Employers often target benefit offerings to specific groups of workers—think dependent care accounts or student loan repayment matching contributions—so maybe it was inevitable....more
Employers, at least for now, may have some relief from some of the Affordable Care Act (ACA) requirements to cover preventive care services without cost sharing under a nationwide injunction issued March 30, 2023, by a...more
4/20/2023
/ ACIP ,
Affordable Care Act ,
Appointments Clause ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Employer Group Health Plans ,
Health Insurance ,
HRSA ,
HSA ,
Injunctions ,
Preventive Health Care ,
Screening Procedures
Employers can’t say they weren’t warned.
For the second time in six months, frequently asked question (FAQ) guidance from federal regulators is calling attention to the requirement that employer-sponsored health...more
8/5/2022
/ Affordable Care Act ,
Benefit Plan Sponsors ,
Contraceptive Coverage Mandate ,
Contraceptives ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employer Group Health Plans ,
Health Insurance ,
New Guidance ,
Preemption
On June 24, 2022, the Supreme Court of the United States issued its highly anticipated decision in Dobbs v. Jackson Women’s Health Organization, No. 19-1392. The Dobbs decision expressly overrules the two key precedents that...more
6/24/2022
/ Abortion ,
Affordable Care Act ,
Benefit Plan Sponsors ,
COBRA ,
Criminal Code ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Equal Employment Opportunity Commission (EEOC) ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medical Reimbursement ,
Mental Health ,
Mental Health Parity Rule ,
Pharmacy Benefit Manager (PBM) ,
Preemption ,
Roe v Wade ,
SCOTUS ,
Telehealth
Employers that are considering imposing health plan premium surcharges to encourage their employees to get vaccinated have clearer guidance on how to do so without running afoul of the nondiscrimination rules under the Health...more
10/7/2021
/ Affordable Care Act ,
CARES Act ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employer Group Health Plans ,
Guidance Update ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Non-Discrimination Rules ,
Plan Participants ,
Surcharges ,
Vaccinations
New regulatory guidance from three federal agencies that enforce private-sector benefits laws will make employers’ daunting 2021 health benefit to-do lists slightly - but only slightly - more manageable heading into 2022....more
8/24/2021
/ Affordable Care Act ,
Consolidated Appropriations Act (CAA) ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
Health Insurance ,
Mental Health Parity Rule ,
New Guidance ,
Reporting Requirements ,
Surprise Medical Bills ,
U.S. Treasury
A federal court ruling staying key parts of new Affordable Care Act (ACA) regulations in light of the landmark Supreme Court of the United States ruling on sexual orientation and gender identity will provide little certainty...more
Most employer-sponsored health plans will be exempt from the primary Affordable Care Act (ACA) provision governing race, color, age, sex, disability, and national origin discrimination under new final rules issued by the U.S....more
High-deductible health plans may now cover testing and treatment for 2019 novel coronavirus (COVID-19) on a first-dollar basis without risking making participants ineligible to participate in health savings accounts (HSAs)....more
Employer-sponsored health plans and health insurers may be required to post online - and to provide participants upon request - a range of pricing and cost-sharing information beginning in 2021.
Proposed Affordable Care...more
11/26/2019
/ Affordable Care Act ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Employer Group Health Plans ,
Health Care Providers ,
Healthcare Costs ,
Hospitals ,
Out-of-Pocket Expenses ,
Proposed Regulation ,
Proposed Rules ,
Public Comment ,
Transparency
Employer plans will still be able to exclude the value of drug manufacturer coupons from annual out-of-pocket maximums, even when no generic equivalent is available, under new guidance from the Department of Labor, Department...more
8/28/2019
/ Affordable Care Act ,
Benefit Plan Sponsors ,
Co-payments ,
Deductibles ,
Department of Health and Human Services (HHS) ,
Generic Drugs ,
Health Insurance ,
IRS ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
U.S. Treasury
Starting in 2020, employers will be able to offer health reimbursement arrangements (HRAs) that work in conjunction with individual coverage or Medicare without running afoul of the Affordable Care Act’s (ACA) market reform...more
The Department of Labor (DOL), the Department of the Treasury, and the Department of Health and Human Services (HHS) are making good on their promise to issue more guidance and to aggressively enforce the federal Mental...more
5/14/2018
/ 21st Century Cures Initiative ,
Affordable Care Act ,
Benefit Plan Sponsors ,
Comment Period ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Health Insurance ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
New Guidance
The deadline to respond is nearing for employers that received the first wave of Letter 226J mailings proposing to assess them with Employer Shared Responsibility Payments (ESRPs) for 2015 under Section 4980H of the Internal...more
Any privately held, for-profit company could potentially be exempt from the Affordable Care Act’s (ACA) requirement to provide comprehensive contraceptive coverage without cost-sharing based on the company’s “sincerely held...more
While many were hoping that the Affordable Care Act (ACA) would finally be dead by now, and others are lamenting the fact that the “repeal-and-replace” attempts have fallen by the wayside, we thought it may be worthwhile to...more
Employers can expect some challenging information requests about the mental health and substance abuse benefits offered to employees and their dependents through group health plans, if a draft form released by federal...more
Employers looking for strong scores on the Corporate Equality Index (CEI) in coming years may have to make some unexpected changes to their health benefit programs.
Benefit programs are one key component of CEI ratings,...more
Some employers may want to reconsider their approach to gender transition benefits after a federal court enjoined the U.S. Department of Health and Human Services (HHS) from enforcing its 2016 nondiscrimination regulations...more
1/13/2017
/ Abortion ,
Affordable Care Act ,
Anti-Discrimination Policies ,
Covered Entities ,
Department of Health and Human Services (HHS) ,
Federal Contractors ,
Gender Identity ,
OFCCP ,
Preliminary Injunctions ,
Religious Freedom Restoration Act (RFRA) ,
Sex Discrimination ,
Title IX
There are two key benefits takeaways for employers in the bipartisan 21st Century Cures Act, which President Obama signed into law on December 13, 2016.
The act, which passed both houses of Congress by large...more
Expatriate health plans have been surprisingly difficult to reconcile with the Affordable Care Act (ACA). Proposed regulations set to take effect in 2017 provide some useful guidance to U.S. employers that sponsor expatriate...more
7/11/2016
/ Affordable Care Act ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employer Group Health Plans ,
Expatriates ,
Foreign Nationals ,
Health Insurance ,
Minimum Essential Coverage ,
Plan Administrators ,
Proposed Regulation
As many small employers rejoice over a delayed effective date, large employers should be rolling up their sleeves to adapt their evolving shared responsibility compliance strategies for 2015 to a new final rule from the U.S....more
As you may know the Affordable Care Act imposed a new fee on issuers of individual and group health insurance policies and plan sponsors of self-funded plans. As previously noted in our blog, on December 5, 2012, the Internal...more
Could employee benefits regulatory activity under the Patient Protection and Affordable Care Act (Act) be taking a turn toward common sense?...more