Title I of Division BB of the Consolidated Appropriations Act, 2021 (the “Act”), and interim final rules issued by the Departments of Health and Human Services, Treasury and Labor (the “Departments”) in July 2021 (see our...more
10/4/2022
/ Arbitrators ,
Consolidated Appropriations Act (CAA) ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
Final Rules ,
Guidance Update ,
Health Care Providers ,
Health Insurance ,
No Surprises Act (NSA) ,
Out of Network Provider ,
Transparency ,
U.S. Treasury
In a previous post, we reported on an announcement by Delta Airlines that it would impose a premium surcharge on employees covered under its group health plan who failed to get vaccinated for COVID-19. This follow-on post...more
In a recently decided case, Rutledge v. Pharmaceutical Care Management Association, the U.S. Supreme Court held that the Employee Retirement Income Security Act of 1974 (ERISA) does not preempt an Arkansas statute that...more
1/5/2021
/ Drug Pricing ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Health Insurance ,
Pharmaceutical Industry ,
Pharmacies ,
Pharmacy Benefit Manager (PBM) ,
Preemption ,
Prescription Drug Coverage ,
Prescription Drugs ,
Rutledge v Pharmaceutical Care Management Association ,
SCOTUS
As we previously reported, on June 13, the Departments of Health and Human Services, Labor, and the Treasury (collectively, the “Departments”) issued a coordinated set of final regulations (“final rules”) permitting employers...more
11/11/2019
/ Affordable Care Act ,
Department of Health and Human Services (HHS) ,
Employee Benefits ,
Employer Group Health Plans ,
Health Insurance ,
HRA ,
Proposed Regulation ,
Proposed Rules ,
Public Health Service Act ,
Qualified Small Employer Health Reimbursement Plan (QSEHRAs) ,
Safe Harbors ,
Shared Responsibility Rule ,
U.S. Treasury
Health Reimbursement Arrangements (or “HRAs”) are employer-funded, account-based group health plans, which are used to reimburse certain medical expenses incurred by eligible employees, their spouses, and their dependents....more
12/13/2018
/ Affordable Care Act ,
Department of Health and Human Services (HHS) ,
Employee Benefits ,
Employer Group Health Plans ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HRA ,
IRS ,
Proposed Regulation ,
Proposed Rules ,
Qualified Small Employer Health Reimbursement Plan (QSEHRAs)
In the last post in this series, we examined the regulatory response by certain states to the final regulations governing association health plans, which were issued by the U.S. Department of Labor (DOL) in June 2018. As we...more
In a summary of the recently issued Association Health Plan (AHP) final regulations, the U.S. Department of Labor (DOL) rightly observed that AHPs are a species of multi-employer welfare arrangements, or MEWAs, that are...more
10/3/2018
/ Affordable Care Act ,
Association Health Plans ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Health Insurance ,
Healthcare Reform ,
Independent Contractors ,
MEWAs ,
Preemption ,
Regulatory Reform ,
Reporting Requirements ,
Savings Clause ,
Supremacy Clause ,
Trump Administration
Responding to widespread resistance—principally on the part of small businesses—to the increase in the Employer Medical Assistance Contribution (“EMAC”) contributions and the addition of an EMAC supplemental contribution,...more
In a series of blog posts going back to last August, we reported on certain amendments to the Massachusetts Employer Medical Assistance Contribution (EMAC) rules. As we previously explained, the EMAC contributions are...more
This is the first post in a blog series exploring the U.S. Department of Labor’s recently issued final regulation governing Association Health Plans (AHPs). While AHPs can be either fully-insured or self-funded, the final...more
7/24/2018
/ Affordable Care Act ,
Association Health Plans ,
Department of Labor (DOL) ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Executive Orders ,
Final Rules ,
Health Insurance ,
Healthcare Reform ,
MEWAs ,
Trump Administration
In a series of recent posts, we discussed the expanded Massachusetts Employer Medical Assistance Contribution (EMAC) requirements, including the adoption of a new EMAC supplemental contribution. Among other things, we...more
