News & Analysis as of

Employer Group Health Plans Insurance Industry

Alston & Bird

Insurance Insights for the Dog Days of August

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Welcome to the inaugural issue of Insurance Insights, a gathering of notable legal developments and trends relevant to the insurance industry. In this issue, the California Supreme Court covers COVID-19 claims, Georgia...more

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - June 2024

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This month’s Friday Five explores recent decisions with issues spanning physician power of attorney to preexisting exclusions and the fiduciary duty of an insurance company....more

Woodruff Sawyer

Agencies Release Final Regulations on Fixed Indemnity Insurance, Refrain from Addressing Level Funded Plans

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On March 29, 2024, the IRS, DOL and HHS (collectively, “the Agencies”) released final regulations implementing new notice requirements for group hospital or other fixed indemnity plans that begin on or after January 1, 2025....more

McDermott Will & Emery

Gender-Affirming Benefits: Best Practices for Group Health Plans

McDermott Will & Emery on

Federal legislative and regulatory activity related to employer-sponsored group health plans shows no signs of slowing, particularly with the issuance of interpretive guidance regarding the transparency and surprise-billing...more

McDermott Will & Emery

[Webinar] Gender-Affirming Benefits: Best Practices for Group Health Plans - February 29th, 1:00 pm - 1:30 pm EST

McDermott Will & Emery on

Employers and plan sponsors are facing growing – and often conflicting – pressures related to the coverage of gender-affirming care. Join McDermott lawyers Sarah G. Raaii and Alden J. Bianchi for a webinar to review recent...more

McDermott Will & Emery

Special Report - Funding Employer-Sponsored Group Health Coverage: The Group Captive Solution - November 2023

McDermott Will & Emery on

Employer-sponsored health insurance covers almost 159 million non-elderly US workers and their dependents, and employees and jobseekers alike view group health coverage as the single most important non-cash job-related...more

McDermott Will & Emery

Discerning Congressional Purpose from the Proposed MHPAEA Regulations Comment Letters

McDermott Will & Emery on

We continue our investigation of proposed regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA) issued by the US Departments of Labor, Health and Human Services and the Treasury (the Departments)...more

Bass, Berry & Sims PLC

Let the Plan Speak: First Gag Clause Attestation Due December 31, 2023

Bass, Berry & Sims PLC on

By December 31, 2023, group health plans and health insurance issuers must submit an attestation to certify compliance with the “gag clause prohibition” under the Consolidated Appropriations Act of 2021 (CAA)....more

McDermott Will & Emery

The ‘Data Evaluation Requirement’ for NQTLs Under the Newly Proposed MHPAEA Regulations

Last week’s post examined the “no more restrictive” requirement that would apply to non-quantitative treatment limitations (NQTLs) set out in recently proposed regulations under the Mental Health Parity and Addiction Equity...more

Bradley Arant Boult Cummings LLP

ACA Preventive Services Mandate Partially Vacated: What’s Affected, What’s Not, and What’s Next

A federal judge has struck down a provision of the Affordable Care Act (ACA) mandating group health plans and insurers to cover a long list of preventive services without cost-sharing from participants. The March 30 decision...more

Bressler, Amery & Ross, P.C.

Extension of the Covid Public Health Emergency and The Impact on Group Health Plans

The United States Department of Health and Human Services (HHS), on October 13, 2022 renewed the COVID-19 Public Health Emergency for another 90 days continuing the state of emergency through at least January 15, 2023....more

Goodwin

Federal District Court Ruling May Jeopardize Insurance Coverage of More Than 50 Recommended Procedures, Screenings, and Treatments

Goodwin on

Under the Affordable Care Act, group health plans and health insurance issuers are required to provide health insurance coverage based on recommendations made by healthcare coverage professionals. The covered categories...more

Woodruff Sawyer

Managed Care Organization (MCO) Insurance Trends: Expect Another Year of Double-Digit Rate Increases

Woodruff Sawyer on

The market for “signature risks” in the managed care organization (MCO) sector—errors and omissions (E&O), directors and officers (D&O), and cyber—remains hard, with double-digit rate increases being the norm for the fifth...more

