In 2013, many different changes in the law impacted group health plans and arguably, even more changes will occur in 2014. The following is an overview of a few of the key compliance issues that occurred in 2013 which should be addressed before 2014.  First, final HIPAA regulations were issued in January 2013 which generally became effective September 23, 2013.  Sponsors of group health plans should review and update as necessary their plan’s HIPAA Privacy Notice, Business Associate Agreements and HIPAA Privacy policies.  Second, the Patient Protection and Affordable Care Act (“PPACA”) introduced a new Marketplace Notice which employers had to provide to all employees by October 1, 2013 and now must provide to all new hires.  The PPACA also requires group health plans to comply with a number of reforms which take effect starting with the plan year that begins in 2014 (e.g., a plan’s waiting period may not exceed 90 days).  Large employers that are subject to PPACA’s Employer Shared Responsibility Mandate beginning in 2015 (aka “Pay or Play”) who intend on utilizing 12-month measurement periods for a calendar year stability period should have begun such measurement period prior to the end of 2013.  Third, recent guidance from the Internal Revenue Service explained that certain Health Reimbursement Arrangements (“HRAs”) which are not integrated with a group health plan and Health Flexible Spending Arrangements (“FSAs”) which are not considered to be “excepted benefits” may need to be terminated by January 1, 2014.  Finally, due to the U.S. Supreme Court’s decision regarding the Defense of Marriage Act, employers should review their group health plans in light of the expanded benefits and rights available to same-sex spouses.