News & Analysis as of

Employer Group Health Plans

McDermott Will & Emery

Special Report: Examining Group Health Coverage Alternatives for Small Employers - Update

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Originally published in February 2025, this updated report provides new material on physician practice management (PPM) arrangements, reference-based pricing arrangements, minimum essential coverage (MEC) and MEC+ plans, and...more

ArentFox Schiff

Anthem Set to Settle Five-Year Long Mental Health Coverage Class Action

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Anthem Inc. has agreed to settle a class action lawsuit brought by participants in employee health plans administered by the insurer....more

Health Care Compliance Association (HCCA)

[Event] Healthcare Privacy Compliance Academy - June 9th - 12th, Pittsburgh, PA

HCCA's Healthcare Privacy Compliance Academy is a three-and-a-half-day interactive education program with a focus on the vast body of privacy laws and regulations in place to help you protect PHI and other critical data. Our...more

Lathrop GPM

Call for Additional Regulations for Health Plan Compensation Disclosures

Lathrop GPM on

In an April 15 Executive Order, entitled “Lowering Drug Prices by Once Again Putting Americans First,” the Trump Administration has called attention to an ERISA disclosure required by the Consolidated Appropriations Act of...more

Weber Gallagher Simpson Stapleton Fires &...

I’m Getting Divorced. What Happens to My Health Insurance?

One of the biggest issues in this country is healthcare. Specifically, the cost and payment for healthcare and directly related to that, health insurance. Under most family situations at least one family member works for an...more

Dickinson Wright

Federal Enforcement of Mental Health Parity: Key Updates and Challenges Ahead

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On January 17, 2025, the U.S. Departments of Labor, Health and Human Services, and the Treasury (“the Departments”) issued their 2024 Report to Congress on the enforcement and implementation of the Mental Health Parity and...more

Bricker Graydon LLP

Why You Can’t Kick High Claimants Off Your Health Insurance

Bricker Graydon LLP on

If your health insurance premiums have gone up again, you are not alone.  For that reason, we frequently get questions from clients on whether there is anything they can do to get high claimants off of their plans....more

Husch Blackwell LLP

Litigation Looms: ERIC Seeks Stay on 2024 Mental Health Parity Rule Enforcement

Husch Blackwell LLP on

On February 20, 2025, the ERISA Industry Committee (ERIC) announced that its legal counsel submitted a letter to the U.S. Departments of Labor (DOL), Health and Human Services (HHS) and Treasury, requesting a stay of...more

Verrill

The GLP-1 Coverage Conundrum: Managing Costs for Group Health Plans

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Many employers are facing challenges in incorporating high-cost GLP-1 medications, such as Mounjaro, Ozempic, Rybelsus, Trulicity, and Wegovy, into their group health plans, as they must balance the cost to the group health...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Privacy Compliance Academy - March 24th - 27th, Chicago, IL

HCCA's Healthcare Privacy Compliance Academy is a three-and-a-half-day interactive education program with a focus on the vast body of privacy laws and regulations in place to help you protect PHI and other critical data. Our...more

Amundsen Davis LLC

Refusing to Quit: Class Actions on Tobacco Surcharges in Health Plans Continue

Amundsen Davis LLC on

Over the past year, numerous class actions have been filed against large employers claiming their health plan surcharge for tobacco use is not in compliance with HIPAA nondiscrimination rules. With yet another lawsuit filed...more

Arnall Golden Gregory LLP

Challenges in Enforcing Mental Health Parity: EBSA’s Struggle to Ensure Compliance

A recent audit conducted by the U.S. Department of Labor’s Office of Inspector General (“OIG”) has uncovered significant challenges encountered by the Employee Benefits Security Administration (“EBSA”) in ensuring compliance...more

Jackson Lewis P.C.

Make America Healthy Again: New Executive Order Revisits Group Health Plan Price Transparency

Jackson Lewis P.C. on

On February 25, 2025, President Trump signed “Making America Healthy Again with Clear, Accurate, and Actionable Healthcare Pricing Information,” an Executive Order with the stated purpose of making group health plans and...more

Saul Ewing LLP

Trump on Transparency: Making America Healthy Again Through Executive Order 14221; How Plan Sponsors Can Respond

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One mandate under the PPACA required health care providers, non-grandfathered health insurance issuers and self-insured group health plans to provide consumers with access to information about the cost of services before they...more

Morgan Lewis - ML Benefits

US Administration’s Executive Orders and Actions’ Impact on Group Health Plans

Since taking office, President Donald Trump has issued several executive orders (EOs) and actions that may have an impact on group health plans. These EOs provide insight into the US administration’s policies and outline...more

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

Second Circuit Renders Important Decision on Vested Retiree Benefits

In a significant ruling on February 5, 2025, the U.S. Court of Appeals for the Second Circuit addressed the enforceability of an arbitration provision in an expired collective bargaining agreement (CBA) in the case of Xerox...more

Morgan Lewis - ML Benefits

Tobacco Surcharge Lawsuits: Considerations for Plan Sponsors

A growing number of class action lawsuits have been filed against employer-sponsored self-insured group health plans alleging that tobacco cessation wellness programs violate key provisions of the Employee Retirement Income...more

McDermott Will & Emery

Special Report - Examining Group Health Coverage Alternatives for Small Employers

McDermott Will & Emery on

Small employers seeking to offer robust major medical coverage to employees and their dependents face daunting price and transparency hurdles. Employers with 50 or fewer full-time equivalent employees, so-called “small...more

Warner Norcross + Judd

IRS Releases ACA Reporting Relief Guidance

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At the end of last year, we told you about new legislation that provides employers with a little Affordable Care Act (ACA) reporting relief. Specifically, under the Paperwork Burden Reduction Act, applicable large employers...more

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

Employer Group Sues to Block Mental Health Parity Rules

Only weeks after the principal effective date for the final 2024 federal mental health parity rules for employer-sponsored health benefit plans, those rules—and specifically some key features that are frustrating...more

McDermott Will & Emery

Special Report: Examining Group Health Coverage Alternatives for Small Employers

McDermott Will & Emery on

Small employers seeking to offer robust major medical coverage to employees and their dependents face daunting price and transparency hurdles. Employers with 50 or fewer full-time equivalent employees, so-called “small...more

Pillsbury Winthrop Shaw Pittman LLP

IRS Eases Form 1095-C Burden for Employers

President Biden recently signed two new laws that significantly reduce the ACA compliance burden for employers by streamlining Form 1095 reporting and minimizing penalties for failure to file and distribute Form 1095s to...more

Venable LLP

March 1 Deadlines for Group Health Plans

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March 1 brings two annual deadlines for employers that sponsor a group health plan for their employees....more

Polsinelli

Complying with the ACA Disclosure Requirements Just Got a Whole Lot Easier!

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New legislation liberalizing certain disclosure requirements under the Affordable Care Act (“ACA”) was passed at the end of 2024.  Effective for 2024 reporting, mailing a paper copy of Forms 1095-C/1095-B is no longer...more

Verrill

The Gag Clause Quandary for Self-Insured Group Health Plans—New FAQ Guidance

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The Departments of Labor, Health and Human Services, and the Treasury, with the Office of Personnel Management (the “Departments”) jointly released FAQs About Consolidated Appropriations Act, 2021 Implementation Part 69...more

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