News & Analysis as of

The Waiting is the Hardest Part: Final Regulations on the PPACA’s 90-Day Waiting Period Released

On February 24, 2014, the Internal Revenue Service (IRS), the Employee Benefits Security Administration (EBSA) of the U.S. Department of Labor (DOL), and the U.S. Department of Health and Human Services (HHS) jointly released...more

A Rocky Rollout for the Individual Mandate

It should be news to no one that the implementation of the Affordable Care Act (“ACA”) requirement that individuals without employer sponsored health insurance must be covered by minimum essential coverage (the individual...more

New Wellness Program Rules for 2014

Employers continue to look for ways to manage the cost of employee health care coverage as they navigate the turbulent waters of healthcare reform, and wellness programs continue to be a popular strategy. However, adoption...more

Save The Date: Oct. 1, 2013 — ACA Open Enrollment Begins

A fundamental feature of the Patient Protection and Affordable Care Act (“ACA” or “Act”) is the introduction of health care exchanges, or marketplaces, where individuals and small businesses may purchase “affordable” and...more

MA Fair Share Contribution, HIRD Repealed In FY2014 Budget

Governor Deval Patrick recently approved the Commonwealth’s 2014 fiscal year budget, which includes provisions repealing both the Fair Share Contribution (FSC) and the Health Insurance Responsibility Disclosure (HIRD) form...more

Are You Ready to Pay the PCORI Fee?

The Patient-Centered Outcomes Research Trust Fund fee is a fee imposed on insurance carriers of fully-insured group health plans and on plan sponsors of self-insured group health plans to fund the Patient-Centered Outcomes...more

Important Reminder Regarding PCORI Fees

An important deadline is looming under the Affordable Care Act (ACA) for employers that sponsor certain self-insured group health plans and issuers of certain health insurance policies. Under the ACA, employers and insurers...more

The Impact of the Supreme Court’s DOMA Decision on Employee Benefit Plans — Some Certainty, Many Unanswered Questions

The regulation of marriage was historically presumed to be the exclusive domain of the states. Since 1996, however, the Defense of Marriage Act of 1996 (“DOMA”) changed this presumption in two important respects...more

The Obamacare Delays and the Massachusetts "Fair Share" Employer Mandate: Now What?

As we reported in our post earlier today, the Obama administration has decided to delay implementation of the “employer shared responsibility” mandate for in order to afford employers more time to prepare for compliance. ...more

HIPAA Healthcare Reform - Prompt Attention Needed to Address Upcoming 2013 Deadlines

2013 has already been a busy year for employers with group health plans who are trying to navigate the Affordable Care Act and its immediate implications for employee benefits. However, there are other, less talked about but...more

U.S. Supreme Court Rules Section 3 of DOMA is Unconstitutional: What Should Employee Benefit Plan Sponsors and Administrators Be...

The Defense of Marriage Act (DOMA) provides a single definition of marriage, as between one man and one woman, for purposes of all federal laws, including the Internal Revenue Code and ERISA....more

Employer Responsibility – Will You Pay or Play?

Starting in 2014, provisions of the Patient Protection and Affordable Care Act become effective known as “Pay or Play” or “Employer Shared Responsibility.” Large employers will be faced with the decision whether to offer...more

Healthcare Update, No. 2, May 2013 - Court Upholds OFCCP's Jurisdiction Over Healthcare Providers

A federal district court has confirmed the position of the Office of Federal Contract Compliance Programs (OFCCP) finding that three hospitals providing medical services to U.S. government employees, and receiving payments...more

Health Care Reform: Decisions and a Changing World for Employers

Having cleared the hurdles of a Supreme Court decision and the 2010 and 2012 national elections, health care reform mandated by the Patient Protection and Affordable Care Act (“PPACA” or the “Act”) is closing in fast on key...more

SCOTUS Declines Review in Case Allowing Health Care Provider to Pursue State Law Misrepresentation Claims Against ERISA Health...

The United States Supreme Court recently denied certiorari in a Fifth Circuit case, United Healthcare Insurance Co. v. Access Mediquip LLC, that allowed a health care provider to pursue state law misrepresentation claims...more

OSHA Issues Interim Final Rule on Whistleblower Protections under the Affordable Care Act

As the 2014 implementation date for the most controversial provisions of the Affordable Care Act (ACA) draws closer, most businesses are focused on ensuring that their group health plans meet the ACA's requirements. But there...more

New HIPAA Rules Regarding Genetic Information Affect Employers, Group Health Plans, Health Insurers and Healthcare Providers

Genetic Information Under HIPAA - While the final rule supplementing and modifying the Health Insurance Portability and Accountability Act (HIPAA) Privacy, Security, Breach Reporting and Enforcement Rules—78 Fed. Reg....more

The ERISA Litigation Newsletter - February 2013

In This Issue: - Editor's Overview - View from Proskauer: Are Your Conversations Privileged under ERISA? - Rulings, Filings, and Settlements of Interest ...more

Laboratory Retirees May Proceed In Their Lawsuit Over Health Benefits Against Regents

A group of retirees from Lawrence Livermore National Laboratory brought a lawsuit against the Regents of the University of California (“Regents”) after the University of California eliminated their University-sponsored health...more

DOL, IRS, and HHS Put the Brakes on Stand-Alone HRAs Used to Access Health Insurance Coverage in the Individual Market

In a set of Frequently Asked Questions (FAQs) posted to the Department of Labor’s website on January 24, the Departments of Health and Human Services, Labor, and Treasury (the “Departments”) put a stop to an approach to...more

Roadmap to Compliance: Navigating the Employer Shared Responsibility Rules

Earlier this month, the IRS issued proposed regulations that provide much-needed guidance on the new “pay or play” rules (also called the shared responsibility rules) that will apply to employers’ group health plans beginning...more

Exchange Notice Deadline Postponed: Employers Need Not Furnish The Notice Of Coverage Options Available Through Exchanges By March...

The Affordable Care Act requires employers to provide written notice of coverage options available through an Exchange (the Exchange Notice) to each employee by March 1, 2013 and to each new employee thereafter on his or her...more

Restrictions On Fixed Indemnity Coverage

The Department of Labor Employee Benefits Security Administration issued guidance on the issuance of fixed indemnity insurance on January 24, 2013 in its FAQs about Affordable Care Act Implementation Part XI. These FAQs are...more

U.S. Department of Labor Postpones Affordable Care Act’s Employer Health Insurance Notice Requirement

On January 25, 2013, the United States Department of Labor (DOL) announced that it would postpone the implementation of a provision of the Affordable Care Act (ACA) that will require employers to inform employees about health...more

Employers Receive Additional Time to Provide Exchange Notice to Employees

As most are aware, 2013 is an important transition year when it comes to complying with the Affordable Care Act....more

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