On April 29, 2024, the Department of Labor (“DOL”) released a final regulation (the “Final Rule”) that rescinded the Trump Administration rule that expanded the availability of association health plans (“AHPs”) (“Trump DOL...more
Earlier this year, a Johnson & Johnson (“J&J”) employee brought a class action complaint (the “Complaint”) against J&J alleging fiduciary breaches under ERISA related to the prescription drug coverage under J&J’s self-funded...more
On March 28, 2024, the Departments of Labor, Treasury, and Health and Human Services (the “Tri-Agencies”) issued final regulations on short-term, limited-duration insurance (“STLDI”), hospital and other fixed indemnity...more
On January 16, 2023, the Department of Health and Human Services (“HHS”) dropped its appeal of the U.S. District Court for the District of Columbia’s September 29, 2023 decision that vacated a portion of the 2021 Notice of...more
On December 19, 2023, the Department of Labor (“DOL”) issued a proposed rule rescinding a Trump Administration rule that expanded the availability of association health plans (“AHPs”) (the “Proposed Rule”)....more
On September 29, 2023, the U.S. District Court for the District of Columbia vacated the 2021 Notice of Benefit and Payment Parameters (“2021 NBPP”) amendments to Affordable Care Act regulations. The amendments permitted (but...more
On August 15, 2023, the Tenth Circuit issued its much-anticipated decision in PCMA v. Mulready, rejecting Oklahoma’s position that its pharmacy network requirements were not preempted by ERISA. Mulready has been closely...more
State legislatures over the past five years have focused heavily on the role of pharmacy benefit managers (“PBMs”) in the context of health care benefits. While initial efforts were focused largely on PBM services offered to...more
The COVID-19 Public Health Emergency (“PHE”) and National Emergency (“NE”) have been in place since early 2020. In January 2023, President Biden stated his intention for both to end on May 11, 2023. There have been many...more
4/7/2023
/ Coronavirus/COVID-19 ,
Employee Benefits ,
Employer Liability Issues ,
Enrollment ,
Health Insurance ,
Infectious Diseases ,
Medicaid ,
MHPAEA ,
Public Health Emergency ,
Vaccinations ,
Virus Testing ,
Workplace Safety
On August 4, 2022, the Biden Administration published its long-anticipated proposed rulemaking on Affordable Care Act (“ACA”) Section 1557’s nondiscrimination in health programs and activities requirements (“Proposed Rule”)....more
On June 16, 2022 Groom will be hosting a webinar on the impact of state abortion restrictions on employers, insurers, and self-insured plans. Over the past year, numerous states have enacted new abortion restrictions, and we...more
Today, President Biden signed into law the Consolidated Appropriations Act, 2022 (“CAA 2022”), which, among other things, temporarily renews certain relief to individuals to have access to telehealth coverage and other remote...more
The ongoing implementation of the No Surprises Act’s (“NSA”) prohibition on surprise balance billing, and the related independent dispute resolution (“IDR”) process between payers and providers became much less certain after...more
On December 2, 2021, President Biden announced new actions to combat COVID-19, given the emergence of the new Omicron variant. As part of his nine-point plan, the President included a directive that “the more than 150...more
Ever since the Occupational Safety and Health Administration (“OSHA”) published its Emergency Temporary Standard (“ETS”) regarding the COVID-19 vaccine or test requirement, there has been a flurry of litigation, culminating...more
On December 2, 2021, President Biden announced new actions to combat COVID-19, given the emergence of the new Omicron variant. As part of his nine-point plan, the President included a directive that “the more than 150...more
Background -
On December 30, 2021, the Department of Labor (“DOL”) released Field Assistance Bulletin No. 2021-03 (“FAB 2021-03”). FAB 2021-03 announces the DOL’s temporary enforcement policy for group health plan service...more
As we approach the end of 2021, it’s again time for sponsors of 401(a) and 403(b) plans to review their plan documents and plan operations to ensure compliance with increasingly complex qualification requirements. While...more
The IRS recently announced (Notice 2021-61, Nov. 4, 2021) that many of the key pension limits will increase next year – some significantly due to higher inflation. The Social Security Administration and PBGC also recently...more
With rising rates of COVID-19 cases in the past few months, employers have been increasingly interested in exploring incentives designed to increase COVID-19 vaccination rates among employees. One idea that has been gaining...more
On July 1, 2021, the Office of Personnel Management, Department of the Treasury, Department of Health and Human Services (“HHS”), and Department of Labor (“DOL”) (collectively, the “Departments”), released the interim final...more
On May 18, 2021, the IRS released its highly anticipated guidance on the 100% COBRA premium subsidies (the “Subsidy”) and the related tax credit under the American Rescue Plan Act of 2021 (March 11, 2021) (“ARPA”) in Notice...more
On April 7, 2021, the Department of Labor (“DOL”) released initial guidance regarding the 100% COBRA premium subsidies under the American Rescue Plan Act of 2021 (“ARP”), and also issued model notices that can be used in...more
In the early morning hours of February 27, the House of Representatives narrowly passed H.R. 1319, the American Rescue Plan Act (the “Rescue Plan”), by a vote of 219-212. The Senate will now take up the sweeping $1.9 trillion...more
On February 18, 2021, the IRS released Notice 2021-15 (the “Notice”) interpreting section 214 of the Taxpayer Certainty and Disaster Tax Relief Act of 2020 (the “Act”), enacted as Division EE of the Consolidated...more