News & Analysis as of

Cost-Sharing Compensation & Benefits

Seyfarth Shaw LLP

Agencies Release 2026 Out-of-Pocket Limits and 2025 Limits for Health FSAs

Seyfarth Shaw LLP on

Recently HHS issued a memorandum announcing the maximum annual limitation on cost sharing (a/k/a out-of-pocket maximum) for 2026 and the IRS issued Rev. Proc. 2024-40 announcing the cost-of-living adjustments to certain...more

Akerman LLP - HR Defense

Your Employee Benefit Plans May Need a Check Up: Nearing the End of the COVID-19 Public Health Emergency

Where did the time go? Just a brief 1,199 days after it began, the COVID-19 Public Health Emergency (PHE) is coming to an end. The PHE formally ends on May 11, 2023, short of any unexpected developments. And that means the...more

Proskauer - Employee Benefits & Executive...

There’s More! Tri-Agencies Provide Clarifying Guidance on Group Health Plan Coverage of Over-the-Counter At-Home COVID-19 Tests

A few short weeks ago we told you in a blog post that, with only four days’ notice, the Departments of Labor, Treasury, and HHS (the Departments) required that, starting January 15, 2022, group health plans cover FDA-approved...more

Venable LLP

Employer Group Health Plans Must Cover Over-the-Counter COVID Tests

Venable LLP on

On Monday, the government issued frequently asked questions (FAQs) requiring employer group health plans (Plans) and health insurance issuers to cover certain over-the-counter (OTC) COVID-19 tests at no cost to the...more

Polsinelli

Group Health Plan Coverage Requirements Expanded to Include Non-Prescribed Over-the-Counter COVID-19 Testing

Polsinelli on

Effective January 15, 2022, health plans are required to cover the cost of over-the-counter (“OTC”) COVID-19 test kits obtained without a health care provider’s prescription or clinical assessment. This new requirement was...more

Stinson LLP

Agencies Issue Guidance Requiring Coverage for Over-the-Counter COVID-19 Tests

Stinson LLP on

Beginning January 15, 2022, and through the duration of the public health emergency, insurers and group health plans must cover at-home COVID-19 diagnostic tests available over-the-counter (OTC) without imposing cost-sharing,...more

McAfee & Taft

More details on transparency rules that apply in 2022 and beyond

McAfee & Taft on

On December 6, 2020, we posted an article titled “RADICAL new transparency rules likely apply to your health plan in one year.” The regulations are a little more than 150 PDF pages long. The following is intended to provide a...more

Orrick, Herrington & Sutcliffe LLP

Ninth Circuit Withdraws Controversial Altera Opinion And Will Allow New Judge To Make Ultimate Determination

On August 7, 2018, the Ninth Circuit withdrew its July 24 decision in Altera so that new panel member, Judge Susan P. Graber, can now consider the case....more

Orrick, Herrington & Sutcliffe LLP

Ninth Circuit Upholds Validity of Cost-Sharing Regulations that Stray from Arm's-Length Standard

On July 24, 2018, in the Altera Corp v. Commissioner decision, the Ninth Circuit overturned a 2015 U.S. Tax Court opinion and upheld the validity of regulations requiring taxpayers to treat stock-based compensation as a cost...more

Proskauer Rose LLP

ERISA Newsletter - Fourth Quarter 2017

Proskauer Rose LLP on

Editor's Overview - For over two decades, federal law has required covered health plans and insurers to ensure that certain mental health benefits are in parity with offered medical/surgical benefits. The meaning of...more

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