News & Analysis as of

Employer Group Health Plans Patient Protection and Affordable Care Act (PPACA)

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

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

Proskauer - Employee Benefits & Executive...

Recent Health Plan Litigation Puts Family Building Benefits in Focus

Family building benefits continue to be top of mind as employers and plan sponsors implement new benefit programs to support family building journeys for their employees. At the same time, there have been a few recent...more

Bricker Graydon LLP

Summer's Hot Debate: Does a Self-Funded Group Health Plan Cover Gender-Affirming Care?

Bricker Graydon LLP on

As the temperatures continue to rise, regulations and litigation related to employer-sponsored group health plans have followed suit. As these new rules continue to evolve, we are often asked whether a self-insured group...more

Jackson Lewis P.C.

Health Plan Hygiene Part 1: A Spoonful of Sugar Helps the Medicine Go Down

Jackson Lewis P.C. on

During the next several weeks, we will publish a series of articles that dive deeply into “health plan hygiene” relating to health and welfare benefit plan fiduciary issues and how employers can protect themselves in this...more

Quarles & Brady LLP

Uncertain Future for ACA Preventive Services Mandate

Quarles & Brady LLP on

Pursuant to provisions of the Affordable Care Act (ACA), most employer-sponsored health plans must cover 100% of the cost of preventive care services without regard to deductible and other out-of-pocket costs, such as...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

Verrill

Can a Self-Funded Group Health Plan Exclude Coverage for Gender-Affirming Care?

Verrill on

We are sometimes asked whether a self-funded group health plan is required to cover gender-affirming medical services. As this post explains in detail, it is generally impracticable for a self-funded ERISA-covered plan to...more

Bass, Berry & Sims PLC

Gender-Affirming Care Remains a Hot Topic in 2024

Bass, Berry & Sims PLC on

Our April 9 blog post highlighted several issues to watch during 2024, one of which was gender-affirming care considerations. Just over a month later, there have now been three key developments with respect to that issue:...more

Sheppard Mullin Richter & Hampton LLP

U.S. Department of Labor Rescinds Trump-Era Rule on Association Health Plans (AHPs)

On April 29, 2024, the U.S. Department of Labor (the “DOL”) issued a final rule (the “Final Rule”) rescinding the 2018 Association Health Plan rule (“2018 AHP Rule”), thereby marking a return to the more rigid pre-2018...more

Akerman LLP - HR Defense

On the Basis of Sex… Discrimination in Group Health Plans and What Employers Should Know

In just a few days’ time, recently promulgated federal final rules addressing sex-based nondiscrimination in the administration of health care benefits have created a flurry of healthcare industry activity. The angst arises...more

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

ACA-Required Coverage of Contraceptive Care Remains Agency Focus

Once again, the U.S. Departments of Labor, Health and Human Services, and the Treasury have issued guidance on the Affordable Care Act’s (ACA) required coverage of contraception without cost sharing, clarifying the permitted...more

McDermott Will & Emery

[Webinar] Gender-Affirming Benefits: Best Practices for Group Health Plans - February 29th, 1:00 pm - 1:30 pm EST

McDermott Will & Emery on

Employers and plan sponsors are facing growing – and often conflicting – pressures related to the coverage of gender-affirming care. Join McDermott lawyers Sarah G. Raaii and Alden J. Bianchi for a webinar to review recent...more

Proskauer - Employee Benefits & Executive...

Agencies Update Guidance on Group Health Plan Contraceptive Coverage Requirements

The Departments of Labor, Treasury, and Health and Human Services (the “Departments”) recently issued guidance for group health plans outlining a “therapeutic equivalence” medical management technique for required preventive...more

Trusaic

[Webinar] Workday Clients: A Game Changing Approach to ACA Compliance - January 11th, 10:00 am - 10:30 am PST

Trusaic on

Join us for a workshop tailored exclusively to teams who use Workday. Discover how to revolutionize your ACA compliance process with Trusaic’s game-changing approach. Led by ACA expert Anuj Mongia, Vice President of Strategic...more

Ballard Spahr LLP

HHS Announces Temporary Copay Accumulator Non-Enforcement Policy

Ballard Spahr LLP on

The United States Department of Health and Human Services (HHS) has filed court pleadings stating that it does not intend to initiate enforcement actions against plans that maintain copay accumulator programs....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

Jackson Lewis P.C.

Health Plan Sponsors in the Crosshairs?

Jackson Lewis P.C. on

America’s cultural wars may be opening up a new front, and group health plans may be caught in the fray. Since the US Supreme Court decision in Dobbs ended almost fifty years of constitutional protection for abortion rights...more

McDermott Will & Emery

Special Report - Funding Employer-Sponsored Group Health Coverage: The Group Captive Solution - November 2023

McDermott Will & Emery on

Employer-sponsored health insurance covers almost 159 million non-elderly US workers and their dependents, and employees and jobseekers alike view group health coverage as the single most important non-cash job-related...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

Williams Mullen

PODCAST: Williams Mullen's Benefits Companion - IRS 2024 Health Plan Affordability Threshold May Put Some at Risk

Williams Mullen on

On this episode of Williams Mullen's Benefits Companion, host Brydon DeWitt shares insight on what employers need to consider now that the Affordable Care Act benchmark for determining the affordability of employer-sponsored...more

Woodruff Sawyer

Agencies Issue Additional FAQs Regarding the Transparency in Coverage Final Rules

Woodruff Sawyer on

On September 27, 2023, the DOL, IRS, and HHS released FAQs About Affordable Care Act Implementation Part 61 (“FAQ Part 61”) which addresses lingering questions about enforcement of the Transparency in Coverage Final Rules...more

Snell & Wilmer

2023 End-of-Year Plan Sponsor “To Do” Lists (Part 1) Health and Welfare

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We are pleased to present our annual End of Year Plan Sponsor “To Do” Lists. This year, we present our “To Do” Lists in four separate Employee Benefits Updates. This Part 1 covers year-end health and welfare plan issues....more

Seyfarth Shaw LLP

Employers May Have to Pay More in 2024 as Affordability Threshold Hits New Low for Second Year in a Row

Seyfarth Shaw LLP on

Seyfarth Synopsis: The IRS has announced adjustments decreasing the affordability threshold for plan years beginning in 2024, which may cause employers to have to pay more for ACA compliant coverage in 2024. The IRS...more

Williams Mullen

IRS Reduces 2024 Affordability Percentage

Williams Mullen on

The Internal Revenue Service (IRS) decreased the Affordable Care Act (ACA) affordability percentage for 2024 to 8.39%. This percentage is used to assess whether an applicable large employer’s (ALE) lowest-premium health plan...more

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