejudice) a complaint by the Equal Employment Opportunity Commission (EEOC) that a company’s wellness program violated the Americans with Disabilities Act (ADA). The EEOC...more

Employee Benefits: 2015 Ends With a Flurry of ACA Activity (1/16)

Employers were treated to a number of Affordable Care Act (ACA) developments just in time for the holidays and to ring in the New Year. Many of the developments are welcome news for employers, including an extension of the...more

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