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
Employer-sponsored health plans can add air ambulance claims reporting to the list of required disclosures that will go into effect in the next several years.
Under proposed regulations published September 16, 2021, by...more
9/30/2021
/ Ambulance Providers ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Disclosure Requirements ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Enforcement ,
Insurance Claims ,
Out of Network Provider ,
Penalties ,
Surprise Medical Bills
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
Plan participants can be hit with surprise medical bills when they receive care from out-of-network providers. Sometimes, this happens when participants do not know that the care they are receiving is from an out-of-network...more
7/22/2021
/ Benefit Plan Sponsors ,
Consolidated Appropriations Act (CAA) ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Dispute Resolution ,
Employer Group Health Plans ,
Interim Final Rules (IFR) ,
New Guidance ,
Out of Network Provider ,
Self-Insured Health Plans ,
Surprise Medical Bills ,
U.S. Treasury
Participants in dependent care assistance programs (DCAPs) will get the best of both worlds (at least in 2021) under new guidance from the Internal Revenue Service (IRS).
In another of what appears to be a seemingly...more
The American Rescue Plan Act of 2021 (ARPA) implemented a 100 percent COBRA subsidy for certain qualified beneficiaries beginning on April 1, 2021, and ending September 30, 2021. On May 18, 2021, more than a month into the...more
The new 100 percent premium subsidy applies to individuals eligible for Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage due to either a reduction in hours or an involuntary termination of employment, and it...more
4/28/2021
/ American Rescue Plan Act of 2021 ,
COBRA ,
Coronavirus/COVID-19 ,
Corporate Counsel ,
Department of Labor (DOL) ,
Employee Benefits ,
Employer Group Health Plans ,
Health Insurance ,
New Guidance ,
Notice Requirements ,
Premium Subsidies ,
Relief Measures ,
Tax Credits
More than a year into the COVID-19 pandemic, employers are happy to be more focused on vaccine issues than on issues relating to furloughs and layoffs.
As record numbers of vaccinations take place daily, many employers...more
4/22/2021
/ Americans with Disabilities Act (ADA) ,
Best Practices ,
CARES Act ,
Civil Rights Act ,
Coronavirus/COVID-19 ,
Employee Assistance Programs ,
Employee Incentive Plans ,
Employee Retirement Income Security Act (ERISA) ,
Employment Policies ,
Incentives ,
Infectious Diseases ,
Paid Time Off (PTO) ,
Title VII ,
Vaccinations ,
Wellness Programs ,
Workplace Safety
Less than a month after the American Rescue Plan Act of 2021 (ARPA) was signed into law, new U.S. Department of Labor (DOL) guidance and model forms are clearing up a number of employer concerns about the 100 percent COBRA...more
4/12/2021
/ American Rescue Plan Act of 2021 ,
COBRA ,
Coronavirus/COVID-19 ,
Corporate Counsel ,
Department of Labor (DOL) ,
EBSA ,
Employee Benefits ,
Employer Group Health Plans ,
Health Insurance ,
IRS ,
New Guidance ,
Premium Subsidies ,
Premiums ,
Relief Measures ,
Tax Credits
The American Rescue Plan Act of 2021 (ARPA), which became law on March 11, 2021, provides a 100 percent subsidy of premiums under the Consolidated Omnibus Budget Reconciliation Act (COBRA) beginning on April 1, 2021, through...more
3/18/2021
/ American Rescue Plan Act of 2021 ,
Benefit Plan Sponsors ,
Biden Administration ,
COBRA ,
Coronavirus/COVID-19 ,
Employee Benefits ,
Employer Group Health Plans ,
Families First Coronavirus Response Act (FFCRA) ,
Health Insurance ,
Medicare ,
Notice Requirements ,
Popular ,
Premium Subsidies ,
Relief Measures ,
Tax Credits
Beginning in 2022, employer-sponsored health plans will be required to pay providers certain emergency and out-of-network charges that would have otherwise been balance billed to participants.
That is the centerpiece of...more
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
Employers have more clarity on COVID-19 testing coverage requirements - including new details on at-home tests, return-to-work testing, and out-of-network pricing - under new guidance that the U.S. Department of Health and...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
Employers now have greater clarity on how the new federal requirements covering COVID-19 testing and diagnosis apply to their group health plans, under guidance issued by the U.S. Department of Labor, U.S. Department of...more
The Coronavirus Aid, Relief, and Economic Security (CARES) Act, which was signed into law on March 27, 2020, contains several provisions - some mandatory and some optional - that affect employer-sponsored group health...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
Under a California law that took effect on January 1, 2020, employers will have to provide extra notices to California employees enrolled in flexible spending accounts (FSAs) explaining the “use it or lose it” federal tax...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
Behavioral health claims administrators and plan sponsors alike may be looking more closely at their care guidelines—and how they are applied—after a federal court ruled in a California class action that a claims...more
Employers may soon find themselves reviewing and revising health plan master documents and summary plan descriptions (SPDs) and administrative service agreements with respect to an obscure claims administration practice known...more
Employers looking for greater transparency on prescription drug pricing and pharmacy benefit manager (PBM) services will soon have a powerful new tool from an unlikely source: California lawmakers.
Under Assembly Bill (AB)...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