Health Insurance Employer Group Health Plans

News & Analysis as of

Iowa Supreme Court Affirms Ruling for Health Insurer in Antitrust Dispute

In late February, the Iowa Supreme Court affirmed a lower court ruling in Mueller v. Wellmark, ending a seven year battle over whether the health insurer’s agreement with employers operating “self-funded” insurance plans to...more

EEOC Issues Proposed Regulations On Wellness Programs

Last week, the U.S. Equal Employment Opportunity Commission (EEOC) officially published proposed regulations that provide employers guidance on implementing wellness programs that comply with the Americans with Disabilities...more

EEOC Proposes Rules for Employer Wellness Programs

In response to the increasing cost of providing group health coverage, employers have begun encouraging their employees to participate in wellness programs with the goal of improving overall employee health and reducing...more

Some Good News For Small Employers with Employer Premium Payment Plans

Since the Affordable Care Act (the “ACA”) was enacted, many employers offered “employer payment plans” to effectively cover employee health insurance plans. Per IRS Notice 2013-54, however, employer payment plans are group...more

Avoiding Job Applicants who Smoke: Is Snuffing out Smokers Discrimination?

Faced with increasing healthcare costs and wanting to be a good role model, Gus Grohcer of Canned Foods 4 Less advises all prospective employees that he does not hire smokers and tests for nicotine, making all job offers...more

Understanding and Managing Compliance with the Affordable Care Act for Schools

Under the Patient Protection and Affordable Care Act (“PPACA”), employers are required to offer healthcare coverage that meets the PPACA’s definitions of “affordable” and “minimum value” to all their full-time employees...more

EEOC Endorses Incentives To Employees For Participation In Qualified Wellness Programs

On April 20, 2015, the United States Equal Employment Opportunity Commission (“EEOC”) issued proposed guidance concerning employer wellness programs. The proposed rule would amend the EEOC’s regulations and interpretive...more

HHS releases HIPAA guidance on workplace wellness programs

The Department of Health and Human Services (HHS) recently issued guidance on “HIPAA Privacy and Security and Workplace Wellness Programs.” The guidance helps employers determine whether or not the health information it may...more

EEOC’s Proposed Wellness Regulations Add Burdensome Notice Requirement; Still Prohibit Mandatory HRAs

On April 16, 2015, the Equal Employment Opportunity Commission (EEOC) released proposed regulations covering wellness programs that involve disability-related inquiries or medical examinations....more

EEOC Issues Proposed Rules for Wellness Program Compliance Under the ADA

Employer-sponsored wellness programs attempt to control medical costs and improve employee health by incentivizing certain behaviors through medical monitoring, disease prevention strategies and other activities. Over the...more

Hey – That EEOC Wellness Rule Isn’t Half Bad

Is the proposed rule good for employers, or bad? Pretty good overall. The EEOC has, for the most part, proposed that providing “incentives” for employees to participate in wellness programs (both rewards and penalties, which...more

EEOC Issues Proposed ADA Regulations Regarding Wellness Programs

The regulations are a win for employers, but there is still important work to be done during the comment period. On April 17, the Equal Employment Opportunity Commission (EEOC) released proposed regulations under the...more

The Big Picture of the Employer Shared Responsibility Tax

Ever since the Treasury Department in early 2014 issued final regulations on the employer shared responsibility tax (ESR tax)1 and the related final reporting regulations (ESR regulations)2 under the Patient Protection and...more

EEOC Initiates Rulemaking Process for Employer-Sponsored Wellness Programs

Addressing the ongoing controversy over employer wellness programs, which we discussed in a prior alert, the EEOC recently submitted a notice of proposed rulemaking to the White House Office of Management and Budget (OMB)....more

Multiple Departments Issue Guidance on Wellness Programs

The Equal Employment Opportunity Commission (EEOC) made headlines during the second half of 2014 by attacking employers' wellness programs that require employees to undergo certain medical testing or be penalized....more

IRS Traded in Your Chevy for a “Cadillac (ac-ac-ac-ac-ac) Tax”: Agency Issues First Guidance on the Implementation Code Section...

On February 23, 2015, the Internal Revenue Service (IRS) issued the first piece of guidance that discusses the excise tax, better known as the “Cadillac Tax,” imposed by Section 4980I of the Internal Revenue Code of 1986, as...more

Limited Relief for Certain Employer Health Plan Premium Payments or Reimbursements

Under so-called “employer payment plans” (“EPPs”), an employer pays or reimburses an employee for substantiated premium costs under individual health plan insurance coverage (i.e., nonemployer individual health plan...more

Wellness Programs: Agencies Issue Helpful Guidance but Look Before You Leap

Recent studies indicate that wellness programs significantly improve the health of workers. If only it were so easy to implement a wellness program . . . As explained in our July 17, 2013 Benefits Update – Final...more

IRS Clarifies That After-Tax HRAs and Other Individual Health Insurance Payment Arrangements Generally Violate the Affordable Care...

Any employer who offers an arrangement that reimburses employees (or pays directly) for premiums or other medical costs of individual health insurance coverage, including a health reimbursement account ("HRA") provided in...more

Small Retailers Again Face Increased Health Insurance Costs

The owners of small retail businesses in Massachusetts have come to expect to pay higher health insurance costs than their counterparts in the rest of the country, and unfortunately last year was no exception. ...more

Meet the ACA’s Employer Mandate

After several delays, the Affordable Care Act’s "employer mandate" has begun to take effect. Under the mandate, employers with more than 50 fulltime employees (Large Employers) must offer affordable, minimum essential...more

HIPAA Breach Affects Many Western New York School Districts

Recently, a national BlueCross BlueShield affiliate, Anthem, Inc., discovered that its information technology systems was hacked. The information believed to have been accessed includes names, member ID numbers, dates of...more

Obama Administration Finalizes Health Insurance Wraparound Coverage Rule

The Departments of Labor, Health and Human Services, and Treasury published a final rule on March 18, 2015 that amends the definition of excepted benefits to allow group health plan sponsors, in limited circumstances, to...more

BEST IN LAW: Employers need to heed Obamacare Reporting Rules

Compliance with reporting obligations is always important for any employer, but the employer reporting requirements under the Affordable Care Act pack a significant penalty that makes compliance particularly...more

New HHS Regulations “Clarify” that Health Plans Covering Families Must Have “Embedded” Individual Cost-Sharing Limits

On February 27, 2015, the Department of Health and Human Services (HHS) released its final HHS Notice of Benefit and Payment Parameters for 2016. The lengthy regulation covers a wide range of topics affecting group health...more

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