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Final Rules Related to the Mental Health Parity and Addiction Equity Act May Drive You Wild

Seyfarth Synopsis: On September 9, 2024, the Departments of the Treasury, Labor, and Health and Human Services (the “Departments”) released highly anticipated Final Rules under the Mental Health Parity and Addiction Equity...more

Does Section 1557 Apply to Employer Group Health Plans? (And — Why That Question May Not Even Matter)

Seyfarth Synopsis: Following years of back and forth, new final rules were published by the Department of Health and Human Services (HHS) on May 6, 2024 reinstituting the Department’s interpretation that the prohibition on...more

Agencies Defer Final Action on Junk Insurance, While Suggesting Caution Against One Last “Binge”

The agencies have finalized a portion of their proposed rules impacting so-called “junk insurance” regarding short-term limited-duration insurance, but deferred finalizing the more significant changes that would have impacted...more

Employers Consider Post-Dobbs Playbook in Dealing with Alabama Ruling on IVF Treatments

Seyfarth Synopsis: Last week, the Alabama Supreme Court ruled that cryogenically frozen embryos are children and are protected from destruction under state law. This is the latest in a series of post-Dobbs judicial rulings...more

Drugmaker Sued for…Overpaying for Drugs? Lawsuit Ushers in Expected Wave of Welfare Fiduciary Litigation

The first complaint was filed in what is expected to be a wave of litigation alleging breach of fiduciary duty in selecting and monitoring welfare plan vendors. While the facts of this particular case may make it somewhat...more

Mental Health Compliance Report Issued to Congress Spoiler Alert – Plans All Fail

Seyfarth Synopsis: The Mental Health Parity and Addiction Equity Act (MHPAEA) requires group health plans and insurers to cover treatments for mental health and substance use disorders in a manner that is equitable to the...more

Mental Health Request for Public Comment Spoiler Alert – The Departments Need Help

Seyfarth Synopsis: The Mental Health Parity and Addiction Equity Act (MHPAEA) requires group health plans and insurers to cover treatments for mental health and substance use disorders in a manner that is equitable to the...more

Mental Health Parody: In A Cruel Prank, Agencies Respond to Employer Pleas for Guidance with More Stringent Regulations

Seyfarth Synopsis: The Mental Health Parity and Addiction Equity Act (MHPAEA) requires group health plans and insurers to cover treatments for mental health and substance use disorders in a manner that is equitable to the...more

My Insurance Doesn’t Cover That? Agency Guidance on “Junk Insurance”

Seyfarth Synopsis: Fresh on the heels of the IRS Chief Counsel Memorandum on wellness and indemnity products, discussed in our prior post here, the agencies have weighed in with more formal and more expansive guidance...more

OMG! OMB Reviewing Long-Awaited Mental Health Parity Regulations – Public Release Imminent

Seyfarth Synopsis: Employer health plan sponsors, administrators, and insurers have been eagerly awaiting the U.S. Department of Labor’s upcoming guidance on mental health parity.  According to recent reports, newly proposed...more

Who Do I Need to Sue to Get a Decent Cup of Coffee? Jittery Fiduciaries Consider Options as Health Plan Litigation Froths Up

Seyfarth Synopsis: In light of a recent focus on price transparency, claims data, and hidden fees in the health plan world, employer-sponsored health plans have been bringing their fight to the courtroom in an effort to lower...more

FICA Tax Avoidance Wellness Program Viewed Unfavorably by 87,000 New IRS Agents

Seyfarth Synopsis: Just like a bad penny, schemes promising employers ways to reduce their FICA tax burden, and maybe their employees’ income tax burden at the same time, keep popping up with a slightly different burnish on...more

Final Rules Fix Family Glitch

Seyfarth Synopsis: Recently, on October 11, 2022, the Internal Revenue Service (IRS) issued final regulations which finalized changes to affordability of employer coverage for the family members of employees under Internal...more

Are We There Yet? Emergency Declarations and COVID Relief Are Extended Into 2023

Seyfarth Synopsis: HHS has announced that the COVID-19 Public Health Emergency (PHE) has been extended another 90 days, and will run until January 11, 2023....more

Agency FAQs Reveal Employers Continue to Struggle with No Surprises Act & Transparency in Coverage Implementation

Seyfarth Synopsis: With staggered effective dates continuing over the course of the next several years, the No Surprises Act (NSA) and Transparency in Coverage requirements impose a number of additional compliance...more

Businesses Seek to Provide Abortion Travel Benefits in Light of Potential Supreme Court Decision

Seyfarth Synopsis: In light of recent state-level trends, businesses have begun exploring avenues to assist employees in states with restrictive abortion laws with travel to nearby states to receive abortion services. In...more

No More Surprises, But Much Uncertainty Over Non-Network Bills

Seyfarth Synopsis: Last summer and fall, the Departments of Treasury, Labor, and Health and Human Services issued Interim Final Rules (IFRs) [here] and [here], implementing the sweeping changes that applied to out-of-network...more

If You Can Find an At-Home COVID-19 Test, Your Plan Must Now Pay For It

Seyfarth Synopsis: Since March 18, 2020, group health plans have been required to provide benefits for certain items and services related to testing for or diagnosis of COVID-19 during the applicable emergency period - see...more

Latest Biden Administration Order Requires Some Employers to Pay for Cost of COVID Testing

Seyfarth Synopsis: The OSHA COVID-19 Vaccination and Testing Emergency Temporary Standard (ETS) will require unvaccinated employees to submit weekly COVID-19 testing results by February 9, 2022. New guidance from the Biden...more

Guidance Arrives on Long-Awaited Compensation Disclosures for Group Health Plans

Seyfarth Synopsis: Almost a decade after the 408(b)(2) fee disclosure requirements took effect for retirement plan service providers, Congress finally passed legislation addressing compensation disclosure rules for service...more

More Vax Facts – The Agencies Weigh In

Seyfarth Synopsis: We previously discussed how to apply the HIPAA wellness rules to a premium differential based on a participant’s vaccination status in our Legal Update. At the time, we were left to interpret the existing...more

Anti-Vax Tax Facts: Legal Considerations for Premium Differentials Based on Vaccination Status

Seyfarth Synopsis: As employers continue to struggle with strategies for safely re-opening their workplaces, we have previously discussed the possibility of mandating a vaccine or providing incentives for getting the vaccine....more

Agencies Add Lengthy “No Surprises Act” Regulations to your Summer Reading List: Overview of Impact on Employer-Sponsored Plans

Seyfarth Synopsis: The No Surprises Act (the “Act”) was part of the Consolidated Appropriations Act of 2021 signed into law last December 2020. The Act was aimed at protecting insured individuals from getting a bill from a...more

SCOTUS Doesn’t Want to Tell Us How They Really Feel About The ACA

Dismissal of ACA Lawsuit Based Only on Standing Grounds - Seyfarth Synopsis: In Texas v. California, the Supreme Court rejected another challenge to the Affordable Care Act (“Obamacare” or “ACA”). The Court never reached...more

IRS Releases Extensive Guidance on ARPA COBRA Subsidy

Seyfarth Synopsis: On March 11, 2021, President Biden signed into law the American Rescue Plan Act (“ARPA”), which requires plan sponsors to provide free COBRA coverage from April 1, 2021 through September 30, 2021, to...more

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