News & Analysis as of

Employer Group Health Plans Employee Benefits

Manatt, Phelps & Phillips, LLP

Biden Administration Finalizes Mental Health Parity Rules and Priorities

On September 9, the U.S. Departments of Labor, Health and Human Services, and the Treasury (collectively, the Departments) released a final rule to strengthen implementation of the Mental Health Parity and Addiction Equity...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

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

Seyfarth Shaw LLP

Agencies Release Final Mental Health Parity Rule

Seyfarth Shaw LLP on

On Monday, September 9, 2024, the Departments of Health and Human Services, Labor and Treasury (the “Departments”) issued their final rule regarding the nonquantitative treatment limitation (NQTL) comparative analysis...more

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - September 2024

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This month’s Friday Five discusses cases addressing the effect of continuing to receive benefits during the period of alleged disability, reliance on an employer’s records in making a disability determination, the...more

Lathrop GPM

Fifty Years of ERISA

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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

Epstein Becker & Green

Three Things That Employer Health Plan Sponsors Should Do When the New MHPAEA Rules Are Published

Epstein Becker & Green on

The U.S. Departments of Labor (DOL), Health and Human Services, and the Treasury (collectively, the “Tri-Departments”) published a Notice of Proposed Rulemaking (NPRM) on August 3, 2023, to propose new regulations for the...more

Woodruff Sawyer

Employer Cost Saving Strategies for Fully Insured Health Plans

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When you have a fully insured health plan, you might think you don’t have a viable way to reduce benefits costs. After all, you can’t access the data analytic insights you would see if you were self-funded. But switching to...more

Hall Benefits Law

Federal Agencies Issue Updated Instructions for Annual Submission of Gag Clause Prohibition Compliance Attestation

Hall Benefits Law on

​​​​​​​The U.S. Department of Labor (DOL), the U.S. Department of Health and Human Services (HHS), and the Internal Revenue Service (IRS) have updated the Submission Instructions and User Manual for the Gag Clause Prohibition...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

Holland & Hart - The Benefits Dial

Hole in the Bottle… Employer Considerations After Another Lawsuit Against an Employer Health Plan

Last week, former Wells Fargo employees filed a class action lawsuit against Wells Fargo and its health plan fiduciaries alleging that Wells Fargo’s self-funded health plan violated ERISA by paying its pharmacy benefits...more

Kilpatrick

ERISA Blog | Changes to the HIPAA Privacy Rules A Primer for Self-Insured Group Health Plans

Kilpatrick on

The Office for Civil Rights (“OCR”) of the US Department of Health and Human Services recently released a final rule (“Final Rule”) to update the HIPAA Privacy Rules for reproductive health care information. The Final Rule...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

Fisher Phillips

Don't Forget About ERISA in Your Health Plan’s Cybersecurity Efforts: Important Reminders for Plan Fiduciaries in the Wake of...

Fisher Phillips on

Earlier this year, a cyberattack on a leading healthcare claims processing provider had an unprecedented impact on patients and healthcare providers across the country. While group health plans were not directly targeted in...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

Hall Benefits Law

Biden’s Proposed FFY 2025 Budget Seeks Mental Health Access Expansion

Hall Benefits Law on

The Biden administration unveiled its FFY 2025 budget, which calls for $7.3 trillion in spending. In the proposed budget, Biden maintains his pledge to focus on expanding and transforming the nation’s mental health system. He...more

Robinson+Cole ERISA Claim Defense Blog

Ninth and Second Circuit Courts of Appeals Rule that Preauthorization Process Does Not Impose Independent Contractual Liability on...

Within days of one another, the U.S. Court of Appeals for the Ninth and Second Circuits ruled—on issues of first impression for both—that ERISA expressly preempts state law breach of contract and promissory estoppel claims...more

Littler

July is Still the New January! Littler’s Workplace Policy Institute’s Mid-Year Legislative Report

Littler on

Hot off the press – here is Littler’s mid-year report!  As federal regulators, states and cities continue to pass new workplace regulations through the calendar year, we summarize each state’s notable labor and employment law...more

Jackson Lewis P.C.

Employer-Provided Health Coverage During Employee Leaves of Absence

Jackson Lewis P.C. on

When an employee is on an extended leave of absence, there is often confusion regarding whether and to what extent the employer must continue to provide coverage to the employee under the employer-provided health plan. To...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

Fisher Phillips

Appeals Court Hands Victory to Transgender Employee Seeking Health Benefits: Key Takeaways and 3 Steps Employers Can Take Now

Fisher Phillips on

A federal appeals court recently held that an employer’s health insurance plan wrongly excluded coverage for gender-affirming care in violation of federal civil rights law – offering a warning to employers across the country...more

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - June 2024

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This month’s Friday Five explores recent decisions with issues spanning physician power of attorney to preexisting exclusions and the fiduciary duty of an insurance company....more

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