Employer Group Health Plans

News & Analysis as of

Two Important Deadlines Approaching for Self-Insured Group Health Plans

If you sponsor a self-insured group health plan, then November includes two important deadlines: (1) you must obtain a health plan identifier for your plan, and (2) you must report the number of participants for whom a...more

Eleventh Circuit Upholds $83,000 Fine Against Employer for Failure to Send COBRA Dental Coverage Notice

Employers know that the Consolidated Omnibus Budget Reconciliation Act (COBRA) requires them to send qualifying employees notice of their ability to continue group medical, dental and vision plan coverage at their own expense...more

Failure to Cover Applied Behavior Analysis for Autism Spectrum Disorder Violates Federal Mental Health Parity Law

Parents have searched for effective therapies for children with autism spectrum disorder. One therapy that has shown promise, at least for some children, is applied behavior analysis (“ABA”), which is an intensive behavioral...more

Fiduciary Notice Obligations Associated with Change of Carriers

This case discusses the fiduciary obligation of plan administrators to inform participants in advance of ERISA’s statutory notice periods regarding the potential impact caused by a change of life insurance carrier under a...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 23: The Impact of Employment Contract Terms on Variable Hour...

For applicable large employers (i.e., employers who employed at least 50 full-time and full-time equivalent employees on business days during the preceding calendar year) endeavoring to comply with the Affordable Care Act’s...more

More Post-Windsor Tax Guidance: IRS Issues Letter Outlining Steps for Individuals to Obtain Tax Refunds for Same-Sex Spousal...

On June 27, 2014, the IRS published a letter outlining the steps taxpayers should take in order to obtain a refund for taxes paid on the value of employer-sponsored health coverage provided to an employee’s same-sex spouse....more

The Affordable Care Act—Countdown to Compliance for Employers, Week 24: Can Offers of Group Health Plan Coverage Under Code...

The Employer Shared Responsibility provisions of the Affordable Care Act (“ACA”) generally require “applicable large employers” (i.e., employers who employed at least 50 full-time and full-time equivalent employees on...more

Impact to Calif. Employers From Hobby Lobby Ruling

On June 30, 2014, the U.S. Supreme Court handed down its decision in the Burwell v. Hobby Lobby case, holding that closely held corporations could refuse to provide contraceptive coverage mandated by U.S. Department of Health...more

Midyear Check on Health Plan Compliance

If you sponsor or administer a group health plan, you are almost certainly taking steps to prepare for legal requirements that will become effective on or before January 1, 2015. New rules under HIPAA, the Affordable Care Act...more

California Governor Signs Bill Giving Small Businesses Extra Time To Comply With ACA

On July 7, 2014, Governor Jerry Brown signed legislation that will give small business owners additional time to comply with the Affordable Care Act (ACA). The bill takes effect immediately as an urgency statute. Senate Bill...more

Recent Employee Benefits Developments

Amending Retirement Plans to Recognize Same-Sex Marriages Plan sponsors need to review retirement plan documents and operations to determine whether changes are needed in response to last year's Supreme Court decision in U.S....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

New Guidance on Employment-Based Orientation Periods

As employers who sponsor group health plans well know, health care reform prevents plans from imposing waiting periods in excess of 90 days for employees who are otherwise eligible to enroll in a plan. The latest guidance...more

Health Care Update - June 2014 #4

In This Issue: - Hobby Lobby decision further complicates ACA implementation - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Congressional and State...more

New Obamacare Benefit Mandate Takes Aim at Breast Cancer

Under the Affordable Care Act, insurers and employers that sponsor non-grandfathered medical plans must cover and pay the full cost of specified preventive services in accordance with recommendations issued by the U.S....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 Affordable Care Act—Countdown to Compliance for Employers, Week 28: The Logic, Calculus, and Limits of “Skinny” Plans

It was just over a year ago that the Wall Street Journal published an article entitled, “Employers Eye Bare-Bones Health Plans Under New Law,” which highlighted a compliance strategy to minimize employer exposure for...more

The Federal Court for the Southern District of New York Rules that Employers with Self-Insured Health Plans Need Not Offer Medical...

The issue of same-sex spousal rights is now largely resolved for qualified retirement plans. However, substantial questions about same-sex spouse health benefits remain unanswered. In Roe v. Empire Blue Cross Blue Shield,...more

What's New Under the Defense of Marriage Act?

A major reason that employee benefits, such as employer- provided healthcare and retirement plans, exist is that they provide a tax-advantaged way for an employer to provide additional compensation to an employee, her spouse,...more

June and July 2014 Filing and Notice Deadlines for Qualified Retirement and Health and Welfare Plans

Employers and plan sponsors must comply with numerous filing and notice deadlines for their retirement and health and welfare plans. Failure to comply with these deadlines can result in costly penalties and excise taxes. To...more

Pay-or-Play: Think Globally

With the effective date of the “pay-or-play” employer mandate just over the horizon, employers who sponsor group health plans are well aware of the layers of complexity presented by the mandate. One of the layers that...more

IRS Issues Guidance Effectively Prohibiting Employers From Reimbursing Employees For Individual Health Insurance Premiums

The IRS’ reasoning is that such reimbursement arrangements, often referred to as “employer payment plans” are “group health plans.” All group health plans must meet the Affordable Care Act’s “market reform” requirements, such...more

Health care reform reporting requirements: Final rules

The Patient Protection and Affordable Care Act (PPACA) contains requirements for both individuals and employers related to health care coverage. In order to assure compliance with certain of these requirements, PPACA requires...more

Labor Pains: The $2 Million Part-Time Employee

One of your employees (we’ll call him “Don”) cannot enroll in your health insurance plan because you classify him as “part-time” (one who works less than 30 hours a week). This forces Don to get health insurance through a...more

Further Guidance for Employers Providing Benefits Through Captives

On May 8, 2014, the IRS released Rev. Rul. 2014-15 (available here). The ruling provides guidance to the growing number of employers electing to insure or re-insure employee benefits through captive insurance arrangement. The...more

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