On April 26, 2024, the Office for Civil Rights (“OCR”) at the U.S. Department of Health & Human Services (“HHS”) published a final rule to amend the HIPAA Privacy Rules to support reproductive health care privacy (the...more
We are pleased to present our annual End of Year Plan Sponsor “To Do” Lists. This year, we present our “To Do” Lists in four separate Employee Benefits Updates. This Part 1 covers year-end health and welfare plan issues....more
10/12/2023
/ Abortion ,
Affordable Care Act ,
Birth Control ,
Cafeteria Plans ,
CARES Act ,
Children's Health Insurance Program (CHIP) ,
Civil Rights Act ,
COBRA ,
Consolidated Appropriations Act (CAA) ,
Coronavirus/COVID-19 ,
Cost-of-Living Adjustment (COLA) ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Disclosure Requirements ,
Dobbs v. Jackson Women’s Health Organization ,
Drug Pricing ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Families First Coronavirus Response Act (FFCRA) ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Health Plan Sponsors ,
IRS ,
MHPAEA ,
Non-Discrimination Rules ,
NQTLs ,
Out of Network Provider ,
Penalties ,
Pharmacy Benefit Manager (PBM) ,
Popular ,
Recordkeeping Requirements ,
Reporting Requirements ,
Reproductive Healthcare Issues ,
Student Loans ,
Surprise Medical Bills ,
Title VII ,
Transparency ,
Travel Time ,
Wellness Programs
Just when you thought the confusing COVID-19 ERISA deadline extensions were behind you, the Biden-Harris Administration asks you to reconsider. ...more
Effective December 27, 2020, the Consolidated Appropriations Act, 2021 (“CAA”), as part of its transparency in health care protections, prohibits group health plans and issuers from entering into agreements that directly or...more
6/12/2023
/ Attestation Requirements ,
Compliance ,
Consolidated Appropriations Act (CAA) ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
Gag Clauses ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Pharmacy Benefit Manager (PBM) ,
U.S. Treasury
On January 10, 2022, the Departments of Labor, Health and Human Services, and Treasury (collectively the “Departments”) issued Affordable Care Act FAQs Part 51 which addresses, in relevant part, payment for over-the-counter...more
5/23/2022
/ Affordable Care Act ,
Compensation & Benefits ,
Coronavirus/COVID-19 ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Infectious Diseases ,
Medical Reimbursement ,
New Rules ,
Over The Counter Drugs (OTC) ,
Virus Testing
Summer has come and gone, but there was no summer vacation for employee benefits legislation and guidance. In case you have been too busy to check out our blogs lately, here are some key items to help you stay organized and...more
10/13/2021
/ Affordable Care Act ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employer Group Health Plans ,
Employer Liability Issues ,
Equity Compensation ,
Health Plan Sponsors ,
Interim Final Rules (IFR) ,
Preventive Health Care ,
Startups
On July 1, 2021, the Office of Personnel Management, Department of the Treasury, Department of Health and Human Services (“HHS”), and Department of Labor (collectively the “Departments”) issued the interim final rule...more
8/17/2021
/ Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
Health Care Providers ,
Health Insurance ,
Healthcare Facilities ,
Interim Final Rules (IFR) ,
OPM ,
Out of Network Provider ,
Surprise Medical Bills ,
U.S. Treasury
On December 27, 2020, former President Trump signed the Consolidated Appropriations Act, 2021 (the “CAA”) into law. The CAA includes numerous provisions that impact employer-sponsored group health plans, including the...more
For years we have been trying to understand how the EEOC regulates wellness programs. Although we still do not have a complete picture, we are getting closer with the EEOC’s new Notices of Proposed Rulemaking on wellness...more
2/11/2021
/ Americans with Disabilities Act (ADA) ,
Employee Benefits ,
Employer Group Health Plans ,
Employer Liability Issues ,
Equal Employment Opportunity Commission (EEOC) ,
GINA ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Non-Discrimination Rules ,
Proposed Rules ,
Safe Harbors ,
Wellness Programs
We are pleased to present our annual End of Year Plan Sponsor “To Do” Lists. This year, we present our “To Do” Lists in four separate Employee Benefits Updates. This Part 1 covers year-end health and welfare plan issues....more
9/28/2020
/ Affordable Care Act ,
Anti-Discrimination Policies ,
Benefit Plan Sponsors ,
COBRA ,
Compensation & Benefits ,
Coronavirus/COVID-19 ,
Cost-of-Living Adjustment (COLA) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Executive Compensation ,
Families First Coronavirus Response Act (FFCRA) ,
HDHP ,
Health Insurance Portability and Accountability Act (HIPAA) ,
IRS ,
MHPAEA ,
Retirement Plan ,
Trump Administration ,
Year-End Tax Planning
On May 12, the IRS issued Notice 2020-29 “COVID-19 Guidance Under Section 125 Cafeteria Plans and Related to High Deductible Health Plans” and Notice 2020-33 “Section 125 Cafeteria Plans – Modification of Permissive Carryover...more
6/24/2020
/ Cafeteria Plans ,
CARES Act ,
Coronavirus/COVID-19 ,
Dependent Care Assistance Program (DCAP) ,
Employee Benefits ,
Employer Group Health Plans ,
Families First Coronavirus Response Act (FFCRA) ,
Flexible Spending Accounts ,
HDHP ,
Health Plan Sponsors ,
IRS
On April 11, 2020, the Departments of Labor, Health and Human Services, and the Treasury (the “Departments”) issued "FAQs About Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act...more
What is the Annual Maximum Out-Of-Pocket Limit (“MOOP”)?
