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News from the Health Law Gurus™

Chinese Hackers Infiltrate Health System Network Affecting 4.5 Million Individuals – Community Health Systems, Inc. (“CHS”) reported this week that the information of approximately 4.5 million individuals has been affected by...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

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

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

A Tale of Two Circuits: D.C. Circuit, Fourth Circuit Split on ACA Subsidies

It was the best of times for ACA subsidies, it was the worst of times for ACA subsidies. On Tuesday, the Court of Appeals for the D.C. Circuit (“D.C. Circuit”) and the Court of Appeals for the Fourth Circuit (“Fourth...more

Health Law Blog: Court Strikes Down Tax Credit Provision for Low Income Americans Participating Through Federal and Federal/State...

Yesterday, the United States Court of Appeals for the District of Columbia ruled the IRS’ interpretation of a key ACA provision is invalid. Specifically, the court found that the IRS did not have the authority to interpret...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

News from the Health Law Gurus™: July 2014

Survey of ACA Navigators Finds 10.6 Million People Sought Enrollment Help — In a survey released this week, the Kaiser Family Foundation (“Kaiser”) estimates that approximately 10.6 million people received assistance...more

High Rates of Unhealthy Enrollees in ACA Exchanges

Perhaps putting added pressure on insurers as they prepare to set rates for 2015, new evidence suggests that people enrolled in health plans under the Affordable Care Act have higher rates of serious health conditions than...more

The IRS Says (Again) That Certain Employer Payment Plans Won’t Fly

The IRS recently issued two new Q&As to underscore that arrangements allowing employers to reimburse employees on a pre-tax basis for premiums used to purchase individual health coverage, either inside or outside of a public...more

Employer Reimbursements For Health Insurance Policy Premiums–Care Needed

Employers who reimburse employees on a pre-tax basis for premiums the employees pay on their own individual health insurance policies (whether under an Obamacare Exchange or otherwise) are at risk for a $100 per day per...more

Labor Pains: The $2 Million Part-Time Employee

One of your employees (we’ll call him “Don”) cannot enroll in your health insurance plan because you classify him as “part-time” (one who works less than 30 hours a week). This forces Don to get health insurance through a...more

Changes & Opportunities in 2014 for Small Employers under ACA

The Affordable Care Act (ACA) brings about significant healthcare reform changes, as well as opportunities for small employers in 2014. Many of the reforms affect all employers who sponsor group health plans; however, the...more

HEAL Advisory: New COBRA Model Notices and Coordination with Marketplace Enrollment

On May 2, 2014, the U.S. Departments of Labor and Health and Human Services published a series of guidance and model notices clarifying the provision of health insurance to recently terminated employees. The Department of...more

New Model COBRA Notices

To coordinate information about the new marketplace/exchange coverage that may be available under the Affordable Care Act, today the U.S. Department of Labor, in conjunction with the IRS and U.S. Department of Health and...more

Affordable Care Act Transitional Policy For Individual And Small Group Plans

On November 14, 2013, the Obama Administration announced a transitional policy, whereby insurers may, but are not required to, renew existing health plans in the individual and small-group markets in 2014, even if those plans...more

CMS Letter to State Insurance Commissioners Offers Transitional Policy to Prevent Health Insurance Issuers from Cancelling Plans...

On November 14, 2013, the CMS Center for Consumer Information and Insurance Oversight issued a letter to State Insurance Commissioners announcing a “transitional policy” to permit health insurance issuers to continue plan...more

“Any Willing Insurer” Legislation Introduced in Pennsylvania

A significant number of states have “Any Willing Provider” statutes that require a health insurer to admit all requesting providers into the health insurer’s preferred provider network. While some of these statutes are...more

HHS: Providers May Be Able to Subsidize Premiums For Uninsured in Marketplace Plans

An announcement October 30 from Health and Human Services Secretary Kathleen Sebelius could remove the first hurdle for providers wishing to offer premium support for individuals eligible for health insurance on the Health...more

Challenge to Premium Assistance for Individuals Who Purchase Insurance on Federally Established Exchanges Allowed to Proceed in...

A D.C. district court judge ruled that a case can proceed challenging the IRS rule allowing individuals who purchase insurance on exchanges established by the Federal government (and not by a State) to be eligible for premium...more

Treasury Department/IRS Issue Proposed Rules on Employer Reporting of Health Insurance Coverage Under the Affordable Care Act

In addition to imposing substantive requirements on health insurance issuers in the group and individual markets and employer-sponsored group health plans, the Patient Protection and Affordable Care Act (Act) imposes three...more

Healthcare Law -- Jul 15, 2013

How Does the DOMA Defeat Impact Healthcare Reform and Health Insurance Access? - NOTE: The Supreme Court's 5-4 decision to invalidate the Defense of Marriage Act (DOMA) will affect more than 1,000 federal statutes—and...more

2013 and 2014 under the Affordable Care Act - Updated as of May 14, 2013

This is an update on an earlier Client Advisory on this subject, with updates to reflect recently issued guidance. Employers should consider the following checklist of new requirements as the nation moves ahead with...more

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