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The IRS Giveth and Then Giveth Again: New DCAP Guidance Provides Welcome Tax Relief

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 New IRS COBRA Subsidy Guidance: Key Takeaways for Employers

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

COBRA Subsidy: You’ve Got Questions...We’ve Got Answers

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

Vaccine Incentives - You Have Questions, We Have Answers

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

COBRA Subsidy: What We Know Now After Initial DOL Guidance

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

New COVID-19 Relief Law Includes Full COBRA Premium Subsidy

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

Surprise Medical Billing Protections Coming for Participants in 2022

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

Post-Bostock Ruling Does Little to Resolve Health Plan Uncertainty

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

Guidance Clarifies COVID-19 Testing Coverage Requirements for Employer Health Plans

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

Health Plans Post-Bostock: Mixed Signals on Sex Discrimination?

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

FAQs Clarify COVID-19 Testing and Diagnosis Requirements for Employer Health Plans

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

CARES Act Prompts Changes to Employer-Sponsored Health Plans

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

IRS to Waive HSA Rule for Coronavirus Coverage

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

New California Law Requires Additional Flexible Spending Account Notices

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

Employers May Need to Provide Cost Data Under Proposed ACA Rules

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

2020 Drug Coupon Rule Dropped Due to Implementation Concerns

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

New HRA Rules: What Employers Need to Know

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

Key Takeaways From an ERISA Fiduciary Breach Ruling on Behavioral Standards of Care After a 10-Day Trial

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

Eighth Circuit Casts Doubt on Cross-Plan Offsetting for ERISA Health Plans

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

New California Law Aims to Increase PBM Disclosure and Transparency

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

New Mental Health Parity Guidance and Enforcement Efforts May Warrant a Deep Dive Into Plan Administration

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

State Male Contraceptive Laws May Create HSA Problems for Employers

States such as Illinois, Maryland, and Oregon that have enacted laws requiring health insurers to cover certain male contraception on a first-dollar basis may be creating traps for unwary employers that sponsor...more

’Tis the Season to Answer Employer Shared Responsibility Payment Letters From the IRS

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

Is the New Moral Exemption From ACA Contraceptive Coverage a Game Changer?

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

Out of Sight, Out of Mind...But Don’t Forget the Possibility of ACA Retaliation Claims

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

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