News & Analysis as of

Employer Group Health Plans New Guidance

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

ACA-Required Coverage of Contraceptive Care Remains Agency Focus

Once again, the U.S. Departments of Labor, Health and Human Services, and the Treasury have issued guidance on the Affordable Care Act’s (ACA) required coverage of contraception without cost sharing, clarifying the permitted...more

Bricker Graydon LLP

Departments Roll Back Enforcement Discretion in New Guidance on Transparency in Coverage Rules.

Bricker Graydon LLP on

Well, it was good while it lasted. On September 27th, the Departments issued new FAQs regarding implementation of provisions of The Transparency in Coverage Final Rules (TiC Final Rules). ...more

Foley & Lardner LLP

Action Steps Health Plans Should Take Now In Response To New DOL Guidance on Mental Health Parity

Foley & Lardner LLP on

The Consolidated Appropriations Act, 2021 (CAA) added a requirement for health plans to document their compliance with nonquantitative treatment limitations (NQTLs) under the Mental Health Parity and Addiction Equity Act...more

Schwabe, Williamson & Wyatt PC

‎2024 Healthcare Affordability Percentage Makes Benefits More Expensive for Employers‎

The employee benefits 2024 open enrollment season is quickly approaching and, with newly released IRS guidance, employers should be careful to ensure the health plan they offer employees is considered affordable. According to...more

Seyfarth Shaw LLP

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

Seyfarth Shaw LLP on

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

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

COVID-19 Relief for High Deductible Health Plans Expires in 2024

Employers’ high deductible health plans (HDHPs) can continue to cover COVID-19 testing and treatment without violating the eligibility rules for health savings accounts (HSAs)—but only through 2024—under new Internal Revenue...more

Verrill

Gag Clauses – New Guidance and Litigation Will Inform Compliance

Verrill on

Certain provisions of the Transparency in Coverage Final Regulations and the Consolidated Appropriation Act, 2021 (“CAA”) require group health plans and/or their vendors to report information to federal agencies. On December...more

Sheppard Mullin Richter & Hampton LLP

Navigating the Wild West of the New ACA Preventative Care Ruling

On March 30, Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas issued a decision in Braidwood Management Inc. v. Becerra (“Braidwood”), invalidating the Affordable Care Act’s (“ACA’s”) mandate...more

Bradley Arant Boult Cummings LLP

Departments Issue Guidance on Preventive Services under the ACA Following the Braidwood Decision

In light of the March 30 Braidwood Mgmt. Inc. v. Becerra decision, the Department of Labor, Department of Health and Human Services, and Department of the Treasury (the “departments”) have issued FAQ guidance on how the...more

Warner Norcross + Judd

Benefit Plan Guidance for the End of the Public Health Emergency and “Outbreak Period”

With President Joseph Biden’s administration having announced its intent to end the presidential COVID-19 National Emergency on May 11, 2023, and with the COVID-19 Public Health Emergency ("Public Health Emergency") set to...more

Laner Muchin, Ltd.

Employers Face Another Annual Disclosure for their Group Health Plan Related to the No Surprises Act: “Gag Clauses”

Laner Muchin, Ltd. on

The No Surprises Act (the NSA) bans “gag clauses” that prevent disclosure of price or quality information in agreements between health plans and certain service providers. In addition, the NSA requires plan sponsors to attest...more

Husch Blackwell LLP

New Federal Guidance on Employer-Sponsored Group Health Plans and Required Action Steps for 2023

Husch Blackwell LLP on

The Consolidated Appropriations Act, 2021 (CAA) prohibits employer-sponsored group health plans from entering into agreements that contain so-called “gag clauses.” This prohibition generally restricts group health plans from...more

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

HHS, DOL, and Treasury Give Employer-Sponsored Health Plans Another Warning on Providing Contraceptive Coverage

​​​​​​​Employers can’t say they weren’t warned. For the second time in six months, frequently asked question (FAQ) guidance from federal regulators is calling attention to the requirement that employer-sponsored health...more

Faegre Drinker Biddle & Reath LLP

New COVID-19 Guidance: Government Requires Health Plans to Cover At-Home COVID-19 Tests

On January 10, 2022, the Departments of Health and Human Services, Labor and Treasury issued guidance addressing a group health plan’s obligation to cover the cost of over-the-counter, at-home COVID-19 tests starting January...more

Laner Muchin, Ltd.

