News & Analysis as of

New Proposed Rules Streamline ACA Summary of Benefits and Coverage (SBC) Disclosure Requirement

In a very welcome development for health insurance issuers and employers who sponsor self-funded group health plans, the Departments of Treasury, Labor, and HHS have issued joint new proposed regulations that will streamline...more

2015 Health Care Reform Compliance Checklist for Employers

The United States has entered a new era of health care reform. Until now, United States employers were generally not required to provide health care coverage to employees (although many did so for employee relations and...more

Caution: Big Penalties for Reimbursing Health Care Premiums

Even if you are a small employer who is not required to provide your employees with health insurance under the Affordable Care Act (ACA), if you reimburse your employees for health insurance premiums, you run the risk of...more

Administration Issues Proposed Rules on ACA Summary of Benefits and Coverage, Excepted Benefits/Wraparound Coverage

On December 30, 2014, the Internal Revenue Service (IRS), the Employee Benefits Security Administration (EBSA), and the Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would revise Affordable...more

Health Headlines: Also in the News - January 2015 #2

House Passes Bill to Redefine Full-Time Employee Under ACA – On January 8, 2015, the House of Representatives in a 252-172 vote approved a bill that would redefine a full-time worker under the ACA employer mandate from one...more

Employing Veterans May Help Avoid the ACA’s Employer Mandate

The new Republican Congress began its session with an attempt to narrow the Affordable Care Act’s (ACA) employer mandate by exempting certain veterans and their families from counting toward the number of employees at small...more

Obama Administration Seeks Comments on Proposed Changes to Summary of Benefits and Coverage Document and Requirements

On December 30, 2014, the Departments of Health and Human Services, Labor, and the Treasury (collectively, “Departments”) issued a proposed rule (“Proposed Rule”) regarding the summary of benefits and coverage (“SBC”) for use...more

A Quick Look at Healthcare Issues Expected to Make News in 2015

As we look into our crystal balls, we do not expect a lot of new issues in 2015. Rather, we believe that most of the significant issues will be a continuation of issues that arose in 2014 or earlier. ...more

Distant Cousins, not Twins: Some Key Differences between the Massachusetts and Federal Health Care Reform Laws

On January 1, 2015, the Affordable Care Act’s (ACA) employer shared responsibility mandate took effect. Up until July 1, 2013, most employers doing business in Massachusetts were required to comply with an employer mandate...more

Legal Alert: Ring in the New Year with New Summary of Benefits and Coverage Requirements for 2015

On December 30, the Departments of Treasury, Labor, and Health and Human Services published a joint notice of proposed rulemaking modifying the Summary of Benefits and Coverage (SBC) final regulations issued in 2012. In...more

Excepted Benefits: Final regulations provide guidance on dental, vision and employee assistance plans

The Departments of Labor, the Treasury, and Health and Human Services (the “Departments”) have recently published final regulations related to when limited scope dental and vision benefits and employee assistance programs...more

DOL and Treasury Update 2014-2015 Regulatory Agendas for Employee Benefits

The principal regulators of U.S. employee benefits have recently published updates to their guidance plans for the coming months. The updated plans are reflected in the attached chart. ...more

Employee Benefits Developments - December 2014

Can a Medical Plan Enforce a Third-Party Recovery Provision Appearing Only in an SPD? Group health plans are often required to cover medical expenses associated with injuries caused by a third party’s negligence. These...more

No Pre-Existing Condition Exclusions Means HIPAA Certificates No Longer Required

Earlier this year, the Departments of Health and Human Services, Labor and the Treasury issued a final rule implementing the Affordable Care Act (ACA) and revising the requirements of other healthcare laws and regulations...more

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

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