Health Insurance Employer Group Health Plans

News & Analysis as of

May Companies Reduce Employee Hours to Avoid ACA Requirements?

The Affordable Care Act (the “ACA”) generally requires that large employers offer health coverage that meets certain requirements to their full-time employees (i.e., employees working 30 hours or more per week) and their...more

Agencies issue proposed regulation on summary of benefits and coverage and uniform glossary

In December of 2014, the Employee Benefits Security Administration of the Department of Labor (“DOL”), the Internal Revenue Service (“IRS”) and the Department of Health and Human Services (“HHS”) (collectively, the...more

Alert: Health Plan Update on Out-of-Pocket Limitations

The Affordable Care Act (the “ACA”) established limitations on the annual out-of-pocket costs that a health plan may impose on a participant. The U.S. Department of Health and Human Services, Department of Labor and the...more

Administration Releases Final ACA Summary of Benefits and Coverage and Uniform Glossary Rule

On June 12, 2015, the Internal Revenue Service, Employee Benefits Security Administration, and Centers for Medicare & Medicaid Services released final regulations regarding the summary of benefits and coverage (SBC) and the...more

EEOC Guidance: Redesigning Wellness Programs to Comply with the ADA

Although the Equal Employment Opportunity Commission (EEOC) has been actively taking legal action against employers over wellness programs that it considers coercive under the Americans with Disabilities Act (ADA), companies...more

Agencies Clarify Cost-Sharing Limits Under the Affordable Care Act

The U.S. Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (collectively, the Departments) have issued a set of Frequently Asked Questions (FAQs) clarifying the limitations on cost sharing under...more

Week in Review – June 2015

Special Session – Not Yet - Governor Mark Dayton and House Republican leaders on Monday tentatively agreed to a two-year school spending budget, moving them one step closer to avoiding a partial government shutdown...more

What's Next in Employee Wellness: Impact of the Affordable Care Act and New EEOC Initiatives  [Video]

The Affordable Care Act provides employers with a road map on how to implement and administer employee wellness programs. Spilman attorneys Eric Kinder and Erin Jones Adams discuss the components of an effective wellness...more

GM Not Obligated to Make $450 Million Contribution to Fund Union Retiree Health Benefits

The Sixth Circuit held that GM was not obligated to contribute $450 million to fund retiree health benefits for UAW members because the most recent contract between the UAW and GM extinguished GM’s former obligation to...more

Employer Paid Individual Health Insurance Policies Create the Potential for Significant Penalties, But Limited Relief Is Available

Despite guidance from the Internal Revenue Service (“IRS”), the Department of Labor (“DOL”) and the Department of Health and Human Services (“HHS”) indicating the prohibition of the practice under the Affordable Care Act...more

EEOC Proposes Regulatory Clarification on the Application of the ADA to Employer Wellness Program Incentives

Action Item: Employers who already have, or are considering implementing, wellness programs that involve cost-sharing reductions or other financial incentives for participants should carefully review their programs given the...more

The ACA’s Toyota tax

For several years now, employers have spent a great deal of time focusing on the Affordable Care Act’s (ACA) play-or-pay mandate. Numerous articles have been written and numerous educational seminars have been given...more

EEOC Issues Proposed Rule Addressing Employer Wellness Programs and the ADA

On April 20, 2015, the Equal Employment Opportunity Commission (“EEOC”) issued a proposed rule to amend the regulations and interpretive guidance implementing Title I of the Americans with Disabilities Act (“ADA”) as it...more

Manatt on Health Reform: Weekly Highlights - May 2015 #2

Latest numbers show dramatic post-ACA coverage gains; in California, an increase in dental-related ER visits follows cuts to Medicaid dental benefits; and the Massachusetts governor requests to maintain its definition of...more

What’s Up With Wellness Programs Anyway?

My personal interest in employer wellness programs increased a few months ago when my wife and I were offered significant health insurance premium savings through her employer by participating in such a program. We completed...more

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

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