News & Analysis as of

Bipartisan Budget Act Extends MAP-21 Pension Funding Relief and Increases PBGC Premiums

On Monday, November 1, 2015, President Obama signed into law the Bipartisan Budget Act of 2015 (the “BBA”) which brings familiar changes for sponsors of defined benefit pension plans. Similar to the Moving Ahead for Progress...more

Automatic Enrollment for Health Plans Has Been Repealed

Budget legislation signed into law by President Barack Obama on November 2, 2015, the Bipartisan Budget Act of 2015, repeals the controversial automatic enrollment provision under the Affordable Care Act (ACA). Section 18A of...more

Manatt on Health Reform: Weekly Highlights - October 2015 #4

HHS announces average premium price increases of 7.5% across; Michigan and Illinois launch the country’s first joint cloud-based, real-time Medicaid information management system; and the Marketplace carrier...more

Fenwick Employment Brief

California Legislature Acts to Outlaw Pre-Employment Mandatory Agreements to Arbitrate Labor Code Claims - In late August, the California Senate and Assembly passed AB 465, which, if signed by Governor Jerry Brown, will...more

Manatt on Medicaid: Arizona Releases Draft Waiver Request for Approval to Implement Reforms to ACA Medicaid Expansion

Overview - On August 18, 2015, Arizona released the Modernizing Arizona Medicaid proposal for a new 1115 waiver to implement coverage and delivery system reforms in its Medicaid program, the Arizona Health Care Cost...more

Manatt on Health Reform: Weekly Highlights - September 2015

CMS permits states to use income information from other means-tested benefit programs for Medicaid eligibility determinations; Alaska’s Medicaid expansion is given the green light to launch today; and Washington State submits...more

Filed Rate Doctrine Addressed in Recent Second Circuit Decision

The filed rate doctrine can often provide a strong defense to an insurer in a class action claiming that insurance premiums were too high for some reason. A recent Second Circuit decision applied the doctrine broadly. This...more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 4 of 24): Highlights from the Draft 2015...

The IRS recently issued draft 2015 Instructions for Forms 1094-C and 1095-C (“2015 Instructions”). These are the forms that employers with 50 or more full-time employees (including full-time equivalent employees) in the...more

Will § 4980H Require Judicial Amendment Too?

Absent applicable transitional relief, most of which vanishes after 2015, an ACA Applicable Large Employer that fails to offer Minimum Essential Coverage to at least 70% of its 2015 full-time employees and their dependents...more

Hospitality Businesses Should Consider “Play and Pay” for the ACA

A hospitality industry professional recently asked me if I thought most hotels would stop offering group health insurance coverage to their employees and have them purchase their own policies from Covered California.  My...more

Health Care Update - July 2015

In This Issue: - Medicare Releases Set of Payment Rules, Physician Fee Schedule on Deck - Implementation of the Affordable Care Act - Federal Regulatory Initiatives - Congressional Initiatives - Other...more

Congressional Health Policy Hearings - June 2015 #2

A House Ways and Means Subcommittee on Oversight hearing recently reviewed the effects of the Affordable Care Act (ACA) on health insurance premiums. In addition, a House Energy and Commerce Health Subcommittee hearing...more

Stretched for Resources, the IRS Sets Its Sights on Small Captive Insurers

A "captive" insurance company is an insurer formed for the limited purpose of insuring the risks of its non-insurer owner or owners. A captive can be an effective risk-management tool, especially for costly or unconventional...more

Investors Should Be Aware of an Interesting Blue Cross Antitrust Case

It was recently reported that Blue Cross and Blue Shield (BCBS), along with the Blue Cross Blue Shield Association, was sued across all states in a class action brought by two types of plaintiffs. One plaintiff class reflects...more

Is Private/Non-Profit D&O Coverage Under Priced? [Video]

From the 2015 PLUS D&O Symposium session “Who Me? I Didn’t Do Anything…Wrong,” moderator Jeff Lattmann (Beecher Carlson) and panelists Liz Olsson, RPLU (Wells Fargo Insurance) and Shelley Norman (AIG) discuss the differences...more

Wholly foreign retrocession premiums not subject to US excise tax

The United States Court of Appeals for the District of Columbia has affirmed a lower court’s grant of summary judgment in Validus Reinsurance, Ltd. v. United States, in favor of the taxpayer, though on narrower grounds than...more

Locke Lord QuickStudy: Validus Court of Appeals Decision - Wholly-Foreign Retrocessions Not Subject to Federal Excise Tax

On May 26, 2015, the United States Court of Appeals for the District of Columbia upheld a District Court decision and ruled that the Internal Revenue Service could not impose excise tax on certain wholly-foreign retrocessions...more

Injured Workers – Will Claims Cost You Less?

WorkCover New South Wales (WorkCover NSW) has announced the most significant workers compensation premium changes for medium and large employers in New South Wales since the commencement of the current workers compensation...more

And the Defense Wins

In Banner Life Insurance Co. v. Jacqueline L. Noel, 2013 U.S. App. LEXIS 1539 (4th Cir. 2013), aff’g 861 F. Supp. 2d 701 (E.D. Va. 2012), the U.S. Court of Appeals for the Fourth Circuit recently affirmed the district court’s...more

Stripping the ACA of Both the Carrot and the Stick: Sticking it to Consumers On and Off the Federal Exchange

Even as we write and you read, the Supreme Court in King v. Burwell is considering whether qualifying (often low income) individuals and families who have an opportunity to purchase healthcare coverage through the Affordable...more

Premium Refund Theory in Insurance Class Action Rejected By Michigan Federal District Court

One theory that has been raised by plaintiffs’ lawyers in some insurance class actions is that policyholders should receive a partial refund of their premiums because they are not receiving the coverage they paid for, or...more

FHA Reduces Annual Insurance Premiums

On January 8, HUD announced that the Federal Housing Administration (FHA) will reduce the annual insurance premiums new borrowers pay by 50 basis points....more

Quirky Question #247, An Update on Wellness Programs

Question: Our company has been considering implementing financial incentives for employees to participate in biometric screening as part of an employee wellness program. Are there legal issues we should be...more

Manatt on Health Reform: Weekly Highlights: November 2014 #4

In this week’s highlights, new proposed guidance from the feds would allow default renewals to lower cost plans and bring enhanced transparency to Qualified Health Plan rate increases; open Enrollment hits its stride –...more

Employee Benefits Developments - November 2014

Health Care Cost Consideration May Support Age Discrimination Claim. Recently, the U.S. Court of Appeals for the Eighth Circuit overturned a lower court’s summary judgment ruling against a plaintiff’s age discrimination...more

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