News & Analysis as of

Manatt on Health Reform: Weekly Highlights: November 2014 #2

With the conclusion of the midterm elections last week and open enrollment just around the corner, this week’s news highlights both renewed pledges from the opposition and a flurry of implementation activity in the states....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

Government Kills Aggressive ACA Employer Planning Technique

Action Item: The government has struck down an important Affordable Care Act planning technique: so-called “middle” or “minimum value” plans. Employers that have implemented such plans or are significantly down the road on...more

U.S. Supreme Court Agrees to Hear Arguments Involving Federal Health Insurance Exchange Subsidies

On Friday, the U.S. Supreme Court announced that it would review the U.S. Court of Appeals for the Fourth Circuit’s decision in King v. Burwell. In that case, the Fourth Circuit held that tax credits for health insurance...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

New Agency FAQs Drive a Stake Further into the Heart of Premium Reimbursement Arrangements and Eliminate a Common Executive Perk

In clear and unambiguous terms, the U.S. Departments of Labor (“DOL”) and Health and Human Services and the Internal Revenue Service (“IRS”) (the “Agencies”) drove a stake into the heart of two suspect health insurance...more

The Affordable Care Act – Where Are We Now?

The ACA was signed into law in March of 2010 with the goals of increasing the quality and affordability of health insurance, lowering the uninsured rate by expanding public and private insurance coverage, and reducing the...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

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

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

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

The Affordable Care Act—Countdown to Compliance for Employers, Week 16: So What, Exactly, is an “Offer of Coverage”?

Whether an employer makes the requisite offer of group health plan coverage is critical to the application of the Affordable Care Act’s employer shared responsibility rules as reflected in final implementing regulations...more

Boehner Brings Suit Against Obama Regarding Employer-Mandate Delays

On Wednesday, July 30, House Speaker John Boehner (R-OH) moved to bring suit against President Barack Obama regarding employer-mandate delays as they pertain to the Affordable Care Act. The House voted along party lines...more

Monthly Benefits Update - July 2014

Two federal appeals courts issued contradictory rulings on the validity of subsidies for the purchase of health insurance under the federal marketplace established pursuant to the Affordable Care Act (ACA). On July 22, a...more

HEAL Advisory: How Big Is Halbig? The Potential Effects of This Major Ruling Are Numerous and Significant

On July 22, 2014, the U.S. Court of Appeals for the D.C. Circuit and the U.S. Court of Appeals for the Fourth Circuit issued conflicting opinions on a key aspect of the Affordable Care Act ("ACA"). The cases are Halbig v....more

The Affordable Care Act—Countdown to Compliance for Employers, Week 22: Charting the Future of the Premium Subsidies (and Employer...

On July 22, 2014, two federal appellate courts issued conflicting decisions, within hours of each other, regarding the IRS final rule published on May 23, 2012 (the “IRS Rule”), intended to implement the exchange-related tax...more

Conflicting Rulings on Health Insurance Subsidies Raise Concerns Among Insurers and Providers

On Tuesday, July 23rd 2014, separate federal circuit court panels issued conflicting rulings regarding whether the government could subsidize health insurance premiums for Americans enrolled in federally-run health exchanges....more

Stay Tuned: Impact of Supreme Court Decision on ACA's Contraceptive Mandate Uncertain

It’s too soon to know the impact on the workplace of the U.S. Supreme Court’s recent decision that certain businesses may opt out of the Affordable Care Act’s (ACA) requirement to pay for birth control in their healthcare...more

Of Mice and Elephants: Halbig and King and The Struggle of Two Federal Appeals Courts to Find Meaning in Words That May or May Not...

At issue in Halbig v. Burwell and King v. Burwell is whether or not subsidies to buy insurance on an exchange are available in both state and federal exchanges. On its face the Affordable Care Act (“ACA”) provides for...more

Federal Appeals Court in D.C. Strikes Down Key Aspect of Health Care Reform (Just Before the 4th Circuit’s Opposite Ruling) – Any...

On Tuesday, the U.S. Court of Appeals for the District of Columbia Circuit, in a 2-1 ruling by a three judge panel, invalidated an Internal Revenue Service regulation that interpreted section 36B of the Affordable Care Act...more

Health Care Alert: ACA Health Insurance Subsidies Called into Question by DC Circuit

Yesterday, a divided three judge panel of the United States Court of Appeals for the DC Circuit struck down the IRS regulation allowing federal premium subsidies for individuals buying health insurance at...more

Hobby Lobby: Just a Start

As a trial lawyer, I rarely pay much attention to dissenting opinions. They do not serve as meaningful precedent, and they tend only to express the loser’s frustrated perspective. But Justice Ginsburg’s dissent in the Supreme...more

Rethinking COBRA After Health Care Reform

The Health Care Reform Act made many changes to health plans, but one thing it did not do was expressly eliminate or change the COBRA rules. Although health care reform does not expressly change COBRA, it does, in many ways,...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

Burwell v. Hobby Lobby: What Else the Hobby Lobby Decision means

Whether you are a friend or foe of the Hobby Lobby decision handed down by the United States Supreme Court this past Monday, citizens must know the very real and far-reaching consequences of the decision. This...more

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