News & Analysis as of

Essential Health Benefits Employer Group Health Plans

The American Health Care Act: What Has Changed and What Is Next

by Perkins Coie on

On May 4, 2017, the U.S. House of Representatives approved the American Health Care Act (AHCA) by a vote of 217 to 213 (with 20 Republicans voting against the bill), sending the AHCA to the Senate. As we have reported in...more

Passed House AHCA Bill Contains Numerous Provisions Affecting Employers

by Holland & Knight LLP on

Holland & Knight originally issued this alert in March 2017 regarding the American Health Care Act (AHCA) as it stood on that date. This client alert provides an update on the AHCA as passed by the U.S. House of...more

[Webinar] Hot Topics in Welfare Benefits - September 20th, 12:00pm CST

by Thompson Coburn LLP on

Ever since the passage of health care reform, the applicable government agencies (IRS, DOL, EEOC and HHS) have been actively working to provide new and updated regulations and other guidance governing various aspects of...more

Proposed Rules for Expatriate Health Plan and Certain Excepted Benefits under ACA

Newly proposed regulations address the application of the Affordable Care Act to expatriate health plans (whether insured or self-insured), travel insurance and certain other excepted benefits, effective for plan years...more

No Surprises in the Final Rules Issued Under ACA

Final rules have been issued regarding grandfathered plans, pre-existing conditions, rescissions, dollar limits, claims and appeals procedures, and patient protections. These rules, effective on the first day of the plan year...more

Nondiscrimination in Health Programs and Activities: Proposed Rules from HHS

by Balch & Bingham LLP on

...So, why did HHS need over five years to propose the set of rules published September 8? Here are a few highlights. For brevity’s sake, we omit foreign language service requirements, disability accommodation, compliance...more

Reminder: Non-Grandfathered Plans Must Implement Embedded Out-of-Pocket Maximums

As employers and plans prepare for 2016 open enrollment, they must be sure to address in their benefit design and with their third party vendors the new embedded out-of-pocket maximum limitations on individuals that were...more

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

by Littler on

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

by McGuireWoods LLP on

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

by Miller Canfield on

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...

by Proskauer Rose LLP on

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

by McDermott Will & Emery on

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

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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