In a summary of the recently issued Association Health Plan (AHP) final regulations, the U.S. Department of Labor (DOL) rightly observed that AHPs are a species of multi-employer welfare arrangements, or MEWAs, that are...more
10/3/2018
/ Affordable Care Act ,
Association Health Plans ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Health Insurance ,
Healthcare Reform ,
Independent Contractors ,
MEWAs ,
Preemption ,
Regulatory Reform ,
Reporting Requirements ,
Savings Clause ,
Supremacy Clause ,
Trump Administration
This is the first post in a blog series exploring the U.S. Department of Labor’s recently issued final regulation governing Association Health Plans (AHPs). While AHPs can be either fully-insured or self-funded, the final...more
7/24/2018
/ Affordable Care Act ,
Association Health Plans ,
Department of Labor (DOL) ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Executive Orders ,
Final Rules ,
Health Insurance ,
Healthcare Reform ,
MEWAs ,
Trump Administration
In a series of recent posts, we discussed the expanded Massachusetts Employer Medical Assistance Contribution (EMAC) requirements, including the adoption of a new EMAC supplemental contribution. Among other things, we...more
In last week’s post we explained the changes made by a newly proposed Department of Labor regulation, the purpose of which is make it easier for small employers to band together to form “association health plans” (“AHPs”). In...more
1/22/2018
/ Affordable Care Act ,
Association Health Plans ,
Department of Labor (DOL) ,
Employee Benefits ,
Employer Group Health Plans ,
Executive Orders ,
Health Insurance ,
Healthcare Reform ,
MEWAs ,
NAIC ,
Regulatory Reform ,
Trump Administration
Massachusetts employers with 6 or more employees will soon be required to prepare and file a new health care reporting form referred to as the “healthcare coverage form.” While reminiscent of the now repealed “Health...more
1/17/2018
/ Affordable Care Act ,
Cost-Sharing ,
Employer Group Health Plans ,
Employer Mandates ,
Fair Share Contribution ,
Governor Baker ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Local Ordinance ,
Popular ,
Reporting Requirements
On October 13th, President Trump signed an Executive Order directing various federal agencies to consider how to achieve three administration health reform objectives: (1) expand access to Association Health Plans (AHPs); (2)...more
10/25/2017
/ Affordable Care Act ,
Association Health Plans ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Labor (DOL) ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Executive Orders ,
Healthcare Reform ,
Medical Reimbursement ,
MEWAs ,
New Guidance ,
Secretary of Labor ,
Trump Administration
At this writing, the prospects for success of the latest Republican effort to replace the Affordable Care Act appear bleak — but the Graham-Cassidy bill on which the GOP has pinned its last-ditch hopes highlights a major...more
9/25/2017
/ 1332 Waiver ,
Actuaries ,
Affordable Care Act ,
Block Grants ,
Cost-Sharing ,
EHB ,
Federal v State Law Application ,
Health Insurance ,
Healthcare Reform ,
Insurance Risk Pool ,
Medicaid ,
Medicare ,
Premiums ,
Public Health Insurance Marketplace ,
Repeal
In an effort to make up for a funding shortfall in the Commonwealth of Massachusetts’ Medicaid program, state policymakers have proposed solutions that include a “play-or-pay” option under which employers who fail to offer...more
5/30/2017
/ Children's Health Insurance Program (CHIP) ,
Deficit Reduction ,
Employee Retirement Income Security Act (ERISA) ,
Employer Contributions ,
Employer Group Health Plans ,
Health Insurance ,
Healthcare Reform ,
Medicaid ,
Pay or Play ,
Preemption ,
State Legislatures
A recent report from the nation’s top actuaries takes a sobering look at the challenges policy makers face in creating a viable individual (i.e., non-group) health insurance market—a critical component of any plan to replace...more
This week continues our survey of key Republican proposals to “repeal and replace” the Affordable Care Act (ACA). In the past two weeks, we have reviewed the Trump/Pence transition plan, entitled “Healthcare Reform to Make...more
The recent Republican election victories appear to ensure that the Affordable Care Act’s (ACA) days are numbered. But with nearly a fifth of the U.S. economy, and the health care coverage for some tens of millions of U.S....more
12/29/2016
/ Affordable Care Act ,
Employee Retirement Income Security Act (ERISA) ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Health Savings Accounts ,
Healthcare ,
Healthcare Reform ,
HSA ,
Medical Stop-Loss Rules ,
Medicare ,
MEWAs ,
Wellness Programs
The Trump campaign promised to “repeal and replace” the Affordable Care Act. On the campaign trail, candidate Trump was particularly critical of the ACA’s individual mandate, the subsidization of premium charges to older...more
The Affordable Care Act made fundamental and important changes to the way the United States finances health care. The law did not represent a radical departure from prior law or policy, however. The ACA instead worked within,...more
The Affordable Care Act was—at least until the election of Donald J. Trump as President—the single most important piece of Federal social legislation in the United States in more than a generation. The law’s fate is now...more
The Affordable Care Act is the single most important piece of Federal social legislation in more than a generation. While there was and is broad agreement on the law’s principal goals—to expand medical coverage, increase the...more
A recent Washington Post article (“Glitch in health care law allows employers to offer substandard insurance,” September 12, 2014) highlights an Affordable Care Act compliance strategy being marketed heavily (and adopted...more
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
Following up on our Week 22 ACA Countdown to Compliance post, the D.C. Court of Appeals granted the government’s petition for en banc review in Halbig v. Burwell, which held low income subsidies to purchase coverage through...more
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
7/28/2014
/ Affordable Care Act ,
Chevron Deference ,
Employer Mandates ,
Halbig v Burwell ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare Reform ,
IRS ,
King v Burwell ,
Subsidies ,
Tax Credits
The Departments of the Treasury/IRS, Labor and Health and Human Services (the “Departments”) recently issued a final regulation under the 90-day waiting period limitation, which is included among the Affordable Care Act’s...more
6/30/2014
/ Affordable Care Act ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Retirement Income Security Act (ERISA) ,
Employer Mandates ,
Healthcare ,
Healthcare Reform ,
Internal Revenue Code (IRC) ,
IRS ,
PHSA ,
U.S. Treasury
The IRS recently issued two Q&As on the subject of employer payment plans, the purpose of which was to again underscore that arrangements purporting to allow an employer to reimburse employees on a pre-tax basis for premiums...more
In last week’s post, we examined the appropriateness of capping the annual hours of new “variable hour employees” as a way to limit exposure under the Affordable Care Act’s employer shared responsibility rules. (These rules...more
Whenever Congress draws a line in the sand—such as with exposure for assessable payments under the Affordable Care Act’s employer shared responsibly rules—entities subject to regulation (here, applicable large employers) will...more
With so much attention focused on the particulars of the employer shared responsibility and, to a slightly lesser extent, reporting rules, it’s easy to lose sight of other important changes—including final regulations issued...more
Final regulations under Code § 4980H published in the Federal Register on February 12 include a new term—“limited non-assessment period”—which describes periods for which an applicable large employer (i.e., an employer with...more