Health Insurance

News & Analysis as of

House Passes Budget Reconciliation Bill with ACA Mandate, Tax Repeal Provisions

On October 23, 2015, the House of Representatives approved H.R. 3762, budget “reconciliation” legislation that includes provisions to repeal of four provisions of the Affordable Care Act (ACA). Specifically, the legislation...more

Recent Developments in Massachusetts Health Policy

Building on the momentum of early October hearings on the state’s growing health care expenditures, the Health Policy Commission (HPC), the Joint Committee on Health Care Financing, Governor Charlie Baker, and others spent...more

FOS publishes Ombudsman News

The October 2015 issue of Ombudsman News includes complaints about life assurance and critical illness cover. FOS highlights the delicate considerations involved in such claims....more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 14 of 24): Coding Form 1095-C, Part II for...

When reporting offers of coverage to full-time employees under the Affordable Care Act’s (ACA) employer shared responsibility rules, much of the detail appears in Part II of IRS Form 1095-C, Lines 14, 15 and 16. For the most...more

Employee Health Information: Separate and Secure

There are several reasons an employer might have employee health information, ranging from the results of a pre-employment physical to the contents of a request for FMLA leave to what’s written in a health provider’s note...more

Manatt Digital Media - October 2015

In this newsletter, we highlight some of the ways digital technologies are transforming healthcare and the opportunities and challenges they present to individuals and businesses. We also introduce you to our team at Manatt...more

The PACE Act – Changes to the Definition of Small Group for Purposes of ACA Market Reforms

On October 7, 2015, the Protecting Affordable Coverage for Employees Act ("PACE Act") was enacted, and on October 19, 2015, the Department of Health and Human Services released FAQs providing further guidance on the Act's...more

IRS Adjusted ACA Fee Amounts for the 2015/2016 Policy or Plan Years and Additional Payment Options

The Patient-Centered Outcomes Research Institute (PCORI) fee was established under the Affordable Care Act (ACA) to advance comparative clinical effectiveness research. The PCORI fee is assessed on issuers of health insurance...more

NAIC Cybersecurity “Bill of Rights” Wrong to Many Insurers

Last week, an NAIC task force moved forward in recommending a cybersecurity “bill of rights” that insurance regulators could provide consumers, essentially creating an expectation of notice of a breach “never more than 60...more

Manatt on Health Reform: Weekly Highlights - October 2015 #3

Arizona seeks Medicaid Waiver to implement new coverage restrictions for Medicaid expansion enrollees and delivery system reform; Tennessee’s uninsured rate continues to drop; and Louisiana gubernatorial candidates line up...more

Candidates Begin to Detail Tax Reform Plans

As the 2016 presidential election cycle rolls on, both Republican and Democratic candidates are beginning to release details of their tax reform plans. On the Republican side, Donald Trump released more details of his...more

Health Alert (Australia) - October 19, 2015

In This Issue: -Judgments; Legislation; and Reports -Excerpt from Judgments New South Wales (NSW) 12 October 2015 - Klewer v Sydney Children’s Hospital Specialty Network [2015] NSWSC...more

Washington Healthcare Update

Bicameral Bill Introduced to Provide HHS Authority to Reject Proposed Insurance Rates - Before Congress left for its Columbus Day recess, Rep. Jan Schakowsky (D-IL) and Sen. Diane Feinstein (D-CA) introduced the Health...more

Changes to New York Telehealth Coverage Coming Soon

After New York became the 22nd state to enact a telemedicine commercial coverage statute, Governor Andrew Cuomo signed an amendment changing the statute. The amendment makes sweeping changes to telehealth coverage under New...more

Health Care Update - October 2015

Cuts in Mandatory Entitlement Programs Center of Budget Negotiations: As budget negotiators from both sides of the Hill come together to work out a two-year budget deal, determining how sequestration relief will be paid for...more

IREG Update - October 2015 #2

Hot Topic - The FIO's criticism of state regulators regarding captive reinsurance framework - The Federal Insurance Office in its September 2015 "Annual Report on the Insurance Industry" criticizes state insurance...more

Experts cite employee wellness programs as area of data privacy concern

In an effort to curb rising healthcare costs, many employers have introduced wellness programs, which use assessments and motivators to improve employee health. Such programs collect information from various sources including...more

President Obama Signs ACA Change Into Law

While Republican efforts to effectively repeal the Affordable Care Act (ACA) through the budget reconciliation process have garnered attention, Congress's recent passage of a bipartisan bill making targeted changes to the law...more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 13 of 24): Coding Form 1095-C, Part II for...

Compliance with the Affordable Care Act’s (ACA) employer shared responsibility rules requires that applicable large employers identify their full-time employees. A “full-time employee” for this purpose is an employee who...more

PCORI Fee Inflation Adjustment

In Notice 2015-60 (October 9, 2015), the IRS announced that the PCORI fee will rise to $2.17 per covered life for plan years ending on or after October 1, 2015 and before October 1, 2016. For plan years ending on or after...more

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

Iowa's largest insurer joins the State's Marketplace for coverage year 2017; carrier changes are announced for Marketplaces in Kentucky, Oklahoma and Wyoming; and South Dakota's Governor convenes the Health Care Solutions...more

President Obama Signs Bills to Amend ACA Small Employer Definition, Expand Access to Clinical Trials

On October 7, 2015, President Obama signed into law H.R. 1624, which amends the Affordable Care Act’s (ACA) definition of “small employer” by maintaining the definition of a small group market as 1-50 employees and thus...more

Potential Penalties Creating Adjustments to Health Care Coverage Plan Offerings

What ACA-related issues have had the most impact on welfare benefit plans and may surface during 2016? JRN: 2015 is the year when the potential to be penalized for not offering employee health care coverage that is both...more

Obama Signs Bill Making Changes to Affordable Care Act

On October 7, President Obama signed into law H.R.1624, the Protecting Affordable Coverage for Employees Act. The act amends a provision of the Affordable Care Act (ACA) to allow states to opt out of the scheduled expansion...more

Washington Healthcare Update

On Oct. 8, the House Republican caucus did not select a candidate for Speaker of the House and selection has been delayed. The current Speaker, John Boehner (R-OH), had announced that he would step down and retire from...more

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