News & Analysis as of

Healthcare Patient Protection and Affordable Care Act (PPACA) Employee Benefits

Ballard Spahr LLP

Health Plan Compliance Deadlines Draw Near

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Regulations under Section 1557 of the Affordable Care Act and HIPAA will require health plans and health care providers to take action in the coming months to meet new requirements. Health plan sponsors and providers that...more

Ballard Spahr LLP

Final Section 1557 Rules: Highlights for Health Plan Sponsors

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The U.S. Department of Health and Human Services (HHS) has issued final regulations on the nondiscrimination rules set forth in Section 1557 of the Affordable Care Act. The new rules apply to certain group health plans, as...more

Seyfarth Shaw LLP

HHS Issues New Affordable Care Act Section 1557 Nondiscrimination Regulations

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Seyfarth Synopsis: New regulations effective August 6, 2024 restore and expand scope of civil rights protections under Section 1557 of the Affordable Care Act....more

Akerman LLP - HR Defense

On the Basis of Sex… Discrimination in Group Health Plans and What Employers Should Know

In just a few days’ time, recently promulgated federal final rules addressing sex-based nondiscrimination in the administration of health care benefits have created a flurry of healthcare industry activity. The angst arises...more

Bass, Berry & Sims PLC

UPDATE: Planning for Open Enrollment? Note the ACA Affordability Threshold Drop

This post was updated on February 6, 2024, to reflect the 2024 Federal Poverty Level announced in January 2024. On August 23, 2023, the Internal Revenue Service issued Rev. Proc. 2023-29, announcing that the Affordable...more

Ballard Spahr LLP

HHS Announces Temporary Copay Accumulator Non-Enforcement Policy

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The United States Department of Health and Human Services (HHS) has filed court pleadings stating that it does not intend to initiate enforcement actions against plans that maintain copay accumulator programs....more

Seyfarth Shaw LLP

IRS Releases 2024 Limits for Health and Welfare and Related Plans

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Seyfarth Synopsis: The IRS has announced an increase to the applicable dollar amount for determining the Patient-Centered Outcomes Research Institute (“PCORI”) Fee for 2024 as well as other health and welfare limits....more

Seyfarth Shaw LLP

Preventive Care Mandate Returned to Status Quo — Temporarily

Seyfarth Shaw LLP on

Seyfarth Synopsis: The 5th Circuit Court of Appeals has stayed enforcement of a Texas federal district court ruling that that voided the ACA requirement for health plans to cover preventive care items and services (without...more

Ballard Spahr LLP

Preventive Care Rules Remain in Place for Now

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The Fifth Circuit Court of Appeals has stayed the broad application of a district court decision that would have invalidated a number of preventive care requirements under the Affordable Care Act. As a result, health plans,...more

Foley & Lardner LLP

Applying the ERISA Controlled Group and Affiliated Service Group Rules in the Health Care Industry

Foley & Lardner LLP on

Entities interested in entering into health care related industries must consider compliance with the corporate practice of medicine doctrine. In a number of states, the corporate practice of medicine doctrine prohibits...more

Ballard Spahr LLP

FAQs Provide Guidance on Preventive Care

Ballard Spahr LLP on

Summary - The Departments of Labor, the Treasury, and Health and Human Services have jointly issued FAQs that address the requirement to cover the full cost of certain preventive care services in view of the recent ruling...more

Ballard Spahr LLP

Court Invalidates Certain Preventive Care Requirements

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Summary - Health plans and insurance policies may no longer be required to cover the full cost of preventive care that carries an A or B rating by the U.S. Preventive Services Task Force (USPSTF), following a recent ruling...more

Groom Law Group, Chartered

ACA Preventive Service Requirements Partially Vacated

On March 30, 2023, the District Court for the Northern District of Texas issued an opinion and order in Braidwood Mgmt. Inc. v. Becerra that vacates the implementation and enforcement of certain preventive service provisions...more

Freeman Law

Tax Court in Brief | Henry v. Comm’r | Affordable Care Act and Deficiency for Amounts of Advance Premium Tax Credits

Freeman Law on

Summary: From early 2015 and through 2016 Marie Henry (“Henry”) was unemployed and in a terrible financial, physical, and mental state. To get by, she made early withdrawals from a retirement plan. She was enrolled in health...more

Trusaic

Understanding ACA Affordability for 2023 Tax Year

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Since ACA reporting was first required by employers in 2015, the affordability component under the Employer Mandate was established each year by indexing the standard of 9.5%. This has always been the case, that is, until...more

Trusaic

Receive an ACA Penalty from the IRS? Here’s What to Do

Trusaic on

It’s no secret that IRS enforcement is ramping up. With an additional $80 billion in funding and 87,000 new agents, employers should accept the fact that ACA penalties could be coming their way if they’ve neglected the...more

Trusaic

Final Regulations Amend Eligibility for Premium Tax Credits

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The IRS recently issued final regulations on the use of Premium Tax Credits (PTCs), resolving the “family glitch” and extending PTC eligibility beyond individuals to family members.  As a result, individuals and their...more

Patterson Belknap Webb & Tyler LLP

The Reversal of Roe: Impact on Employer-sponsored Benefits post-Dobbs

On June 24, 2022, the Supreme Court of the United States (the “Court”) issued its opinion in Dobbs v. Jackson Women’s Health Organization, overturning the long-standing precedent of Roe v. Wade. In its 6-3 decision, the Court...more

Roetzel & Andress

President Biden’s Executive Orders: Impact On Employee Benefits And Healthcare

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In the opening days of his administration, President Biden has signed a flurry of Executive Orders impacting multiple sectors of the U.S. economy. This article summarizes the Orders that impact employee benefits and...more

Patrick Malone & Associates P.C. | DC Injury...

The health insurance mess: Worker costs jump anew, as kids’ coverage falls

The Covid-19 pandemic has forced many Americans to reconsider their transportation options, what with fears of infection and the slashing of public transit systems’ routes and schedules. That has made used cars, motorcycles,...more

Troutman Pepper

COVID-19 Employee Benefits: FAQs for Employers Focus on Health and Welfare Benefit Plans

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It is hard to find a sector of the American workforce that has not been affected by the COVID-19 emergency. Employees are being asked to work from home if they are able, businesses are being forced to close, and employers are...more

Proskauer - Employee Benefits & Executive...

New Jersey Individual Mandate Requires State Filings in March 2020

The Affordable Care Act’s individual mandate (i.e., the requirement that most individuals obtain adequate health insurance or pay a penalty) is dead. A side effect of the ACA mandate’s demise is that states are beginning to...more

Jackson Walker

New Tool to Contain Employer Healthcare Costs

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Healthcare coverage became an employer-offered benefit during World War II as the result of the federal government’s wage and price controls. Since that time, Medicare has become an important part of how healthcare is...more

Burr & Forman

What the HRA is going on with HRAs?

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On June 13, the Departments of Labor, Treasury and Health and Human Services jointly released final regulations dealing with health reimbursement accounts (“HRAs”). These regulations fulfill the Trump administration’s...more

Mintz - Employment Viewpoints

Agencies Issue Final Regulations Expanding Access to Health Reimbursement Arrangements

On June 13, 2019, the Department of Health and Human Services (HHS), the Department of Labor (DOL), the Department of the Treasury (Treasury Department) and the Internal Revenue Service (IRS) (collectively, the “Departments”)...more

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