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Health Insurance Employee Benefits Third Party Administrators

Polsinelli

Department of Labor Settles with TPA to End Cross-Plan Offsetting Practice

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The U.S. Department of Labor (“DOL”) recently entered into a settlement agreement with a New York-based insurer and third-party administrator (“Company”) of employer group health plans governed by the Employee Retirement...more

Seyfarth Shaw LLP

Mental Health Parody: In A Cruel Prank, Agencies Respond to Employer Pleas for Guidance with More Stringent Regulations

Seyfarth Shaw LLP on

Seyfarth Synopsis: The Mental Health Parity and Addiction Equity Act (MHPAEA) requires group health plans and insurers to cover treatments for mental health and substance use disorders in a manner that is equitable to the...more

Warner Norcross + Judd

Mental Health Parity Guidance is Coming

Warner Norcross + Judd on

NOTE: As we were preparing to publish this eAlert, the DOL issued proposed mental health parity regulations. We will provide an update on the proposed regulations in a future eAlert. Nonetheless, group health plans must still...more

Woodruff Sawyer

Claims Cost Transparency: Using Data to Optimize Medical Benefits Costs

Woodruff Sawyer on

How much would you get back in your budget if you could save up to 10% on your medical and Rx benefits costs? Employee benefits are the second largest budget item in employee compensation, with medical benefits consuming the...more

Polsinelli

Third Party Administrator Update - TPA Licensing and Compliance: Vermont Issues Proposed Regulation Adopting DECEMBER 2020...

Polsinelli on

In the fall of 2019, we reported that Vermont enacted Senate Bill 41, which granted the Commissioner of the Vermont Department of Financial Regulation (the “Department”) jurisdiction over entities that administer one or more...more

Nossaman LLP

New Disclosure Requirements for Those that Contract with ERISA Group Health Plans

Nossaman LLP on

Included within the 5539 pages of statutory changes in the Consolidated Appropriations Act, 2021 (the COVID-19 relief bill signed into law at the end of December 2020) are important new “transparency” laws that affect third...more

Morgan Lewis - ML Benefits

Mental Health Parity Transparence: Consolidated Appropriations Act, 2021

As we addressed in our recent LawFlash covering the Consolidated Appropriations Act, 2021 (Act), the Act includes several requirements to enhance group health plan transparency. One provision we wanted to further highlight...more

Cozen O'Connor

IRS Announces High Deductible Health Plans Can Cover COVID-19 Expenses Without Applying a Deductible

Cozen O'Connor on

Employers across the country are currently considering what actions to put in place in light of the potential spread of COVID-19 (the coronavirus). Many employers offer their employees high-deductible health plans that can...more

Polsinelli

IRS Issues Guidance on COVID-19 Coverage for High Deductible Health Plans

Polsinelli on

In response to the Coronavirus (“COVID-19”), the Internal Revenue Service advised that a health plan that otherwise satisfies the requirements to be a High Deductible Health Plan (“HDHP”) under section 223(c)(2)(A) will not...more

Morgan Lewis - ML Benefits

IRS Modifies HDHP Rules in Response to Coronavirus Concerns

The IRS issued guidance on March 11 that clears the way for employers to offer employees covered by a high-deductible health plan (HDHP) testing and treatment for the 2019 Novel Coronavirus (COVID-19) with no deductible or at...more

Littler

“Medical Necessity” Isn’t Well-Defined Unless It Is Well-Defined

Littler on

A U.S. District Court in Connecticut recently issued an order that highlights the importance of understanding exactly what the term “medically necessary” means in an ERISA health plan....more

Seyfarth Shaw LLP

Fraud In Your Healthcare Plan? It’s Probably There

Seyfarth Shaw LLP on

Seyfarth Synopsis: Employer subsidized healthcare is one of the largest cost centers for small and large businesses.  This post provides a primer on what to do if you suspect that your healthcare costs are rising because your...more

Seyfarth Shaw LLP

Eighth Circuit Grants Slight Reprieve To Mother Of Transgender Son In ACA Discrimination Suit

Seyfarth Shaw LLP on

Seyfarth Synopsis: The Eighth Circuit upheld dismissal of Title VII claims challenging an employee benefit plan’s blanket transgender exclusion because the exclusion impacted the employee’s transgender son, not the employee....more

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