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Association Health Plan Perspectives (Part 1): Determining the Status of an AHP as “Fully-Insured”

This is the first post in a blog series exploring the U.S. Department of Labor’s recently issued final regulation governing Association Health Plans (AHPs). While AHPs can be either fully-insured or self-funded, the final...more

Revenge of the HIRDs—The New Massachusetts Employer Healthcare Coverage Form

In a series of recent posts, we discussed the expanded Massachusetts Employer Medical Assistance Contribution (EMAC) requirements, including the adoption of a new EMAC supplemental contribution. Among other things, we...more

The Department of Labor’s Proposed Association Health Plan Regulation: Who Wins, Who Loses?

In last week’s post we explained the changes made by a newly proposed Department of Labor regulation, the purpose of which is make it easier for small employers to band together to form “association health plans” (“AHPs”). In...more

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 While reminiscent of the now repealed “Health...more

Expanding Association Health Plans—Which Agencies Need to do What

On October 13th, President Trump signed an Executive Order directing various federal agencies to consider how to achieve three administration health reform objectives: (1) expand access to Association Health Plans (AHPs); (2)...more

Fractal Geometry, Actuarial Risk, and §1332 Waivers—The Role of the States in Reforming Health Care

At this writing, the prospects for success of the latest Republican effort to replace the Affordable Care Act appear bleak — but the Graham-Cassidy bill on which the GOP has pinned its last-ditch hopes highlights a major...more

Efforts to Shore up MassHealth Should Favor Simplicity and Avoid Potential Conflict with Federal Law

In an effort to make up for a funding shortfall in the Commonwealth of Massachusetts’ Medicaid program, state policymakers have proposed solutions that include a “play-or-pay” option under which employers who fail to offer...more

The Future of the Affordable Care Act Week 6: Focus on the Individual Health Insurance Market

A recent report from the nation’s top actuaries takes a sobering look at the challenges policy makers face in creating a viable individual (i.e., non-group) health insurance market—a critical component of any plan to replace...more

The Future of the ACA Week 5: The Rep. Tom Price Plan(s)

This week continues our survey of key Republican proposals to “repeal and replace” the Affordable Care Act (ACA). In the past two weeks, we have reviewed the Trump/Pence transition plan, entitled “Healthcare Reform to Make...more

The Future of the ACA Week 4: The Ryan Plan, “A Better Way”

The recent Republican election victories appear to ensure that the Affordable Care Act’s (ACA) days are numbered. But with nearly a fifth of the U.S. economy, and the health care coverage for some tens of millions of U.S....more

The Future of the ACA (Week 3): The Trump Plan, “Healthcare Reform to Make America Great Again”

The Trump campaign promised to “repeal and replace” the Affordable Care Act. On the campaign trail, candidate Trump was particularly critical of the ACA’s individual mandate, the subsidization of premium charges to older...more

The Future of the Affordable Care Act (Week 2): A Framework for Handicapping Proposals to Replace the ACA

The Affordable Care Act made fundamental and important changes to the way the United States finances health care. The law did not represent a radical departure from prior law or policy, however. The ACA instead worked within,...more

The Future of the Affordable Care Act (Week 1): Assessing the New Normal

The Affordable Care Act was—at least until the election of Donald J. Trump as President—the single most important piece of Federal social legislation in the United States in more than a generation. The law’s fate is now...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 0: Final Thoughts and Acknowledgements

The Affordable Care Act is the single most important piece of Federal social legislation in more than a generation. While there was and is broad agreement on the law’s principal goals—to expand medical coverage, increase the...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 15: Can a Plan That Fails to Cover Inpatient Hospitalization...

A recent Washington Post article (“Glitch in health care law allows employers to offer substandard insurance,” September 12, 2014) highlights an Affordable Care Act compliance strategy being marketed heavily (and adopted...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 16: So What, Exactly, is an “Offer of Coverage”?

Whether an employer makes the requisite offer of group health plan coverage is critical to the application of the Affordable Care Act’s employer shared responsibility rules as reflected in final implementing regulations...more

D.C. Circuit Court of Appeals Agrees to Hear Halbig ACA Case Before Full Court

Following up on our Week 22 ACA Countdown to Compliance post, the D.C. Court of Appeals granted the government’s petition for en banc review in Halbig v. Burwell, which held low income subsidies to purchase coverage through...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 22: Charting the Future of the Premium Subsidies (and Employer...

On July 22, 2014, two federal appellate courts issued conflicting decisions, within hours of each other, regarding the IRS final rule published on May 23, 2012 (the “IRS Rule”), intended to implement the exchange-related tax...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 26: Fitting a Round Peg (the Public Health Service Act 90-day...

The Departments of the Treasury/IRS, Labor and Health and Human Services (the “Departments”) recently issued a final regulation under the 90-day waiting period limitation, which is included among the Affordable Care Act’s...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 30: The IRS Tells Us that Employer Payment Plans (Really,...

The IRS recently issued two Q&As on the subject of employer payment plans, the purpose of which was to again underscore that arrangements purporting to allow an employer to reimburse employees on a pre-tax basis for premiums...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 31: ERISA Section 510 and Limiting Employee Hours

In last week’s post, we examined the appropriateness of capping the annual hours of new “variable hour employees” as a way to limit exposure under the Affordable Care Act’s employer shared responsibility rules. (These rules...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 32: Why Capping Annual Hours at 1560 Does Not Work

Whenever Congress draws a line in the sand—such as with exposure for assessable payments under the Affordable Care Act’s employer shared responsibly rules—entities subject to regulation (here, applicable large employers) will...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 35: ACA, Mental Health Parity, and (the Hazards of the) Final...

With so much attention focused on the particulars of the employer shared responsibility and, to a slightly lesser extent, reporting rules, it’s easy to lose sight of other important changes—including final regulations issued...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 40: Limited Non-assessment Periods under the Final Code §...

Final regulations under Code § 4980H published in the Federal Register on February 12 include a new term—“limited non-assessment period”—which describes periods for which an applicable large employer (i.e., an employer with...more

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