News & Analysis as of

It Was the Economy, Stupid!

Remember Bill Clinton’s 1992 campaign mantra, “It’s the economy, stupid!” A study released today by the Robert Wood Johnson Foundation indicates those four words are the best answer to the question, “Why are so many...more

Supreme Court Rejects Sixth Circuit's Approach to Retiree Medical Benefits

Ordinary contract principles govern disputes about collectively bargained retiree medical benefits. A Morgan Lewis team secured a major victory for employers when the U.S. Supreme Court, in M&G Polymers USA, LLC v....more

Supreme Court Dispenses With the Yard-Man Inferences

In a decision watched closely by both employers and unions, a unanimous Supreme Court has resolved a thirty-plus year split among the circuit courts on the standards governing claims for retiree health-care benefits arising...more

Ding-Dong, Yard-Man Is Dead! Supreme Court Decision in Tackett a Huge Win for Employers in the Retiree Healthcare Arena

On Monday, a unanimous United States Supreme Court issued its decision in M & G Polymers USA, LLC v. Tackett, Supreme Court Case No. 13-101, vacating and remanding the Sixth Circuit’s holding that a group of retirees was...more

U.S. Supreme Court Rejects the Yard-Man Inference Vesting Lifetime Benefits for Union Retirees

In M&G Polymers USA, LLC v. Tackett, the U.S. Supreme Court overturned three decades of precedent by the U.S. Court of Appeals for the Sixth Circuit, unanimously ruling that, when no specific provision in a...more

Supreme Court Rejects Yard-Man: Ordinary Contract Principles Apply When Interpreting Retiree Medical Promises

The Supreme Court has unanimously vacated a Sixth Circuit ruling that a collective bargaining agreement (CBA) vested retirees with lifetime medical benefits. M&G Polymers USA, LLC v. Tackett, No. 13-1010, 2015 U.S. LEXIS 759...more

Decision Alert: US Supreme Court Potentially Shifts the Balance in Healthcare Employee Benefits Litigation

Justice Clarence Thomas and a unanimous US Supreme Court decided to vacate a Sixth Circuit decision and hold that the federal courts cannot assume from silence in a union’s collective bargain agreement that retiree group...more

Agencies Green Light Pilot Program to Allow Limited Wrap-Around Coverage for Health Insurance Policies Purchased on an Exchange

Under proposed rules recently issued by the Departments of Treasury, Labor, and HHS, employers may participate in a pilot program where they offer certain wraparound coverage as an “excepted benefit” to part-time employees,...more

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

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