MOOP is the most a participant must pay for covered services under a group health plan in a plan year. After a participant spends this amount on deductibles,...more
1. What is it?
Wilderness therapy generally is traditional therapy in an outdoor setting that seeks to treat young adults with behavioral or substance use disorders. Some programs are licensed and accredited and the...more
As a follow-up to our recent blog Count Down to Open Enrollment – Some Quick Thoughts, below is a little more detail on how seemingly simple wellness program design changes can have significant legal consequences....more
An employer that employs 50 or more employees for each working day during each of 20 or more calendar workweeks in the current or preceding calendar year is subject to the Family Medical Leave Act (“FMLA”). Therefore, often...more
We previously blogged about the EEOC’s final rules, published in the Federal Register on May 17, 2016, that explain how the Americans with Disabilities Act (“ADA”) applies to employer sponsored wellness programs. These rules...more
Due to the increased litigation of air ambulance claims, employers may want to review their plan language to see whether their group health plan covers air ambulance services, and if so, to better understand the terms of the...more
As 2017 comes to an end, we are pleased to present our traditional End of Year Plan Sponsor “To Do” Lists. This year, we are presenting our “To Do” Lists in four separate Employee Benefits Updates. This Part 1 will cover...more
10/18/2017
/ 21st Century Cures Act ,
AARP ,
Affordable Care Act ,
Breach Notification Rule ,
Cadillac Tax ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Rights Act ,
Cloud Service Providers (CSPs) ,
COBRA ,
Code Sections 4980H ,
Cost-of-Living Adjustment (COLA) ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Disability Benefits ,
Electronic Protected Health Information (ePHI) ,
Employee Assistance Programs ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Employment Discrimination ,
Equal Employment Opportunity Commission (EEOC) ,
Executive Orders ,
Federal Contractors ,
Federal Poverty Line ,
Filing Deadlines ,
Form 5500 ,
Form 720 ,
Full-Time Employees ,
Health Insurance Exchanges ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare Reform ,
Information Letters ,
IRS ,
MHPAEA ,
Minimum Essential Coverage ,
Non-Grandfathered Health Plans ,
Open Enrollment ,
PCORI ,
Preventive Health Care ,
Qualified Small Employer Health Reimbursement Plan (QSEHRAs) ,
Religious Exemption ,
SBC ,
Section 1557 ,
Section 6055 ,
Section 6056 ,
Shared Responsibility Rule ,
Tax Credits ,
Tax Penalties ,
Telemedicine ,
Title VII ,
Trump Administration ,
Wellness Programs
The Mental Health Parity and Addiction Equity Act of 2008 (“MHPAEA”) generally requires that the financial requirements and treatment limitations that apply to mental health and substance use disorder (“MH/SUD”) benefits...more
7/6/2017
/ 21st Century Cures Act ,
Affordable Care Act ,
Deductibles ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
Health and Welfare Plans ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
Substance Abuse
After surviving two Supreme Court cases and numerous repeal efforts, the Affordable Care Act (“ACA”) is in jeopardy again. Despite the law’s uncertainty, employers may want to continue their compliance efforts because: (1)...more
As 2016 comes to an end, we are pleased to present you with our traditional End of Year Plan Sponsor “To Do” Lists. Like last year, we are presenting our “To Do” Lists in three separate Employee Benefits Updates. Part 1 of...more
11/10/2016
/ Americans with Disabilities Act (ADA) ,
Benefit Plan Sponsors ,
Business Associates ,
Cadillac Tax ,
Civil Rights Act ,
Cloud Service Providers (CSPs) ,
Cost-of-Living Adjustment (COLA) ,
Employee Benefits ,
Employer Group Health Plans ,
Equal Employment Opportunity Commission (EEOC) ,
Federal Contractors ,
Form 1094 ,
Form 1095 ,
GINA ,
Grandfathered Status ,
Health and Welfare Plans ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Health Savings Accounts ,
Healthcare Reform ,
HIPAA Audits ,
Large Employer ,
Mental Health Parity Rule ,
Minimum Essential Coverage ,
Non-Discrimination Rules ,
OFCCP ,
PCORI ,
Section 1557 ,
Section 6055 ,
Section 6056 ,
Self-Insured Health Plans ,
Shared Responsibility Rule ,
Summary of Benefits and Coverage ,
Telemedicine ,
Title VII ,
Wellness Programs ,
Year-End Compliance Checklist
Take a deep breath. The HHS Health Insurance Marketplace Notice (the “Notice”) may seem to be a nuisance, but it does not necessarily mean that you will be subject to employer shared responsibility penalties....more
On May 16, 2016, the EEOC issued final rules that explain how the Americans with Disabilities Act (“ADA”) applies to employer sponsored wellness programs. Although some may welcome the guidance, others may be frustrated...more