In a new set of Frequently Asked Questions, the U.S. Departments of Labor, Health and Human Services, and the Treasury provide significant relief to health plan sponsors and insurers seeking to report on expenditures for...more
Summary -
Throughout 2020 and 2021, employers sponsoring health and welfare plans have needed to respond to a myriad of legislative and regulatory changes arising from the COVID-19 pandemic and new health legislation. To...more
Summary -
Two sets of rules were issued last month by federal agencies as part of the No Surprises Act....more
The United States Department of Labor has issued much anticipated guidance and model forms under the COBRA subsidy rules introduced by the American Rescue Plan (ARP). The FAQ guidance and forms clarify some issues that...more
Summary The U.S. Supreme Court unanimously upheld an Arkansas statute that regulates the price that pharmacy benefit managers (PBMs) pay retail pharmacies for prescription drugs. ...more
12/15/2020
/ Drug Pricing ,
Employee Retirement Income Security Act (ERISA) ,
Health Insurance ,
Pharmaceutical Industry ,
Pharmacies ,
Pharmacy Benefit Manager (PBM) ,
Preemption ,
Prescription Drug Coverage ,
Prescription Drugs ,
Rutledge v Pharmaceutical Care Management Association ,
SCOTUS
The U.S. District Court for the Eastern District of New York blocked federal rules seeking to remove nondiscrimination protections for health care patients. The blocked rules would have removed protections against...more
8/21/2020
/ Affordable Care Act ,
Bostock v Clayton County Georgia ,
Civil Rights Act ,
Department of Health and Human Services (HHS) ,
Gender Identity ,
Health Care Providers ,
Health Insurance ,
Healthcare Reform ,
New Rules ,
Non-Discrimination Rules ,
Sexual Orientation Discrimination ,
Sexual Stereotyping ,
Title IX ,
Title VII
The Internal Revenue Service (IRS) has issued new guidance, Notice 2020-29, in response to the COVID-19 pandemic, providing for temporary flexibility with respect to mid-year elections made during 2020 under Code section 125...more
On March 19, 2020, the New Jersey Department of Treasury announced that it extended the deadline for applicable coverage providers to file Forms 1095 with the New Jersey Division of Taxation from March 31, 2020, to May 15,...more
Across the United States, employers are carefully considering how the COVID-19 pandemic is affecting their business. As we await further guidance and pronouncements from federal, state, and local officials, some employers are...more
3/18/2020
/ Affordable Care Act ,
COBRA ,
Coronavirus/COVID-19 ,
Crisis Management ,
DFSA ,
Emergency Management Plans ,
Furloughs ,
Health and Safety ,
Health and Welfare Plans ,
Health Insurance ,
Infectious Diseases ,
Layoffs ,
Public Health ,
Retirement Plan ,
Unemployment Benefits
To encourage individuals to seek prompt medical attention for the coronavirus (COVID-19), a number of states have taken, or are considering, action to eliminate the costs associated with testing and treating the virus and to...more
3/16/2020
/ Clinical Laboratory Testing ,
Coronavirus/COVID-19 ,
Cost-Sharing ,
Crisis Management ,
Deductible Expenses ,
Emergency Response ,
Employee Benefits ,
HDHP ,
Health and Safety ,
Health Insurance ,
HSA ,
Infectious Diseases ,
IRS ,
New Guidance ,
Public Health ,
Relief Measures
The Internal Revenue Service (IRS) issued a notice that allows individuals to participate in a health savings account (HSA) while participating in a high deductible health plan (HDHP) that provides coverage for both the...more
3/16/2020
/ China ,
Clinical Laboratory Testing ,
Coronavirus/COVID-19 ,
Crisis Management ,
Deductibles ,
Emergency Management Plans ,
Emergency Response ,
Employee Benefits ,
Employer Group Health Plans ,
HDHP ,
Health Insurance ,
Health Savings Accounts ,
Infectious Diseases ,
IRS ,
Medical Benefits ,
Medical Examinations ,
New Guidance ,
Popular ,
