News & Analysis as of

ACA Brief: Path to Repeal—The American Health Care Act Unveiled

This ACA Brief is the fourth in a series of installments that will closely track congressional and administrative actions relating to ACA provisions that affect large employer-sponsored plans. On March 6, 2017, the U.S....more

Is Obamacare About to Get Trumped? - House Republicans Propose to Repeal and Replace the Affordable Care Act

Earlier this week, on March 6, 2017, House Republicans released their proposals to repeal and replace the Patient Protection and Affordable Care Act, commonly referred to as "Obamacare." The proposals would remove the...more

Update #5: It’s Here! House Republicans Propose ACA Replacement – Key Provisions for Employers

The House Ways and Means and Energy and Commerce Committees have issued draft legislation, the American Health Care Act, to begin the process of repealing and replacing the Affordable Care Act. Both Committees will hold...more

A New Employer Healthcare Plan: Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)

Until very recently, employers were at risk of receiving steep fines if they reimbursed employees for non-employer sponsored medical care – the Affordable Care Act (ACA) included fines of up to $36,500 a year per employee for...more

Trump administration issues proposed health insurance market stabilization rule: Will it be enough to stabilize exchange...

On 15 February 2017, the Centers for Medicare & Medicaid Services (CMS) took a step toward addressing concerns about the stability of the individual and small group health insurance markets by proposing a modicum of...more

New SBC Template Goes Into Effect April 1

The U.S. Department of Labor (DOL) released a new template for the Summary of Benefits and Coverage (SBC) last year. As background, the Affordable Care Act requires health plans and health insurers to annually distribute SBCs...more

The Challenges of the Trump Administration’s Vow to “Repeal and Replace” the Affordable Care Act

In the presentation “ACA Repeal/Replace Under the Trump Administration,” Susan Nash discusses the implications of President Trump and the GOP’s immediate vow to “repeal and replace” the Affordable Care Act (ACA), which was...more

ACA Brief: Path to Repeal - Revenue Provisions in the Crosshairs

This ACA Brief is the third in a series of installments that will closely track congressional and administrative actions relating to ACA provisions that impact large employer-sponsored plans. As detailed in Sutherland’s...more

QSEHRAs: End-of-Year Legislation Provides a New Health Care Option for Small Employers

Tucked at the end of the recently enacted 300-plus-page 21st Century Cures Act (Cures Act) is a provision that offers certain small employers a new opportunity to help employees purchase individual market major medical...more

New ACA FAQs - Special Enrollment, Women’s Preventive Care and a Cure for the HRA that Ails You (If You’re Small Enough)

In the latest round of FAQs on ACA implementation (now up to 35 if you’re keeping track), the DOL, HHS and Treasury Department addressed questions regarding HIPAA special enrollment rights, ACA coverage for preventive...more

Small Employers Have New Health Reimbursement Option Under Cures Act

The 21st Century Cures Act (Cures) signed by President Barack Obama on Dec. 13, 2016, contains a smorgasbord of health-related provisions, from reforming federal mental health policies to increasing funding for medical...more

The ERISA Litigation Newsletter - December 2016

This month Richard Zall, Chair of Proskauer's Health Care Department, explores developments likely to occur with respect to the Affordable Care Act as a result of the new administration. In our Rulings, Filings and...more

Rejoice: The Return of Premium-Reimbursement Plans for Small Employers

Last week Congress passed H.R. 34, which will exempt certain health reimbursement arrangements ("HRA"), including premium-reimbursement plans, from most Affordable Care Act requirements for small employers (i.e. those...more

Employers Need To Be Aware Of Potential Pitfalls Of Providing Opt-Out Incentives To Company Health Insurance

In recent proposed regulations, the Internal Revenue Service (IRS) addressed how the Affordable Care Act (ACA) impacts the use of employer opt-out incentives, which are payments to employees who decline an employer’s group...more

Be wary of counterfactual assertions about Obamacare, Medicare, Medicaid

As speculation explodes about what the GOP and the president-elect will or won’t do with the Affordable Health Care Act (aka Obamacare), Medicare, and Medicaid, skeptical citizens would be well-served to learn as much as they...more

Hospital and Health System Health Benefit Plan Obligations Under New Nondiscrimination Rules: ACA Section 1557 and Requirements...

This impacts any entity (or health benefit plan) that receives federal financial assistance, including Medicare or Medicaid reimbursements. Two new regulations require some employers to make health plan design and...more

Guidance Addresses Mental Health Parity

The U.S. Departments of Labor, Health and Human Services, and the Treasury have issued a set of Frequently Asked Questions and Answers that, among other things, implement certain of the recommendations included in a report...more

Reminder: November 15 Transitional Reinsurance Program Filing Deadline is Fast Approaching

To help stabilize the individual insurance market, Section 1341 of the Affordable Care Act introduced the Transitional Reinsurance Program (TRP), which includes the collection of a TRP fee from “contributing entities” for...more

Religious Institutions Update: October 2016

Timely Topics - The final rule implementing Section 1557 of the Patient Protection and Affordable Care Act (ACA) was issued by the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) on May...more

January 1st is Quickly Approaching – Have you Reviewed your Health Plan for Section 1557 Compliance?

Earlier this year the U.S. Department of Health and Human Services (“HHS”) finalized regulations that implement Section 1557 of the Affordable Care Act (“Section 1557”). You can read our prior discussions of these regulations...more

Employer Obligations Under New Nondiscrimination Rules: ACA Section 1557 and Requirements for Federal Contractors

Two new regulations require some employers to make health plan design and administrative changes. While not all employers are subject to these requirements, those who are will need to review their plans and be aware of other...more

As Obamacare draws fire, millions more struggle with employer coverage

The Affordable Care Act aka Obamacare has been a vital path into health insurance coverage for millions of Americans. But the Houston Chronicle and other media deserve credit for reminding that most people in this country...more

The Road to Higher Out-of-Pocket Medical Costs is Paved with Good Intentions: The Unintended Consequences of High Deductible...

High-deductible health plans (HDHPs) are among the fastest growing health plans in both the individual and group markets. For calendar year 2017, the IRS defines an HDHP as any health plan with a minimum deductible of $1300...more

Half a Loaf: Court Rejects ADA "Safe Harbor" But Approves Pre-Regulations Wellness Program as "Voluntary"

The EEOC’s attack on employee wellness programs as unlawful under the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA) that began in 2014 with three lawsuits, and continued with...more

A Deeper Dive: Employers Receiving Federal Funding May Be Subject to ACA’s Nondiscrimination Rule and Need to Cover Transgender...

In recent months, we have written a fair amount about providing transgender benefits in light of the nondiscrimination provisions of the Affordable Care Act. Our blogs of March 30, 2016 and June 22, 2016 highlight the key...more

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