Essential Health Benefits Employer Group Health Plans

News & Analysis as of

Supreme Court Rejects Analysis of Duration of Retiree Benefits As Contrary to Contract Law

On January 26, 2015, the Supreme Court of the United States resolved a long-standing dispute between the Sixth Circuit Court of Appeals and the remainder of the federal judiciary in a case concerning the extent to which...more

U.S. Supreme Court Rejects the Yard-Man Inference Vesting Lifetime Benefits for Union Retirees

In M&G Polymers USA, LLC v. Tackett, the U.S. Supreme Court overturned three decades of precedent by the U.S. Court of Appeals for the Sixth Circuit, unanimously ruling that, when no specific provision in a...more

Supreme Court Rejects Yard-Man: Ordinary Contract Principles Apply When Interpreting Retiree Medical Promises

The Supreme Court has unanimously vacated a Sixth Circuit ruling that a collective bargaining agreement (CBA) vested retirees with lifetime medical benefits. M&G Polymers USA, LLC v. Tackett, No. 13-1010, 2015 U.S. LEXIS 759...more

U.S. Supreme Court Case Could Alter Retiree Health Benefit Landscape

The U.S. Supreme Court has agreed to review a 2013 Sixth Circuit decision that could alter the way collective bargaining agreement provisions covering retiree health benefits are interpreted. In Taketts v. M&G Polymers, the...more

Special Alert for Employers and Other Benefit Plan Sponsors: How Will the Supreme Court's DOMA Decision Impact Your Employee...

On June 26, 2013, the U.S. Supreme Court issued a decision that will affect virtually all employers across the country. In United States v. Windsor, the Court ruled in a 5-4 decision that Section 3 of the federal Defense of...more

IRS, Treasury Department Issue Proposed Rules Governing Minimum Value, Affordability, and Wellness Programs

A key policy goal of the Patient Protection and Affordable Care Act (the “Act”) is the expansion of health insurance coverage to all Americans. The concepts of “minimum value” and its correlate “actuarial value” speak to the...more

I’m An Applicable Large Employer – To Whom Must I Offer Health Coverage In Order To Avoid Pay Or Play Penalties?

Beginning in 2014, the employer shared responsibility mandate of the Patient Protection and Affordable Care Act requires applicable large employers (those employing on average at least 50 full-time equivalent employees on...more

Staying the Course: HHS Finalizes the Essential Health Benefits Regulations for 2014

The U.S. Department of Health and Human Services (HHS) Essential Health Benefits Final Rule and actuarial value regulations offer few surprises and much needed certainty to enable group health plans and health insurance...more

Affordable Care Act: Preparing for 2014

President Obama’s re-election confirmed that the Affordable Care Act will continue to be rolled out, and that its “pay-or-play” rules will become effective on January 1, 2014. These provisions require public and private...more

California Weighs In on Essential Health Benefits for Group Health Plans and Insurers

As a reminder of the significant role that states will play in implementing the provisions of the Affordable Care Act (ACA), we wanted to highlight some recent legislative developments in California that will be of interest...more

The Affordable Care Act’s Employer Mandate and the Collectively Bargained Workforce

As 2014 rapidly approaches, employers of all sizes and all industries are working hard to avoid the Affordable Care Act’s (the “Act”) Employer Mandate, now appearing in the Internal Revenue Code, Section 4980H. For employers...more

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