Public Health
The U.S. Department of Labor (DOL) recently released a draft model form for plan participants to request disclosures from group health plans and insurers about restrictions on mental health coverage. The form is designed to...more
As widely reported, the U.S. House of Representatives has passed the American Health Care Act (AHCA), a bill that, if enacted, would make the first major legislative changes to the Affordable Care Act (ACA). Modified to...more
5/8/2017
/ Affordable Care Act ,
American Health Care Act (AHCA) ,
Cadillac Tax ,
CBO Report ,
Employer Mandates ,
Essential Health Benefits ,
Flexible Spending Accounts ,
Health Insurance ,
Health Insurance Exchanges ,
Health Savings Accounts ,
Medicare ,
Premium Subsidies ,
Proposed Legislation ,
Repeal ,
Trump Administration
The U.S. Department of Health and Human Services (HHS) has finalized regulations designed to help stabilize the individual and small group health insurance markets and, in particular, the health insurance exchanges...more
The House Ways and Means and Energy and Commerce Committees have released, in two parts, budget reconciliation legislation, the first steps of Congress' proposal to "repeal and replace" the Affordable Care Act. Reconciliation...more
3/8/2017
/ Abortion ,
Affordable Care Act ,
Cadillac Tax ,
Cost-Sharing ,
Employer Mandates ,
Health Insurance ,
Health Savings Accounts ,
Healthcare Reform ,
Individual Mandate ,
Medicaid ,
Proposed Legislation ,
Repeal ,
Tax Credits ,
Trump Administration ,
Ways and Means Committee
When Donald Trump won the presidential election in November, management-side labor and employment lawyers everywhere scrambled to figure out what the changing administration would mean for our nation's employers and our...more
1/23/2017
/ Affordable Care Act ,
Department of Labor (DOL) ,
EEO-1 ,
Employee Benefits ,
Employer Mandates ,
Employment Discrimination ,
Equal Employment Opportunity Commission (EEOC) ,
Fair Labor Standards Act (FLSA) ,
Gender Discrimination ,
Gender-Based Pay Discrimination ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Joint Employers ,
LGBTQ ,
Minimum Salary ,
NLRB ,
Over-Time ,
Section 7 ,
Transgender ,
White-Collar Exemptions
ERISA does not allow a state to compel a self-insured group health plan to compile and report medical claims data for inclusion in a state-wide all-payer health care database, the U.S. Supreme Court has ruled in a landmark...more
The U.S. Departments of Treasury, Labor (DOL) and Health and Human Services (HHS) have issued interim final regulations and Frequently Asked Questions and Answers on the cost-free coverage of preventive services under the...more
8/3/2015
/ Affordable Care Act ,
Burwell v Hobby Lobby ,
Closely Held Businesses ,
Contraceptive Coverage Mandate ,
Corporate Governance ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Health Insurance ,
Healthcare ,
Hobby Lobby ,
Preventive Health Care ,
Privately Held Corporations ,
Religious Institutions ,
U.S. Treasury
In a much-anticipated decision, the U.S. Supreme Court ruled today that individuals who enroll for coverage in a health insurance exchange may qualify for a subsidy to make that coverage more affordable, regardless of whether...more
The U.S. Departments of Labor, Health and Human Services, and the Treasury have jointly issued a new set of FAQs that clarifies the application of the rules establishing cost-sharing limits. For 2016, non-grandfathered group...more
With the news of the breach of security at Anthem health plans, many employers have been wondering whether their employees are affected and how they should respond. The breach extends to members in Anthem-affiliated plans and...more
In M&G Polymers v. Tackett, the U.S. Supreme Court ruled that ordinary contract principles govern whether a collective bargaining agreement vests retirees in health coverage (and the contributions they are required to pay for...more