News & Analysis as of

Insurance Industry Self-Insured Health Plans

Hall Benefits Law

Court Orders Claims Reprocessing After Finding TPA Illegally Excluded Gender-Affirming Care in Violation of ACA Section 1557

Hall Benefits Law on

A federal district court has awarded injunctive relief, including claims processing, after finding that an insurer acting as a third-party administrator (TPA) for a self-insured plan violated Section 1557 of the Affordable...more

Groom Law Group, Chartered

[Webinar] State Abortion Restrictions and the Impact on Employers, Insurers, and Self-Insured Plans - June 16th, 2:00 pm - 3:00 pm...

On June 16, 2022 Groom will be hosting a webinar on the impact of state abortion restrictions on employers, insurers, and self-insured plans. Over the past year, numerous states have enacted new abortion restrictions, and we...more

Holland & Hart - The Benefits Dial

Here We Go Again, PCORI’s Back in Town

For those employers that sponsor a self-insured health plan, it’s important to be aware that the deadline for your 2021 PCORI filing is August 2, 2021. This deadline applies for plan years ending on December 31, 2020 (or any...more

Manatt, Phelps & Phillips, LLP

[Webinar] National Roadmap on State-Level Efforts to End the Drug Overdose Epidemic - February 9th, 2:00 pm - 3:00 pm ET

How Can Mental Health and Substance Use Disorder (SUD) Parity Laws Help Battle the Overdose Epidemic? Learn the Answers—and Catch Up on the Most Recent State and Federal Developments—at a New Webinar from the AMA and Manatt. ...more

Parker Poe Adams & Bernstein LLP

Can Temporarily Laid Off Workers Remain on a Company's Medical Insurance Plan?

We have had a number of questions from clients about their ability to maintain group medical and other employer-provided benefits for employees affected by temporary layoffs and working hours reductions related to COVID-19....more

Clark Hill PLC

Michigan Self-Insured Health Plans are Impacted by Auto Insurance Changes

Clark Hill PLC on

Beginning July 1, 2020, self-insured health plans face changes due to amendments to Michigan’s automobile insurance laws. There are steps that plans can take to limit liability. Below is a summary of the changes and options...more

Snell & Wilmer

Arizona’s New Mini-COBRA Statute Has Arrived, but Is Preemption a Concern?

Snell & Wilmer on

The Consolidated Omnibus Budget Reconciliation Act of 1985 (“COBRA”) requires employers who have 20 or more employees and who offer a group health insurance plan to provide enrollees with a right to continue coverage after...more

McDermott Will & Emery

IRS Adjusted ACA Fee Amounts for the 2015/2016 Policy or Plan Years and Additional Payment Options

McDermott Will & Emery on

The Patient-Centered Outcomes Research Institute (PCORI) fee was established under the Affordable Care Act (ACA) to advance comparative clinical effectiveness research. The PCORI fee is assessed on issuers of health insurance...more

Balch & Bingham LLP

Final 2015 Forms 1094-B, 1095-B, 1094-C, 1095-C and Instructions

Balch & Bingham LLP on

On September 16, 2015, the IRS finalized these ACA coverage reporting Forms and Instructions... We report here, with minimal analysis, changes that we recognized on first comparison to the 2015 Draft Forms and Instructions....more

McDermott Will & Emery

IRS Publishes Final Forms and Instructions on Information Reporting Under the Affordable Care Act

McDermott Will & Emery on

The Internal Revenue Service (IRS) published final forms and instructions addressing information reporting requirements applicable to employers and insurers under Internal Revenue Code Sections 6055 and 6056. The reporting...more

Saul Ewing LLP

ERISA self-insured health plan not required to cover same sex spouses

Saul Ewing LLP on

In Roe v. Empire Blue Cross Blue Shield, No. 12–cv–04788 (NSR), 58 EBC 1077, 2014 WL 1760343 (S.D. N.Y. May 1, 2014), the United States District Court for the Southern District of New York held a self-insured health plan that...more

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