Manatt, Phelps & Phillips, LLP

Federal Regulators Issue Joint Report on MHPAEA Signaling Increased Enforcement Against Plans Likely

On Tuesday, the U.S. Departments of Labor, Health & Human Services, and the Treasury (the Departments) issued their joint report to Congress on the Mental Health Parity and Addiction Equity Act (MHPAEA). The Consolidated...more

Mintz - Employment Viewpoints

Broker and Consultant Disclosures to Group Health Plans under Division BB of the Consolidated Appropriations Act, 2021

Division BB of the Consolidated Appropriations Act, 2021 (“Act”) broadly addresses surprise medical billing and health plan transparency. This post focuses on Section 202 of Division BB (the “Provision”), which establishes...more

Smith Gambrell Russell

Prompt Action by Employers Required for COBRA Changes in the American Rescue Plan Act

Smith Gambrell Russell on

On March 11, 2021, President Biden signed into law the “American Rescue Plan Act” (“ARPA”) (HR 1319). While ARPA addresses many different areas, employers will need to act promptly with regard to benefits under the...more

Sheppard Mullin Richter & Hampton LLP

New Guidance on Health Plans’ COVID-19 Coverage Obligations

On February 26, 2021, the Departments of Labor, Health and Human Services (HHS), and the Treasury issued Frequently Asked Questions (FAQs) on the implementation of the Families First Coronavirus Response Act (“FFCRA”), the...more

Clark Hill PLC

Stop Loss Carriers Need to Consent to any Material Changes to Self-Insured Employers' Healthcare Plans

Clark Hill PLC on

In response to COVID-19, Massachusetts, Illinois, Pennsylvania and a growing list of states have directed health insurance carriers to, among other things, relax cost-sharing and enhance telemedicine services. These...more

Locke Lord LLP

Pandemic Risk Insurance Act – A TRIA-Inspired Model To Backstop The Business Interruption Insurance Market In The Wake Of COVID-19

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The COVID-19 pandemic has rocked the United States and the sense of security of its citizenry in a way not seen since the tragedies of September 11th, 2001. The insurance industry, like the rest of us, is reacting in real...more

BakerHostetler

Recently Issued Insurance Guidance Will Impact Ohio Employment-Based Health Plans

BakerHostetler on

In an effort to alleviate the COVID-19 public health threat, the Ohio Department of Insurance (ODI) issued bulletin 2020-03, titled “Health Insurance Coverage Flexibility for Ohio Employees” (the Bulletin), effective March 20...more

Jackson Lewis P.C.

Special COVID-19 Health Insurance Enrollment Windows And Waivers

Jackson Lewis P.C. on

As a result of the ongoing COVID-19 pandemic, we are observing all sorts of never-before-seen changes in the fully-insured group health plan space. Many insurers are liberally waiving their normal rules to accommodate the...more

Jackson Lewis P.C.

COVID-19 Update – Ohio Changes Rules For Health Insurance Coverage

Jackson Lewis P.C. on

The Ohio Department of Insurance (ODI) has issued guidance pursuant to Governor Mike DeWine’s emergency declaration and March 9, 2020, order directing state agencies to implement procedures consistent with recommendations...more

Sheppard Mullin Richter & Hampton LLP

Families First Coronavirus Response Act Imposes Benefit Mandates on Insurers and Group Health Plans

In a much needed sign of bipartisanship, the Senate passed and President Trump signed last night the Families First Coronavirus Response Act. The new law is effective today and requires insurers and group health plans to...more

Parker Poe Adams & Bernstein LLP

Can Temporarily Laid Off Workers Remain on a Company's Medical Insurance Plan?

We have had a number of questions from clients about their ability to maintain group medical and other employer-provided benefits for employees affected by temporary layoffs and working hours reductions related to COVID-19....more

Foley & Lardner LLP

Massachusetts Governor Proposes Facility Fee Ban

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Massachusetts Governor Charlie Baker has restarted the discussion on health care cost containment in the Commonwealth with a proposed bill that contains a raft of initiatives. This is the first in a series of blog posts to...more

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