News & Analysis as of

Health Insurance Employee Benefits

Beware: IRS To Begin Issuing ACA Employer Shared Responsibility Payment Penalty Notices

The IRS has announced its next steps regarding the Employer Shared Responsibility Payments (the “ESRPs”), which are the ACA penalties assessable to “Applicable Large Employers” for failing to provide affordable health care...more

The Art of Reduction: OPEB Costs, Commitments

by Best Best & Krieger LLP on

California’s gap between promised employee benefits and available cash is wide and ever expanding. Ballooning pension costs and rising deficits are often in the spotlight. But commitments that California’s governing bodies...more

Labor Secretary Discusses DOL Priorities During House Committee Hearing

by Littler on

Labor Secretary Alexander Acosta fielded a range of questions on the DOL's priorities during a November 15 hearing before the House Committee on Education and the Workforce. Although members of the Committee inquired about...more

Fourth Circuit Affirms Health Care Fraud Convictions for Billing Insurers for Medically Unnecessary Services

by Seyfarth Shaw LLP on

Seyfarth Synopsis: The Fourth Circuit found that the medical necessity of a given service constitutes a material element of representations regarding submissions for payment, potentially providing payors with another legal...more

Issue 114: Relief from HIPAA Certification Requirement

by Seyfarth Shaw LLP on

This is the one hundred and fourteenth issue in our series of alerts for employers on selected topics on health care reform. This series of Health Care Reform Management Alerts is designed to provide an in-depth analysis of...more

Treasury Announces 2017-2018 Regulatory Agenda for Employee Benefits

The Internal Revenue Service (IRS) has recently published updates to its guidance plans for the coming months. - On October 20, 2017, the US Department of the Treasury and the IRS released their 2017-2018 Priority Guidance...more

Executive Order on Association Health Plans Could Benefit Employers

by Barley Snyder on

Stymied by the lack of congressional progress toward repealing, replacing or reforming the Affordable Care Act (ACA), President Trump has in recent days issued a number of directives affecting various aspects of the law....more

Back in the Spotlight: The Affordable Care Act Again Takes Center Stage

by Ballard Spahr LLP on

After a brief lull in activity, recent developments are likely to involve all three branches of government in addressing issues under the Affordable Care Act....more

The Health Care Executive Order and Its Effect on Employee Benefit Options

by Hodgson Russ LLP on

In a development with potentially far-reaching ramifications, on October 12, 2017, the President signed Executive Order No. 13813 expressing an executive policy of facilitating, “to the extent consistent with law”, the...more

Health Insurance for U.S. Employees - A New Option for an Old Problem

by Hodgson Russ LLP on

There is good news in the world of U.S. health insurance laws, at least for Canadian companies with fewer than 50 full-time U.S. employees. Effective this year, it is now possible to directly reimburse employees for the cost...more

White House Expands Exemptions to ACA Contraceptive Mandate

by Robinson & Cole LLP on

The Department of Health and Human Services (HHS) issued interim final rules on October 6, 2017, expanding exemptions to protect religious beliefs and moral convictions for certain entities and individuals whose health plans...more

Trump Administration Issues Executive Order Regarding Health Coverage and Discontinues Cost-Sharing Reductions Payments

by Locke Lord LLP on

On October 12, 2017, President Donald Trump signed an Executive Order “to reform the United States healthcare system to take the first steps to expand choices and alternatives to Obamacare plans and increase competition to...more

Trump Administration Takes Aim at ACA With AHP Executive Order

Thursday, October 12th, on the heels of the recent and repeated failures to repeal and replace the Affordable Care Act (“ACA”), President Donald Trump signed an executive order nominally aimed at increasing competition in the...more

Trump Administration Pulls the Plug on CSR Payments

After months of veiled threats, President Trump formally announced that his Administration will cease funding Cost-Sharing Reduction (“CSR”) payments, a key component of the Affordable Care Act (“ACA”) intended to help...more

“Ceasing the CSR’s: Once a Threat, Now A Promise”

by LeClairRyan on

Late in the evening of October 12, 2017, word leaked that the Trump Administration planned to finally carry out its threat to stop the Cost-Sharing Reduction Payments (“CSRs”) under the Affordable Care Act (“ACA”). The...more

President Trump Issues Executive Order to Reshape Health Insurance Market

by Littler on

After failing to achieve a legislative solution to "repeal and replace" the Patient Protection and Affordable Care Act (ACA), President Trump issued an executive order (EO) on October 12, 2017, designed to promote “healthcare...more

White House Narrows ACA Contraception Mandate

by Fisher Phillips on

The Department of Health and Human Services (HHS) just issued new rules which will limit the contraception coverage mandate covering employers under the Affordable Care Act (ACA). The new rules, released Friday, expand the...more

Employee Wellness Developments: Keeping Your Finger on the Pulse

by Akerman LLP - HR Defense on

As we alluded in our “Preparing for the Unknown: Open Enrollment 2018” blog post, employers that are finalizing their employee benefit plan designs in advance of the 2018 plan year would be well-advised to monitor the...more

To Audit Or Not To Audit? A Good Question For Self-Funded Group Health Plans

by Jackson Lewis P.C. on

The rise in insurance premiums for group health plans has prompted many employers to reexamine the decision whether to fund participant health benefits with insurance or self-fund benefits and limit their claims risk by...more

Employee or independent contractor? Right to control is key

by McNair Law Firm, P.A. on

A continuing point of contention in employment law revolves around who is an employee versus who is an independent contractor. The issue seems to come up often in wage and hour cases and workers’ compensation or unemployment...more

EEOC Says It Will Not Propose New Regulations for Employer Wellness Programs Until August 2018

by Pepper Hamilton LLP on

As we reported previously, on August 22, the U.S. District Court for the District of Columbia directed the Equal Employment Opportunity Commission (EEOC) to reconsider its regulations on employer wellness programs under the...more

Employer Health Plan Premiums Rose In 2016, But Just Barely

by Jackson Lewis P.C. on

Premiums for Affordable Care Act (ACA) marketplace coverage continue to sky rocket, with the average cost of a benchmark plan in the individual market place rising 20% this year. There is very different news for...more

School Employee Who Resigned After Her Hospitalization Coverage Was Reduced Entitled To Unemployment Compensation

by Tucker Arensberg, P.C. on

Forbes Road School District V Unemployment Compensation Board of Review, Commonwealth Court of Pennsylvania, Case No. 1814 C.D. 2016 - Claimant was hired as a paraprofessional at $10.15 an hour. She completed health...more

Well, I Know a Little About Wellness Programs: Court Finds EEOC’s Incentive Limit Unsupported, Remands to Agency

On August 22, 2017, the U.S. District Court for the District of Columbia issued its decision in the American Association of Retired Persons, Inc.’s (AARP) challenge to the wellness program regulations issued by the U.S. Equal...more

Employment News - September 2017

by Hogan Lovells on

Don’t look now – European Court decides monitoring employee's email account did breach privacy right - In Barbulescu v Romania the Grand Chamber of the European Court of Human Rights has decided that an employee's right to...more

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