News & Analysis as of

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

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

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

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

Ballard Spahr LLP

Preventive Care Rules Remain in Place for Now

Ballard Spahr LLP on

The Fifth Circuit Court of Appeals has stayed the broad application of a district court decision that would have invalidated a number of preventive care requirements under the Affordable Care Act. As a result, health plans,...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

Groom Law Group, Chartered

ACA Preventive Service Requirements Partially Vacated

On March 30, 2023, the District Court for the Northern District of Texas issued an opinion and order in Braidwood Mgmt. Inc. v. Becerra that vacates the implementation and enforcement of certain preventive service provisions...more

Trusaic

Understanding ACA Affordability for 2023 Tax Year

Trusaic on

Since ACA reporting was first required by employers in 2015, the affordability component under the Employer Mandate was established each year by indexing the standard of 9.5%. This has always been the case, that is, until...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

Roetzel & Andress

President Biden’s Executive Orders: Impact On Employee Benefits And Healthcare

Roetzel & Andress on

In the opening days of his administration, President Biden has signed a flurry of Executive Orders impacting multiple sectors of the U.S. economy. This article summarizes the Orders that impact employee benefits and...more

Troutman Pepper

COVID-19 Employee Benefits: FAQs for Employers Focus on Health and Welfare Benefit Plans

Troutman Pepper on

It is hard to find a sector of the American workforce that has not been affected by the COVID-19 emergency. Employees are being asked to work from home if they are able, businesses are being forced to close, and employers are...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

Burr & Forman

What the HRA is going on with HRAs?

Burr & Forman on

On June 13, the Departments of Labor, Treasury and Health and Human Services jointly released final regulations dealing with health reimbursement accounts (“HRAs”). These regulations fulfill the Trump administration’s...more

Mintz - Employment Viewpoints

Agencies Issue Final Regulations Expanding Access to Health Reimbursement Arrangements

On June 13, 2019, the Department of Health and Human Services (HHS), the Department of Labor (DOL), the Department of the Treasury (Treasury Department) and the Internal Revenue Service (IRS) (collectively, the “Departments”)...more

Proskauer - Employee Benefits & Executive...

Executive Order Seeks to Improve Consumer-Driven Healthcare

On June 24, 2019, the President issued his Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First. The Executive Order directs regulators to take action to improve healthcare...more

Mintz - Health Care Viewpoints

Health Care Weekly Preview from ML Strategies – February 2019

The long-awaiting safe harbor proposed rule was published last week as the Administration looks to get out in front of the drug pricing debate that is sure to shape the 116th Congress. Under the proposed rule,rebates offered...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...

Epstein Becker & Green on

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

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

On and On It Goes: Preventive Care Coverage Updates Under the Affordable Care Act

The Affordable Care Act (ACA) introduced mandatory coverage for a wide array of preventive care services. Section 2713 of the ACA requires most health plans to provide coverage for various preventive care services without...more

Patrick Malone & Associates P.C. | DC Injury...

High-deductible nightmares: the health insurance crisis partisans ignore

While political partisans pound without pause for extreme changes in the Affordable Care Act, Medicare, Medicaid, and other government programs that seek to assist the poor, sick, children, and others with access to health...more

Mintz - Employment Viewpoints

Massachusetts to (Again) Require Health Care Reporting by Employers

Massachusetts employers with 6 or more employees will soon be required to prepare and file a new health care reporting form referred to as the “healthcare coverage form.” While reminiscent of the now repealed “Health...more

Proskauer - Employee Benefits & Executive...

IRS Once Again Extends Distribution (Not Filing) Deadline for ACA Reporting and Continues Good Faith Standard

Following the old “better late than never” axiom, the IRS recently announced (see Notice 2018-06) that once again it would be extending the distribution (but not filing) deadline for the Affordable Care Act (ACA) reporting...more

Ballard Spahr LLP

Guidance Addresses Mental Health Parity

Ballard Spahr LLP on

The U.S. Departments of Labor, Health and Human Services, and the Treasury have issued a set of Frequently Asked Questions and Answers that, among other things, implement certain of the recommendations included in a report...more

Holland & Knight LLP

Religious Institutions Update: October 2016

Holland & Knight LLP on

Timely Topics - The final rule implementing Section 1557 of the Patient Protection and Affordable Care Act (ACA) was issued by the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) on May...more

Sheppard Mullin Richter & Hampton LLP

The Road to Higher Out-of-Pocket Medical Costs is Paved with Good Intentions: The Unintended Consequences of High Deductible...

High-deductible health plans (HDHPs) are among the fastest growing health plans in both the individual and group markets. For calendar year 2017, the IRS defines an HDHP as any health plan with a minimum deductible of $1300...more

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