News & Analysis as of

Health Insurance Employee Benefits Benefit Plan Sponsors

Akerman LLP - Health Law Rx

MHPAEA Final Rule: Clarity on Mental Health Parity?

The three federal agencies tasked with enforcement of the Mental Health Parity and Addiction Equity Act (MHPAEA) — the Departments of Labor, Health & Human Services (through CMS), and Treasury (the Departments) — issued their...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

Hall Benefits Law

9th Circuit Explains ERISA Preemption of State Law Claims Arising from Preservice Coverage Communications

Hall Benefits Law on

The U.S. Court of Appeals for the Ninth Circuit recently issued an opinion with critical implications for the healthcare industry. This court decision clarifies the expansive reach of the Employee Retirement Income Security...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

Seyfarth Shaw LLP

IRS Releases Increased HSA Limits for 2025

Seyfarth Shaw LLP on

Seyfarth Synopsis: The IRS has announced increases to key limits for certain health and welfare benefit programs, including HSA contributions for 2025. The IRS recently released 2025 cost-of-living adjustments applicable to...more

McDermott Will & Emery

The ACA 1557 Final Regulations: Plans and Plan Sponsors as Covered Entities

McDermott Will & Emery on

In a recent On the Subject (available here), we reported on the impact of the final rule (final rule) interpreting Section 1557 of the Affordable Care Act (ACA) on self-funded group health plans that contract with licensed...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

Morgan Lewis - ML Benefits

Managing Welfare Plan Risk: The Fiduciary Committee

Fiduciary committees have long been established in connection with retirement plans to manage the investment, legal compliance, and operational risks that can arise under the Employee Retirement Income Security Act of 1974,...more

Baker Donelson

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

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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

Husch Blackwell LLP

Year-End "To Do's": Reminders for Your Company's Retirement and Health & Welfare Plans

Husch Blackwell LLP on

As the year is quickly coming to an end, it is critical that plan sponsors set time aside to review their operational and administrative practices throughout the year. As appropriate, operational errors may be corrected and...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

Ballard Spahr LLP

Prescription for Chaos: Copay Accumulator Programs Called Into Question

Ballard Spahr LLP on

Summary - Employers taking advantage of copay accumulator programs now face unexpected administrative complications following a recent federal court decision....more

Dickinson Wright

10 Important Issues For Employers During the 2024 Open Enrollment Season

Dickinson Wright on

Open enrollment is rapidly approaching for employers with calendar-year employee benefit plans. Following are ten important issues for employers to consider for the 2024 open enrollment season...more

McDermott Will & Emery

New MHPAEA Guidance Regarding NQTLs: Network Access and Composition

McDermott Will & Emery on

Recently proposed regulations attempt to ensure that health plans allow access to mental health or substance use disorder (MH/SUD) benefits as easily as medical or surgical (M/S) benefits. The proposed regulations, issued by...more

Morgan Lewis

Plan Sponsors and Fiduciaries: Some Clarity on Mental Health Parity Compliance

Morgan Lewis on

A recently issued White House Fact Sheet, along with a regulatory package from the US Departments of the Treasury, Labor, and Health and Human Services (the Departments), provides some welcome clarity for plan sponsors and...more

Foley & Lardner LLP

Illinois Insurance Law Update: H.B. 579 and H.B. 2296 Signed Into Law; Significant Changes On The Horizon For Illinois Health...

Foley & Lardner LLP on

On June 29, 2023, Governor J.B. Pritzker signed House Bills 579 and 2296 into law, enacting sweeping changes to Illinois health insurance law that grants the Illinois Department of Insurance (IDOI) expanded regulatory powers....more

Bradley Arant Boult Cummings LLP

Making the First “Gag Clause” Attestations: A Quick Reference Guide

Under the Consolidated Appropriation Act of 2021 (CAA), group health plans and health insurance issuers are prohibited from entering into agreements with service providers restricting certain information that the plan may...more

Foley & Lardner LLP

High Deductible Health Plan First Dollar Coverages in Flux

Foley & Lardner LLP on

A recent string of lawsuits, regulatory guidance, and market trends have dramatically impacted the types of services that enjoy first dollar coverage under high deductible health plan (HDHP) and health savings account (HSA)...more

Woods Rogers

Does the Fun Ever Stop? COVID-19 Tolling Ends for COBRA Deadlines

Woods Rogers on

On April 10, 2023, President Biden signed legislation to end the COVID-19 national emergency effective immediately, including ending the requirement to extend COBRA deadlines due to the COVID-19 pandemic. Plan administrators...more

McDermott Will & Emery

Preparing for the End of the COVID-19 Emergency: Deadline Tolling

McDermott Will & Emery on

The Biden administration previously announced its intent to end the COVID-19 National Emergency (NE) and the COVID-19 Public Health Emergency (PHE) on May 11, 2023 (read our series introduction for more information). On April...more

Verrill

The End of the COVID-19 Emergency Declarations Raises Questions, but We’ve Got Answers

Verrill on

It seems the COVID-19 pandemic is ending in the benefits world the same way it started: in a flurry of new laws, announcements, and notices intended to offer clarity but sowing confusion. To begin, it is important to remember...more

Ballard Spahr LLP

Reminder: Reporting Requirement for Health Care Costs One Month Away

Ballard Spahr LLP on

Health plan sponsors and health insurers will need to report prescription drug and other health plan costs (RxDC reporting) for 2022 by June 1, 2023. Unlike the RxDC reporting requirements for 2020 and 2021, this deadline is...more

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