News & Analysis as of

Benefit Plan Sponsors Employer Group Health Plans

Ogletree, Deakins, Nash, Smoak & Stewart,...

What the Final Mental Health Parity Rules Mean for Employers

The wait is over, and now the work begins for health plan sponsors. Much-anticipated final rules implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) were...more

McDermott Will & Emery

Landmark Mental Health Parity Final Rule: What Plan Sponsors and Insurers Need to Know

McDermott Will & Emery on

The US Departments of the Treasury, Labor, and Health and Human Services (the Departments) recently issued much-anticipated final regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA). The newly issued...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Supreme Court to Determine Whether Retirees Can Claim Disability Discrimination in Benefits

The Supreme Court of the United States has agreed to hear a case that will decide whether retirees can sue for disability discrimination because of changes to retiree benefit plans....more

Bricker Graydon LLP

You May be Able to Increase Health Plan Premiums and Stay Affordable in 2025

Bricker Graydon LLP on

For the first time in four years, the IRS adjusted the affordability percentage used for the shared responsibility penalties. The IRS recently announced that the affordability percentage for 2025 will be 9.02%....more

Baker Donelson

Health Plan Compliance Concerns for Year-End 2024

Baker Donelson on

As employers look toward open enrollment for their group health plans, now is a good time to review action items needed for those plans by year-end, as well as upcoming deadlines in the near future. While fully-insured health...more

Lathrop GPM

Fifty Years of ERISA

Lathrop GPM on

On Labor Day fifty years ago, September 2, 1974, President Ford signed the Employee Retirement Income Security Act of 1974 (ERISA) into law. It is a combination of tax and labor law incorporating trust law like fiduciary...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - August 2024

The August Monthly Minute highlights new IRS guidance addressing student loan matching programs, HHS’s increases to civil monetary penalties and Form 5330 paper filing updates....more

McDermott Will & Emery

The Case for the Welfare Plan Fiduciary Committee

Recent lawsuits filed against the group health plans of two large US employers underscore the importance of implementing formal welfare benefit plan governance structures that include fiduciary committees comparable to the...more

McDermott Will & Emery

It’s the Plan Assets, Stupid: Why Group Medical Stop-Loss Captives and Level-Funded Plans Don’t Mix

McDermott Will & Emery on

A question in response to last week’s post on self-funding of employer group health plans assumed that stop-loss coverage under a level-funded plan could be provided under a group captive medical captive. However, it cannot...more

McDermott Will & Emery

Group Medical Captives, Level Funding and US Healthcare Policy

McDermott Will & Emery on

In a recent article in Managed Healthcare Executive, Peter Wehrwein examines the trend of self-funding of group health benefits by smaller employers who used to depend mainly or entirely on fully insured programs....more

Laner Muchin, Ltd.

Eleventh Circuit Finds Gender-Affirming Surgery Exclusion in Governmental Employer’s Health Plan Violated Title VII

Laner Muchin, Ltd. on

held that a governmental employer’s health plan violated Title VII by applying an exclusion for services and supplies associated with gender reassignment surgery. The Court relied on the Supreme Court’s decision in Bostock v....more

McDermott Will & Emery

IRS Announces 2025 Limits for Health Savings Accounts, High-Deductible Health Plans and Excepted Benefit HRAs

McDermott Will & Emery on

The Internal Revenue Service (IRS) recently announced (see Revenue Procedure 2024-25) cost-of-living adjustments to the applicable dollar limits for health savings accounts (HSAs), high-deductible health plans (HDHPs) and...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

HIPAA Privacy Rules Get a Post-Dobbs Refresh on Reproductive Health Care

Employers will soon see the national debate about abortion popping up in some unexpected places: the HIPAA privacy policies and procedures and notices of privacy practices they use for their health benefit plans....more

Hall Benefits Law

The DOL’s New “Economic Realities” Test to Determine Employee Status: ERISA Considerations for Benefit Plan Sponsors

Hall Benefits Law on

The Department of Labor (DOL) Wage and Hour Division issued final regulations, effective March 11, 2024, which are intended to serve as a practical guide to employers on how the DOL determines whether a worker is an employee...more

Verrill

Health and Welfare Benefit Plan Fiduciary Governance in the Wake of the Johnson & Johnson Lawsuit

Verrill on

For the past few years, we have encouraged plan sponsors to focus on matters of fiduciary governance for their health and welfare benefit plans (see our 2021 blog post). Yet many plan sponsors overlook the fact that the...more

Dickinson Wright

Why Establish a Fiduciary Committee for Welfare Benefit Plans?

Dickinson Wright on

Many plan sponsors have read about the lawsuit filed against Johnson & Johnson alleging that it breached its fiduciary duties with regard to the prescription drug component of its group health plan, causing participants to...more

DRI

What Is the Future of Monetary Relief under ERISA, Section 502(a)(3)?

DRI on

The Employee Retirement Income Security Act of 1974 (“ERISA”), as amended, regulates virtually every private employee benefit program in the United States. Among other things, ERISA contains its own civil enforcement section,...more

Verrill

Cross-Plan Offsetting in Group Health Plans—The DOL Makes its Position Clear

Verrill on

Under Section 404 of ERISA, plan fiduciaries must act for the exclusive benefit of plan participants and beneficiaries and use plan assets only to provide benefits and defray reasonable expenses of administering the plan. In...more

Fenwick & West LLP

The Shifting Regulatory Landscape for Level-Funded Plans: An Alternative for Group Health Insurance

Fenwick & West LLP on

In the constantly changing health insurance landscape, level-funded health plans are steadily gaining ground as a viable middle approach between fully insured health plan and self-funded health plans—arguably offering...more

McAfee & Taft

Employee benefit rules: The gifts that keep on giving

McAfee & Taft on

As employers look back at 2023 and ahead to 2024, there are so many compliance-related items to consider relating to their employee benefit plans.  The rules employers are supposed to be complying with keep growing and...more

Baker Donelson

Surprise! Gag Clause Attestation Due by 12/31/2023

Baker Donelson on

As part of the No Surprises progeny of legislation seeking transparency in health care, the Consolidated Appropriations Act of 2021 prohibits the use of "gag clauses" in group health plan agreements. All group health plans...more

Alston & Bird

Year-End Health Benefits Roundup 2023

Alston & Bird on

It was a lively year for health benefits. Our Employee Benefits & Executive Compensation Group unpacks 2023, from the end of the COVID-19 emergencies to the much-anticipated Mental Health Parity and Addiction Equity Act...more

Williams Mullen

2023 Annual Employee Benefits Compliance Checklist for Plan Administrators

Williams Mullen on

Plan administrators should review actions to be taken before the end of 2023 and focus on what to expect for 2024. This checklist addresses plan amendments, notices and other considerations for qualified retirement plans,...more

Bass, Berry & Sims PLC

Let the Plan Speak: First Gag Clause Attestation Due December 31, 2023

Bass, Berry & Sims PLC on

By December 31, 2023, group health plans and health insurance issuers must submit an attestation to certify compliance with the “gag clause prohibition” under the Consolidated Appropriations Act of 2021 (CAA)....more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Options for Menopause Benefits for Employees

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

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