News & Analysis as of

Group Health Plans: Year-End Action Items and Upcoming Changes - 2014

Employers should note upcoming cafeteria plan design changes that require an amendment no later than December 31, 2014 and other upcoming 2015 action items....more

Labor & Employment E- Note - December 2014

In This Issue: - SCOTUS Says Firms Don't Have to Pay for Security Screening Time - EEOC Saw Decline in Discrimination Settlements, Number of Cases - HHS Closes Loophole Allowing Employers to Cut Hospital...more

Employer Cash Payments To Reimburse Employees For Health Insurance Costs – No!

Many employers offer or provide cash to employees to reimburse them for the cost of purchasing an individual health insurance policy. Others offer employees with high claims risk a choice between enrolling in the company’s...more

Ninth and Tenth Circuits Address Removal Under CAFA's "Mass Action" and "State Action" Provisions

In Corber v. Xanodyne Pharmaceuticals, the Ninth Circuit – on rehearing en banc –examined the applicability of the “mass action” provision of CAFA, which provides federal jurisdiction for any civil action in which monetary...more

"New Preventive Services Under the Affordable Care Act"

The Affordable Care Act (ACA) requires non-grandfathered group health plans to provide benefits for items or services recommended by the U.S. Preventive Services Task Force (USPSTF). These benefits must be provided without...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 5: Health and Human Services (HHS) Wastes No Time Issuing...

Over the last couple of months, we have followed and reported on a particular ACA compliance strategy under which an employer subject to the Affordable Care Act’s employer shared responsibility (or “pay-or-play”) rules...more

DOL Gives States More Control Over Self-Insured Health Plans

On November 6, 2014, the U.S. Department of Labor, Employee Benefits Security Administration (DOL) published Technical Release 2014-01, which provides technical guidance to States concerning stop-loss insurance. Stop-loss...more

ACA Fees, and Forms, and Delays, Oh My!

In the latest round of delays under the Affordable Care Act (ACA), the Employee Benefits Security Administration recently announced that the deadline for health plans to provide enrollment information to the transitional...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 6: Labor and Treasury Departments Play Whack-a-Mole with...

Last year, the Department of Labor and the Treasury Department/IRS (Departments) issued guidance on the application of certain of the Affordable Care Act’s insurance market reforms to health reimbursement arrangements (HRAs),...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 7: IRS Puts the Kibosh on Health Plans that Fail to Cover...

In a previous post, we described an Affordable Care Act compliance strategy—referred to commercially as a “minimum value plan” or “MVP”—that involves an offer of group health plan coverage that, while similar in most respects...more

Group health plans for same-sex spouses: Equal treatment required or not?

In our recent webinar, McAfee & Taft attorneys shared with you a number of ramifications from the recent U.S. Supreme Court decision that effectively legalized same-sex marriage in Oklahoma. One of the key questions we...more

Affordable Care Act Update: Hospitalization Services Required for Plan to Meet Minimum Value

On November 4, 2014, the Internal Revenue Service (IRS) released guidance (Notice 2014-69) clarifying that certain group health plans that do not provide for hospitalization services or physician services or both will fail to...more

Eighth Circuit Permits Employee to Maintain Age Bias Claim Based on Company's Age-Based Health Care Considerations

With the rising costs of health care benefits for both employers and employees alike, a recent case out of the Eighth Circuit provides an important reminder that even seemingly innocuous cost control measures can have a...more

Updated Timeline of Highlights for Employer Group Health Plan Compliance with the Affordable Care Act

Since enactment of the Affordable Care Act (“ACA”), the regulators have promulgated a myriad of regulations implementing the ACA’s requirements for group health plans. Over the past several years, the Obama administration has...more

Provider Competition Matters—Even for “Reference Pricing”

In a recent blog post, three Federal Trade Commission (FTC) economists splashed some cold water on advocates of “reference pricing” that seem to imply that such pricing “will increase competition between providers.” In the...more

IRS Issues New Forms And Instructions Regarding The Employer Mandate Information Reporting Requirements Under The ACA

In order to administer and enforce the rules of the Employer Shared Responsibility Mandate, the Affordable Care Act (ACA) added Sections 6055 and 6056 to the Internal Revenue Code, which require insurance providers and...more

IRS to Amend Cafeteria Plan Regulations to Facilitate Enrollment in Marketplace Coverage

On Thursday, September 18, 2014, the Internal Revenue Service (“IRS”) released Notice 2014-55, which expands the cafeteria plan “change in status” rules to allow plans to offer employees an option to revoke their elections...more

California Repeals 60-Day Limit on Waiting Periods

On August 15, 2014, California passed Senate Bill 1034, which repealed an insurance law (Assembly Bill 1083) that prohibited insurance companies from including waiting periods in excess of 60 days in their group health...more

Illinois Supreme Court Rules that Public Sector Retiree Health Subsidies are Constitutionally Protected Benefits

As covered in more detail in a separate alert, the Illinois Supreme Court ruled in Kanerva v. Weems by a 6-1 margin that state-subsidized retiree health coverage premiums are subject to the pension protection clause of the...more

Failure to Cover Applied Behavior Analysis for Autism Spectrum Disorder Violates Federal Mental Health Parity Law

Parents have searched for effective therapies for children with autism spectrum disorder. One therapy that has shown promise, at least for some children, is applied behavior analysis (“ABA”), which is an intensive behavioral...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 23: The Impact of Employment Contract Terms on Variable Hour...

For applicable large employers (i.e., employers who employed at least 50 full-time and full-time equivalent employees on business days during the preceding calendar year) endeavoring to comply with the Affordable Care Act’s...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

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

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

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