Health Insurance Employee Benefits

News & Analysis as of

ERISA Preempts State Law Requiring Insurer “Prompt Payment”

Alaska’s prompt pay statute—which requires insurers to pay benefit claims within 30 days of submission—is preempted by federal laws governing employer-provided benefits and benefits for government workers, a federal judge...more

Religious Institutions Update: August 2016

When was the last time your organization reviewed your insurance policies? Not all policies are equal. Many religious organizations are underinsured. Most should have general liability, property, professional liability,...more

Traps for the Unwary: Does Your Employee Handbook Comply with the Affordable Care Act?

Do you think you’ve complied with the Affordable Care Act mandates? Before you answer yes, you’d best take a close look at your Employee Handbook – a minefield for mistakes....more

IRS Proposes Adjustments in Individual Mandate Reporting

The IRS has issued proposed regulations on the individual mandate reporting requirements under section 6055 of the Internal Revenue Code. To a significant degree, the new regulations reflect guidance previously published by...more

ERISA: 2nd Circuit — Mental Health Provider Lacks Standing to Challenge ERISA Benefit Denial

Who can challenge an ERISA benefit denial? Does a physician have standing to challenge the denial of a patient’s coverage? It depends....more

Employee Benefits Developments - July 2016

Section 409A of the Internal Revenue Code (“Section 409A”) generally provides that, if a plan providing for deferred compensation fails to comply with Section 409A, either in form or in operation, then all amounts deferred...more

The EEOC's View of Wellness Programs

The EEOC’s regulations allayed many concerns over the permissible level of incentives/penalties, as well as the challenge of dealing with inconsistent requirements under the various laws. Originally published in The HR...more

Appellate Division Finds c.78 Health Benefits Contributions Requirements Do Not Apply to Public Sector Disability Retirees

Last month, in Brick Twp. PBA Local 230 v. Twp. of Brick, the Appellate Division of the Superior Court of New Jersey confirmed that N.J.S.A. 40A:10-21.1, P.L. 2011, c. 78, § 42, more commonly known as Chapter 78, does not...more

Best in Law: Beware of In-Lieu-Of Payments to Employees

Employers who allow their employees to opt for taxable cash payments in lieu of health benefits must consider the value of the payments when calculating overtime rates, a federal appellate court has ruled. Originally...more

Time for a Wellness Check on your Wellness Program? New EEOC Regulations Could Diagnose Need for Change

In light of new rules from the Equal Employment Opportunity Commission (EEOC), employers should examine their wellness programs now (and during open enrollment for next year) to determine the potential impact of the final...more

More Clarity on Expatriate Health Plans and the ACA

Expatriate health plans have been surprisingly difficult to reconcile with the Affordable Care Act (ACA). Proposed regulations set to take effect in 2017 provide some useful guidance to U.S. employers that sponsor expatriate...more

IRS Issues Proposed Regulations on Health Plan Opt-Out Payments

The Internal Revenue Service (“IRS”) has issued proposed regulations that include additional guidance on the treatment of employer-provided opt-out payments for purposes of affordability under the Affordable Care Act (“ACA”)....more

New Notice Requirements For Employer Wellness Programs

Employers who sponsor employee wellness programs must plan now to comply with a new notice requirement that takes effect soon. Beginning with the first plan year on or after January 1, 2017, employers sponsoring wellness...more

COBRA Notices May Include Additional Information on Exchanges

The Department of Labor (DOL) recently issued an FAQ addressing the inclusion of information about the Health Insurance Exchanges (Marketplace) in COBRA notices. The guidance could be very helpful for employers in directing...more

Transitioning to Coverage: Three Things to Know About the New Transgender Healthcare Regulations

On May 18, 2016, the Department of Health and Human Services (“HHS”) issued final regulations implementing the nondiscrimination provisions of the Affordable Care Act. As we discussed in our March 30, 2016 blog, the rule...more

HHS Issues Final Rule on ACA Nondiscrimination in Health Programs and Activities

On May 18, 2016, the Department of Health and Human Services (“HHS”) issued final regulations interpreting the nondiscrimination provisions of Section 1557 of the Affordable Care Act (“ACA”). The rule mainly impacts insurers...more

Workplace Policy Institute Insider Report — June 2016

Littler's Workplace Policy Institute Insider Report details key labor, employment, and benefits news and events at the federal, state, local, and global levels. The June edition of the Insider Report highlights recent federal...more

Second Circuit Affirms Dismissal of Claim Arising from Incorrectly Addressed COBRA Notice

In Vangas v. Montefiore Medical Center, 2016 WL 2909354 (2d Cir. May 19, 2016), the Second Circuit affirmed the district court’s holding that an employer is not liable for failing to provide a COBRA notice to a terminated...more

Employee Benefits Developments - May 2016

Agencies Issue New FAQs on the Affordable Care Act.The Departments of Labor, Health and Human Services, and the Treasury (the agencies) issued another set of frequently asked questions (FAQs) regarding the implementation of...more

ACA Nondiscrimination Regulations Finalized

The U.S. Department of Health and Human Services (HHS) has issued final regulations under Section 1557 of the Affordable Care Act (ACA) which prohibit discrimination on the basis of race, color, national origin, sex, age, or...more

The Legalization of Medicinal Marijuana in PA – What Does it Mean for Employer Provided Insurance Coverage?

Pennsylvania’s Medical Marijuana Act (MMA) was signed into law on April 17, 2016 and officially took effect last week. One of the questions we’ve been asked since the passage of the Act is: how will employer provided...more

ERISA Preemption: Don't Tread on my Uniform System of Plan Administration

On March 1 the U.S. Supreme Court again reinforced the broad preemptive scope of the Employee Retirement Income Security Act of 1974, 29 U.S.C.A. §1001. In Gobeille v. Liberty Mutual Insurance Co., 136 S. Ct. 936, the court...more

Illinois Supreme Court Issue Long-Awaited Decision on Vesting of Retiree Health Care Benefits in Matthews v. Chicago Transit...

On May 5th, nearly a full year after it heard oral arguments in the case, the Illinois Supreme Court issued its decision in Matthews v. Chicago Transit Authority, et al., addressing the interplay between a public sector...more

Employee Assistance Programs and State Insurance Regulation Structuring EAPs to Ensure Compliance

Employee Assistance Programs (or EAPs) have served employers and their employees for decades, providing a variety of benefits to address issues that might otherwise adversely affect the overall health and work of employees. A...more

Cadillac Tax: A Levy in Limbo

The future of the Cadillac tax, a key cost-control mechanism and federal revenue source enacted as part of the Patient Protection and Affordable Care Act (ACA), is unclear. Though initially set to take effect in 2018,...more

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