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One Court Permits Tobacco Premium Surcharge Claims to Proceed Beyond the Pleading Stage, While Dispositive Motions Remain Pending...

In fall 2024, plaintiffs filed a wave of putative class action lawsuits against employers challenging wellness programs that impose a health coverage premium surcharge on participants if they do use tobacco or do not complete...more

IRS Provides Tax Guidance Related to State-Run Paid Family and Medical Leave Programs

On January 16, 2025, the Internal Revenue Service (“IRS”) issued Revenue Ruling 2025-4 (the “Rev. Rul.”). The Rev. Rul. provides guidance on the federal tax treatment of contributions to and benefits paid under a state paid...more

Wellness Programs Under Scrutiny in EEOC’s New Wearable Devices Guidance

In December 2024, the U.S. Equal Employment Opportunity Commission (“EEOC”) published a fact sheet addressing how federal nondiscrimination laws, such as the Americans with Disabilities Act (“ADA”), may apply to an employer’s...more

New Year, New ACA Penalty and Reporting Relief!

In late December, President Biden signed into law relief related to Code section 4980H employer mandate penalties and Code section 6055 minimum essential coverage (“MEC”) and Code section 6056 employer mandate reporting on...more

Court Vacates Fixed Indemnity Regulations

On December 4, 2024, a federal court in the Eastern District of Texas issued a ruling vacating the notice requirement under the final regulations (the “Final Rule”) on hospital and other fixed indemnity insurance (“Fixed...more

2024 IRS PCORI Fee Increase

On December 2, the IRS issued Notice 2024-83, which increased the PCORI fee from $3.22 per covered life to $3.47 per covered life for policy and plan years that end on or after October 1, 2024 and before October 1, 2025....more

DOL & Treasury Extend Certain ERISA-Related Deadlines for Helene and Milton Impacted Areas

On November 8, the Departments of Labor and Treasury (the “Departments”) issued guidance extending certain deadlines related to retirement, health, and welfare plans in response to Hurricane Helene, Tropical Storm Helene, and...more

The IRS Issues Two Notices Regarding Preventive Care and Medical Care

On October 17, 2024, the IRS issued two Notices: one regarding preventive care services that an HSA-compatible high deductible health plan (“HDHP”) can cover on a pre-deductible basis and another allowing the cost of condoms...more

IRS Announces 2025 Health and Welfare Limits

On October 22, 2024, the IRS issued Rev. Proc. 2024-40, which announces the 2025 indexed limits for certain health and welfare benefits. This is in addition to the limits that the IRS announced on May 9, 2024 in Rev. Proc....more

Recent Lawsuits Target Health Plan Premium Surcharges Based on Tobacco Use

There is a new series of putative class action lawsuits in which the plaintiffs allege that employers that sponsor self-funded health plans with health plan premium surcharges related to tobacco use or vaccination status...more

IRS Ruling Allows Employees to Choose Between Health, Retirement, and Student Loan Benefits

On May 20, 2024, the IRS issued private letter ruling (“PLR”) 202434006 (the “2024 PLR”) that permits employees to allocate an employer contribution among various benefits outside of a cafeteria plan. The IRS has previously...more

IRS Issues FAQs on Educational Assistance Programs

On June 17, 2024, the IRS issued Fact Sheet 2024-22, which includes nine FAQs about educational assistance programs. The Fact Sheet also links to a sample program document for employers....more

Latest Update to the Ongoing Challenge to the ACA’s Preventive Services Mandate

On June 21, 2024, the United States Court of Appeals for the Fifth Circuit (“Fifth Circuit”) issued its ruling in Braidwood v. Becerra. The court determined that the Affordable Care Act’s (“ACA”) requirement that group...more

ERISA Group Health Plans – The New Target in Fee Cases

Earlier this year, a Johnson & Johnson (“J&J”) employee brought a class action complaint (the “Complaint”) against J&J alleging fiduciary breaches under ERISA related to the prescription drug coverage under J&J’s self-funded...more

2024 Fiduciary Rule – Impact on HSAs and Health & Welfare Plans

The Department of Labor (“DOL”) recently released a final regulation (the “Fiduciary Rule”) redefining “investment advice” under the Employee Retirement Income Security Act of 1974, as amended (“ERISA”) and section 4975 of...more

IRS Issues FAQs on the Tax Treatment of Employer-Provided Work-Life Referral Services

On April 16, 2024, the IRS issued Fact Sheet 2024-13, which includes FAQs addressing the tax treatment of employer-provided work-life referral services. The FAQs generally provide that the value of these services can be...more

Tri-Agencies Finalize Rule on STLDI, but Kick the Can Down the Road on Fixed Indemnity and the Health Plan Tax Exclusion

On March 28, 2024, the Departments of Labor, Treasury, and Health and Human Services (the “Tri-Agencies”) issued final regulations on short-term, limited-duration insurance (“STLDI”), hospital and other fixed indemnity...more

Déjà Vu: Biden’s 2025 Budget Nearly Identical on Health, Retirement

On March 11, 2024, President Biden released his budget for Fiscal Year 2025. Hewing closely to proposals in its last budget, the Administration’s new budget proposes a number of major tax increases, including the following...more

Tri-Agencies Issue FAQs on Contraceptive Coverage

On January 22, the Departments of Labor, Treasury, and Health and Human Services (“Tri-Agencies”) issued a set of Frequently Asked Questions (“ACA FAQs Part 64”) clarifying the contraceptive-related services that plans and...more

Possible Impact of New DOL Employee Classification Rule on Employee Benefits

The DOL Wage and Hour Division recently released a new rule changing how workers are classified under the Fair Labor Standards Act (“FLSA”) (“Final Rule”). The Final Rule replaces DOL’s 2021 final regulation and provides a...more

HHS Drops Appeal in Drug Coupon Case

On January 16, 2023, the Department of Health and Human Services (“HHS”) dropped its appeal of the U.S. District Court for the District of Columbia’s September 29, 2023 decision that vacated a portion of the 2021 Notice of...more

DOL Proposes Rescinding Prior Rule Relating to Association Health Plans

On December 19, 2023, the Department of Labor (“DOL”) issued a proposed rule rescinding a Trump Administration rule that expanded the availability of association health plans (“AHPs”) (the “Proposed Rule”)....more

IRS Announces 2024 Health and Welfare Limits

On November 9, 2023, the IRS issued Rev. Proc. 2023-34, which announces the 2024 indexed limits for certain health and welfare benefits. This is in addition to the limits that the IRS announced on May 16, 2023 in Rev. Proc....more

IRS Increases PCORI Fee

On October 18, the IRS issued Notice 2023-70, which increased the PCORI fee from $3 per covered life to $3.22 per covered life for policy and plan years that end on or after October 1, 2023 and before October 1, 2024....more

10/24/2023  /  Fees , Health Insurance , IRS , PCORI

Court Ruling Calls Into Question Whether Plans and Issuers Can Exclude Drug Coupons Towards the MOOP

On September 29, 2023, the U.S. District Court for the District of Columbia vacated the 2021 Notice of Benefit and Payment Parameters (“2021 NBPP”) amendments to Affordable Care Act regulations. The amendments permitted (but...more

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