Group Health Plans Must Now Cover Over-the-Counter COVID-19 Tests

Laner Muchin, Ltd. on

Pursuant to recent federal guidance, group health plans and insurers must now cover over-the-counter COVID-19 tests without cost-sharing, prior authorization or other medical management requirements effective January 15,...more

Williams Mullen

At-Home COVID Tests Must be Reimbursed by Insurance Companies

Williams Mullen on

Group health plans and health insurance issuers are now required to cover the cost of over-the-counter (OTC) COVID-19 diagnostic tests. Last week, the Departments of Labor, Health and Human Services, and the Treasury issued...more

Smith Gambrell Russell

New Agency Guidance Requires Employer-Sponsored Group Health Plans to Cover Over-the-Counter COVID-19 Tests

Smith Gambrell Russell on

On January 10, 2022, the Departments of Labor, Health and Human Services, and the Treasury (collectively, the “Departments”) issued guidance requiring employer-sponsored group health plans to cover the cost of...more

Eversheds Sutherland (US) LLP

Plans and insurers must cover over-the-counter COVID-19 tests under new tri-agency guidance

Health plans and insurers must generally cover over-the-counter COVID-19 tests under Frequency Asked Questions (FAQs) issued on January 10 by the Departments of Labor, Treasury and Health and Human Services (tri-agencies)....more

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

COVID-19 Testing Coverage Requirements for Group Health Plans and Insurers to Take Effect on January 15, 2022

Employer health plans and health insurers will be required to cover over-the-counter (OTC) COVID-19 tests, even without a health care provider’s order or an individualized clinical assessment, and generally without cost...more

Laner Muchin, Ltd.

Federal Regulators Clarify the Application of HIPAA Privacy and Nondiscrimination Rules to COVID-19 Vaccines in the Workplace

Laner Muchin, Ltd. on

On September 30, 2021, the Department of Health and Human Services (HHS) issued FAQs addressing how the HIPAA Privacy Rule applies to individuals’ disclosures of their COVID-19 vaccination status in the workplace and health...more

Parker Poe Adams & Bernstein LLP

Federal Agencies Issue FAQ on Health Plan Premium Discounts for COVID-19 Vaccinations

The federal Centers for Medicare & Medicaid Services (CMS) issued a set of Frequently Asked Questions about the interaction of HIPAA, the Affordable Care Act, and various group health plan issues relating to the COVID-19...more

Smith Anderson

New Guidance for Employers on COVID-19 Vaccine Coverage and Incentives

Smith Anderson on

Employers who sponsor group health plans will be interested in new guidance released last week by the DOL, IRS and HHS in the form of five COVID-19 related FAQs. Two of the FAQs address group health plan coverage requirements...more

McGlinchey Stafford

Nice Try, But HIPAA Privacy Doesn’t Stop Vaccine Inquiries by Employers and Businesses

McGlinchey Stafford on

HIPAA privacy rules do not prevent employers and businesses from asking employees and visitors about their COVID-19 vaccination status, the government recently reiterated. In guidance issued on September 30, 2021, the U.S....more

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

New Guidance Delays Some Key CAA and Other Health Benefit Effective Dates

New regulatory guidance from three federal agencies that enforce private-sector benefits laws will make employers’ daunting 2021 health benefit to-do lists slightly - but only slightly - more manageable heading into 2022....more

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

Initial No Surprises Act Regulations Provide Some Clarity for Employer Plans

Plan participants can be hit with surprise medical bills when they receive care from out-of-network providers. Sometimes, this happens when participants do not know that the care they are receiving is from an out-of-network...more

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