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Healthcare Benefit Plan Sponsors

Hall Benefits Law

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

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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

Bass, Berry & Sims PLC

Welfare Plan Class Action Litigation Underscores Importance of Minding Your Fiduciary Duties

Bass, Berry & Sims PLC on

As mentioned in our recent blog post, the recently filed class action lawsuit against Johnson & Johnson (Lewandowski v. Johnson & Johnson et. al., D.N.J., No. 1:24-cv-00671 (Feb. 5, 2024)) over alleged excessive prescription...more

Fenwick & West LLP

The Shifting Regulatory Landscape for Level-Funded Plans: An Alternative for Group Health Insurance

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In the constantly changing health insurance landscape, level-funded health plans are steadily gaining ground as a viable middle approach between fully insured health plan and self-funded health plans—arguably offering...more

Bass, Berry & Sims PLC

UPDATE: Planning for Open Enrollment? Note the ACA Affordability Threshold Drop

This post was updated on February 6, 2024, to reflect the 2024 Federal Poverty Level announced in January 2024. On August 23, 2023, the Internal Revenue Service issued Rev. Proc. 2023-29, announcing that the Affordable...more

Bradley Arant Boult Cummings LLP

Holidays and Happier at Work: Tips for Creating a Mentally Healthy Workplace

Tips to Change the Mental Health Culture in Your Workforce - Let’s face it—while the stigma about mental health issues has gotten better, much work is still needed. It is up to all of us to help improve the dialogue and tone...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

Verrill

How to Comply with the Health FSA Debit Card Claims Substantiation Rules

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The IRS’s recent Chief Counsel Advice Memorandum 202317020 (the “Memo”) brings into focus the importance of compliance with the debit card claims substantiation requirements for medical care expenses reimbursed or paid for...more

Sheppard Mullin Richter & Hampton LLP

Navigating the Wild West of the New ACA Preventative Care Ruling

On March 30, Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas issued a decision in Braidwood Management Inc. v. Becerra (“Braidwood”), invalidating the Affordable Care Act’s (“ACA’s”) mandate...more

McDermott+

Healthcare Preview for the Week of: April 24, 2023

McDermott+ on

A Busy Week in Congress - This week will be very busy on Capitol Hill. Six hearings will focus specifically on healthcare. The House Energy and Commerce Committee will hold a legislative hearing to review 17 pieces of...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - September 2022

The September Monthly Minute reports on the IRS’ new amendment extension deadline with respect to coronavirus-related distributions and qualified disaster distributions, a recent $131.8 million settlement stemming from...more

Patterson Belknap Webb & Tyler LLP

The Reversal of Roe: Impact on Employer-sponsored Benefits post-Dobbs

On June 24, 2022, the Supreme Court of the United States (the “Court”) issued its opinion in Dobbs v. Jackson Women’s Health Organization, overturning the long-standing precedent of Roe v. Wade. In its 6-3 decision, the Court...more

Clark Hill PLC

The Demise of Roe v. Wade – An Analysis of the Critical Group Health Plan Issues for Employers

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The essential holding of the Supreme Court’s recent 6-3 decision in Dobbs v. Jackson Women’s Health Organization is that a woman’s ability to obtain an abortion in the United States is now to be determined entirely under...more

Proskauer - Employee Benefits & Executive...

New Jersey Individual Mandate Requires State Filings in March 2020

The Affordable Care Act’s individual mandate (i.e., the requirement that most individuals obtain adequate health insurance or pay a penalty) is dead. A side effect of the ACA mandate’s demise is that states are beginning to...more

Jackson Walker

New Tool to Contain Employer Healthcare Costs

Jackson Walker on

Healthcare coverage became an employer-offered benefit during World War II as the result of the federal government’s wage and price controls. Since that time, Medicare has become an important part of how healthcare is...more

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

Key Takeaways From an ERISA Fiduciary Breach Ruling on Behavioral Standards of Care After a 10-Day Trial

Behavioral health claims administrators and plan sponsors alike may be looking more closely at their care guidelines—and how they are applied—after a federal court ruled in a California class action that a claims...more

Proskauer - Employee Benefits & Executive...

[Podcast]: Texas Judge Declares Affordable Care Act Unconstitutional

In this episode of the Proskauer Benefits Brief, partner Robert Projansky and associate Katrina McCann discuss the recent district court case, Texas et al. v. The United States of America, which declared the Affordable Care...more

Epstein Becker & Green

Is the Affordable Care Act a House of Cards? If Yes, What Does the Recent Texas Court Decision Mean for the US Health Insurance...

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In an unexpectedly broad ruling issued December 14, 2018, the U.S. District Court for the Northern District of Texas declared the Affordable Care Act (“ACA”) as unconstitutional in its entirety. This decision, if ultimately...more

Seyfarth Shaw LLP

Watching SCOTUS – ERISA Church-Plan Exemption Revisited

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Seyfarth Synopsis: Currently before the Supreme Court are two petitions regarding the thorny legal question of which organizations can qualify for ERISA’s Church-plan exemption. If the Supreme Court grants certiorari and...more

BakerHostetler

State Data Breach Notification Requirements Specifically Applicable to Insurers

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Almost all U.S. states and territories have enacted breach notification laws requiring private and/or government entities to notify individuals when their personal information is compromised....more

McAfee & Taft

The skinny on narrow networks

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The insurance exchanges created under Affordable Care Act have facilitated increased competition. Old version managed care models implemented cost-savings measures like pre-authorizations for medical care, hospital length of...more

Miller Canfield

EEOC Proposes Wellness Program Regulations

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The Equal Employment Opportunity Commission (EEOC) has proposed much-anticipated regulations regarding the use of employee health program under the Americans with Disabilities Act (ADA). The regulations are an attempt to...more

Patterson Belknap Webb & Tyler LLP

Reminder: Amendments needed to reflect $2,500 limit on Health FSA contributions by year end

As mentioned in a prior Alert, beginning in 2013 employees’ salary reduction contributions to a health flexible spending account (health FSA) may not exceed $2,500 per plan year. This limit is to be indexed for inflation in...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights: October 2014

This week, states’ Marketplaces are busy preparing for the 2015 Open Enrollment Period. Marketplaces are reviewing projected enrollment and renewal figures and releasing searchable databases for 2015 health plan rates, among...more

Foley & Lardner LLP

Two Important Deadlines Approaching for Self-Insured Group Health Plans

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If you sponsor a self-insured group health plan, then November includes two important deadlines: (1) you must obtain a health plan identifier for your plan, and (2) you must report the number of participants for whom a...more

Ary Rosenbaum - The Rosenbaum Law Firm P.C.

Plan Sponsors Should Avoid Using Their Payroll Provider as Their 401(k) TPA

I stick to what I know, so I venture very little outside the retirement plan space. I do that because I believe it is less likely to cause trouble. The two largest payroll providers don’t follow that philosophy -- they are...more

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