News & Analysis as of

Health Plan Sponsors Health Insurance

Proskauer - Employee Benefits & Executive...

Recent Health Plan Litigation Puts Family Building Benefits in Focus

Family building benefits continue to be top of mind as employers and plan sponsors implement new benefit programs to support family building journeys for their employees. At the same time, there have been a few recent...more

Holland & Hart - The Benefits Dial

Hole in the Bottle… Employer Considerations After Another Lawsuit Against an Employer Health Plan

Last week, former Wells Fargo employees filed a class action lawsuit against Wells Fargo and its health plan fiduciaries alleging that Wells Fargo’s self-funded health plan violated ERISA by paying its pharmacy benefits...more

Mintz - Health Care Viewpoints

Mintz IRA Update — The Consequences and Costs of Redesigning the Part D Program

The passage of the Inflation Reduction Act of 2022 (IRA) marked a significant milestone in Congress’s ongoing efforts to address escalating health care costs. While the IRA aims to rein in government spending on Medicare and...more

Ballard Spahr LLP

Final Section 1557 Rules: Highlights for Health Plan Sponsors

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The U.S. Department of Health and Human Services (HHS) has issued final regulations on the nondiscrimination rules set forth in Section 1557 of the Affordable Care Act. The new rules apply to certain group health plans, as...more

Troutman Pepper

Ninth Circuit Court of Appeals Restricts Out-of-Network Providers’ Ability to Avoid ERISA Preemption of State Law Claims

Troutman Pepper on

On May 31, the Ninth Circuit Court of Appeals published an opinion in Bristol SL Holdings, Inc. v. Cigna Health and Life Insurance Company, which has significant implications for the healthcare industry, most notably by...more

McDermott Will & Emery

IRS Announces 2025 Limits for Health Savings Accounts, High-Deductible Health Plans and Excepted Benefit HRAs

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The Internal Revenue Service (IRS) recently announced (see Revenue Procedure 2024-25) cost-of-living adjustments to the applicable dollar limits for health savings accounts (HSAs), high-deductible health plans (HDHPs) and...more

Ballard Spahr LLP

Final Rules Overturn Trump Era Health Benefit Rules

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The Biden administration has issued two sets of final regulations that overturn rules adopted during the Trump administration pertaining to association health plans and short-term, limited-duration insurance (STLDI). The...more

Husch Blackwell LLP

Mental Health Parity and Addiction Equity Act: Comprehensive Final Rule Expected in 2024

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In the United States, mental health (“MH”) and substance use disorder (“SUD”) (collectively “MH/SUD”) have continued to represent areas of intense concern. During the COVID-19 pandemic, the MH struggles of essential workers...more

Manatt, Phelps & Phillips, LLP

[Webinar] Mental Health Parity Update 2024: The Latest Regulatory and Litigation Trends - March 26th, 1:00 pm - 2:00 pm ET

The Mental Health Parity and Addiction Equity Act (MHPAEA) requires health plans and insurers to offer mental health coverage in “parity” with a plan’s medical or surgical coverage. In 2024, as the post-COVID era brings a...more

McDermott Will & Emery

[Webinar] Gender-Affirming Benefits: Best Practices for Group Health Plans - February 29th, 1:00 pm - 1:30 pm EST

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Employers and plan sponsors are facing growing – and often conflicting – pressures related to the coverage of gender-affirming care. Join McDermott lawyers Sarah G. Raaii and Alden J. Bianchi for a webinar to review recent...more

Epstein Becker & Green

Medicare Advantage, Part D, and More: Proposed Rule Outlines Significant Policy and Technical Changes for CY 2025

Epstein Becker & Green on

On November 15, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule titled Contract Year 2025 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit...more

Husch Blackwell LLP

Year-End "To Do's": Reminders for Your Company's Retirement and Health & Welfare Plans

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As the year is quickly coming to an end, it is critical that plan sponsors set time aside to review their operational and administrative practices throughout the year. As appropriate, operational errors may be corrected and...more

Manatt, Phelps & Phillips, LLP

[Webinar] Mental Health Parity Update: Key Takeaways From the Newest Regulatory Guidance and Litigation Trends - September 19th,...

