News & Analysis as of

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

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

Legal Alert: Ring in the New Year with New Summary of Benefits and Coverage Requirements for 2015

On December 30, the Departments of Treasury, Labor, and Health and Human Services published a joint notice of proposed rulemaking modifying the Summary of Benefits and Coverage (SBC) final regulations issued in 2012. In...more

Excepted Benefits: Final regulations provide guidance on dental, vision and employee assistance plans

The Departments of Labor, the Treasury, and Health and Human Services (the “Departments”) have recently published final regulations related to when limited scope dental and vision benefits and employee assistance programs...more

No Pre-Existing Condition Exclusions Means HIPAA Certificates No Longer Required

Earlier this year, the Departments of Health and Human Services, Labor and the Treasury issued a final rule implementing the Affordable Care Act (ACA) and revising the requirements of other healthcare laws and regulations...more

Manatt on Health Reform: Weekly Highlights: December 2014 #4

With the holiday season underway, this week the Federal government awarded $110 million in exchange establishment grants, released proposed rules to permit employees to receive employer-sponsored insurance and tax credits,...more

Monthly Benefits Update - November 2014

U.S. Supreme Court Grants Review of ACA Case Involving Premium Subsidies Offered Through Federally Facilitated Exchanges - The Supreme Court granted review in King v. Burwell, a Fourth Circuit case that upheld an IRS...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 5: Health and Human Services (HHS) Wastes No Time Issuing...

Over the last couple of months, we have followed and reported on a particular ACA compliance strategy under which an employer subject to the Affordable Care Act’s employer shared responsibility (or “pay-or-play”) rules...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 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

Action Required for Health Plans and Their Business Associates

Early last year, the Department of Health and Human Services issued final privacy and security regulations (Final Rule) under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The Final Rule, effective...more

Monthly Benefits Update

In Burwell v. Hobby Lobby, the Supreme Court held that regulations under the Affordable Care Act that require employer group health plans to provide contraceptive coverage violate the Religious Freedom Restoration Act (RFRA)....more

Final Regulations on Orientation Periods Released

On June 20, the Federal regulatory agencies in charge of health care reform guidance (the Departments of Labor, Treasury, and Health and Human Services) released final regulations (“Final Regulations”) clarifying the...more

The Waiting is the Hardest Part: Final Regulations on the PPACA’s 90-Day Waiting Period Released

On February 24, 2014, the Internal Revenue Service (IRS), the Employee Benefits Security Administration (EBSA) of the U.S. Department of Labor (DOL), and the U.S. Department of Health and Human Services (HHS) jointly released...more

Final Regulations for the Mental Health Parity and Addiction Equity Act of 2008

On November 8, 2013, the Departments of Treasury, Labor, and Health and Human Services (collectively, the "Departments") jointly issued final regulations under the Mental Health Parity and Addiction Equity Act of 2008 (the...more

The Affordable Care Act Creates Compliance Challenges For HRAs And Other Arrangements

On September 13, 2013 the U.S. Department of the Treasury (IRS), the U.S. Department of Health and Human Services (HHS), and the U.S. Department of Labor (DOL), collectively referred to herein as the Departments, coordinated...more

Employers, Remember Your SBC and New Template!

Employers conducting their annual group health plan open enrollments this fall must remember to include a summary of benefits and coverage (SBC), along with a uniform glossary to that SBC, as required by the Affordable Care...more

Sponsors Of Group Health Plans Must Take Action To Comply With The Upcoming September 23, 2013 HIPAA Compliance Deadline

In January 2013, the U.S. Department of Health and Human Services (HHS) released final regulations which revised existing regulations under the Health Insurance Portability and Accountability Act (HIPAA). ...more

Business Associate Agreements: Time to Update

If you sponsor a group health plan that is subject to the HIPAA Privacy and Security Rules, it is time to review and potentially update your business associate agreements....more

Breach Notification: New Rules!

If you sponsor a group health plan that is subject to the HIPAA Privacy and Security Rules, it is time to review and revise your policies and procedures and re-train your employees regarding the proper procedures when...more

Final Wellness Rules May Require Review of Existing Wellness Programs

Final wellness regulations were issued by the Departments of Treasury, Labor, and Health and Human Services (the “Departments”) on June 3, 2013 and apply to employer-sponsored group health plans for plan years beginning on or...more

Agencies Provide Guidance on Additional Health Care Reform Changes Impacting Non-Grandfathered Employer Group Health Plans

The Departments of Health and Human Services, Labor, and Treasury (collectively, the “Departments”) during the first half of the year issued guidance in the form of Frequently Asked Questions (the “FAQs”) on certain...more

Final Wellness Regulations Clarify Rules For Discounts Linked To Health Results

The Internal Revenue Service (IRS), the Department of Labor (DOL), and the Department of Health and Human Services (HHS), the three federal agencies with primary responsibility for implementing the Affordable Care Act (ACA),...more

Final HIPAA Regulations Impact Group Health Plans

The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) sets forth rules to protect the privacy and security of individuals’ health information that is held by “covered entities,” such as group health plans....more

Health Care Reform Update: Proposed Rules Issued On 90-Day Limit Placed On Waiting Periods For Health Coverage

Beginning in 2014, the Affordable Care Act of 2010 (the "Act") will prohibit group health plans and group health insurers from imposing waiting periods greater than 90 days of employment....more

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