Employer Group Health Plans

News & Analysis as of

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

The Affordable Care Act – What You Need to Know Checklist

In This Presentation: - Review Employer Information - Fees - Mandates - Additional Points - Communications - Excerpt from Review Employer Information. Employer’s Health Plans - 1. Identify the...more

The Devil is in the Details: Advising Your Clients on the Affordable Care Act

The Affordable Care Act (ACA) represents a fundamental shift in healthcare delivery and insurance. The law is complex and many of its provisions are delayed due to implementation difficulties. However, virtually all...more

TCPA Plaintiff Loses—Express Consent Given to Health Insurance Plan Trumps Claim

In a recent case in the U.S. District Court for the Eastern District of Missouri, the district court held that the plaintiff’s Telephone Consumer Protection Act (“TCPA”) claim should be dismissed. The court ruled that the...more

Changes & Opportunities in 2014 for Small Employers under ACA

The Affordable Care Act (ACA) brings about significant healthcare reform changes, as well as opportunities for small employers in 2014. Many of the reforms affect all employers who sponsor group health plans; however, the...more

So, Are You Really Compliant With HIPAA?

As covered entities under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), healthcare providers are intimately familiar with the strict privacy and security requirements imposed on them by HIPAA and...more

Third Circuit Issues Opinion On Arbitrability Of Direct And Assigned, Or Derivative, Claims

The Third Circuit recently vacated a lower court’s decision granting a motion to compel arbitration of (1) direct claims by certain cardiac services health providers against CIGNA and...more

Can A Failure To Hire Violate ERISA?

A recent decision of the federal district court for the southern district of Ohio raises interesting questions under Employee Retirement Income Security Act of 1974 (ERISA) that might also affect employer liability under the...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 33: The Impact of Value-Based–Plan Designs and Reference...

Whether a group health plan provides minimum value is central to the application of the Affordable Care Act’s employer shared responsibility rules. The particulars of the role of minimum value in determining assessable...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

The Affordable Care Act—Countdown to Compliance for Employers, Week 34: When Can Carriers Impose Minimum Participation and Minimum...

Commencing with plan and policy years beginning on or after January 1, 2014, the Affordable Care Act amends the Public Health Service Act (“PHS Act”) to make three important changes to the rules governing health insurance...more

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