The Mental Health Parity and Addiction Equity Act (MHPAEA) requires health plans to provide mental health benefits, including coverage for substance use disorders (SUDs), that are in “parity” with medical and surgical...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

Proskauer - Employee Benefits & Executive...

Fifth Circuit Stay Reinstates Preventive Services Mandate—For Now

On Monday, the U.S. Court of Appeals for the Fifth Circuit issued an administrative stay of enforcement of the district court decision in Braidwood Management Inc. v. Becerra. Readers of our earlier blog (found here) will...more

Bradley Arant Boult Cummings LLP

ACA Preventive Services Mandate Partially Vacated: What’s Affected, What’s Not, and What’s Next

A federal judge has struck down a provision of the Affordable Care Act (ACA) mandating group health plans and insurers to cover a long list of preventive services without cost-sharing from participants. The March 30 decision...more

Woodruff Sawyer

Agencies Release FAQs in Advance of the Upcoming Gag Clause Attestation Filing Deadline

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When the Consolidated Appropriations Act, 2021 (the “CAA”) was enacted on December 27, 2020, it included a provision that prohibits group health plans and health insurance carriers from entering into certain agreements that,...more

Manatt, Phelps & Phillips, LLP

[Webinar] Navigating the Rapidly Changing Medicare Advantage Regulatory Landscape - April 11th, 1:00 pm - 2:00 pm ET

Medicare Advantage (MA) plans now cover about half of Medicare beneficiaries, and with that enrollment growth has come increased scrutiny from federal and state regulators. As federal regulators complete a busy season of...more

McDermott Will & Emery

[Webinar] How Employers Should Prepare for the End of the Covid-19 National & Public Health Emergencies - April 3rd, 12:00 pm -...

McDermott Will & Emery on

The Biden administration recently announced its intention to end the COVID-19 National Emergency and the COVID-19 Public Health Emergency effective May 11, 2023. These emergency declarations have been in place for nearly...more

Ballard Spahr LLP

Unmuzzled: Time to Attest That No Gags Apply

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Summary - The Departments of Labor, Health and Human Services, and the Treasury have issued guidance on how health plans and insurers may attest to their compliance with the anti-gag rules of the Consolidated...more

Ballard Spahr LLP

Holiday Relief for Reporting Requirements

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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

Manatt, Phelps & Phillips, LLP

[Webinar] Vital Access: How Policymakers Can Streamline the Cancer Care Journey - January 10th, 1:00 pm - 2:00 pm ET

Over the past 50+ years, there has been enormous progress in understanding the mechanisms that cause blood cancer. As a result, new and groundbreaking treatments have led to significantly improved blood cancer survival rates....more

Woodruff Sawyer

Compliance Alert: IRS Releases PCORI Fee For Plan Years Ending Before October 1, 2023

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The IRS has released Notice 2022-59, which sets the applicable PCORI fee for plan years ending between October 1, 2022 and September 30, 2023 at $3.00 per covered life....more

Foley & Lardner LLP

Upcoming Deadline Under The No Surprises Act – Air Ambulance Reporting By Group Health Plans and Insurance Issuers

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Air ambulance services often result in large, unanticipated medical bills for patients. A study by the Government Accountability Office found that in 2017, 69% of air ambulance transports provided to individuals covered by...more

Manatt, Phelps & Phillips, LLP

[Webinar] A Guide to Mental Health Parity: The Latest Litigation, Regulatory and Legislative Actions - October 27th, 1:00 pm -...

The Mental Health Parity and Addiction Equity Act (MHPAEA) requires health plans to provide equal levels of coverage for mental health conditions and substance use disorders (SUD) as for physical illnesses. Understanding and...more

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