In advance of issuing the Executive Order that culminated in the promulgation by the Department of Labor of proposed regulations expanding the availability of Association Health Plans, President Trump announced that one of...more
In last week’s post we explained the changes made by a newly proposed Department of Labor regulation, the purpose of which is make it easier for small employers to band together to form “association health plans” (“AHPs”). In...more
1/22/2018
/ Affordable Care Act ,
Association Health Plans ,
Department of Labor (DOL) ,
Employee Benefits ,
Employer Group Health Plans ,
Executive Orders ,
Health Insurance ,
Healthcare Reform ,
MEWAs ,
NAIC ,
Regulatory Reform ,
Trump Administration
Massachusetts employers with 6 or more employees will soon be required to prepare and file a new health care reporting form referred to as the “healthcare coverage form.” While reminiscent of the now repealed “Health...more
1/17/2018
/ Affordable Care Act ,
Cost-Sharing ,
Employer Group Health Plans ,
Employer Mandates ,
Fair Share Contribution ,
Governor Baker ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Local Ordinance ,
Popular ,
Reporting Requirements
On January 3, 2018, the Department of Labor issued proposed regulations that will make it easier for small employers to band together to form “association health plans” (“AHPs”), thereby providing access to more liberal...more
1/11/2018
/ Affordable Care Act ,
Association Health Plans ,
Corporate Counsel ,
Department of Labor (DOL) ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Employer Liability Issues ,
Executive Orders ,
Health Insurance ,
MEWAs ,
Proposed Regulation ,
Trump Administration
As we reported in a previous post, Massachusetts Governor Charlie Baker in August 2017 signed into law H. 3822, “An Act Further Regulating Employer Contributions to Health Care” (the “Act”). Among other things, the law...more
1/10/2018
/ Affordable Care Act ,
Covered Employees ,
Employer Contributions ,
Fair Share Contribution ,
Governor Baker ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
PHI ,
Proposed Rules ,
State Health Plans ,
Unemployment Insurance
In a November 20, 2017 post, we reported on Massachusetts’ passage of H. 3822, “An Act Further Regulating Employer Contributions to Health Care,” (the “Act”), the purpose of which is to shore up the finances of the...more
12/14/2017
/ Affordable Care Act ,
Children's Health Insurance Program (CHIP) ,
Covered Employees ,
Employee Benefits ,
Employer Contributions ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medicaid ,
Shared Responsibility Rule ,
Tax Penalties ,
Unemployment Insurance
In recent weeks, the Trump Administration has been considering allowing health insurance to be purchased across state lines and expanding access to “Association Health Plans” (AHPs) that could take economic advantage of...more
At this writing, the prospects for success of the latest Republican effort to replace the Affordable Care Act appear bleak — but the Graham-Cassidy bill on which the GOP has pinned its last-ditch hopes highlights a major...more
9/25/2017
/ 1332 Waiver ,
Actuaries ,
Affordable Care Act ,
Block Grants ,
Cost-Sharing ,
EHB ,
Federal v State Law Application ,
Health Insurance ,
Healthcare Reform ,
Insurance Risk Pool ,
Medicaid ,
Medicare ,
Premiums ,
Public Health Insurance Marketplace ,
Repeal
On August 1, Massachusetts Governor Charlie Baker signed into law H. 3822, “An Act Further Regulating Employer Contributions to Health Care” (the “Act”). The purpose of the Act is to shore up the finances of the...more
With its “employer mandate”—i.e., the requirement that applicable large employers make an offer of group health coverage to substantially all full-time employees or face the prospect of a penalty—the Affordable Care Act (ACA)...more
6/15/2017
/ Affordable Care Act ,
Captive Insurance Company ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Employer Mandates ,
Health Insurance ,
IRS ,
Large Employer ,
Medical Stop-Loss Rules ,
MEWAs ,
Self-Funded Health Plans
Senate Majority Leader Mitch McConnell recently gave a candid assessment of the chances of getting an Affordable Care Act (ACA) replacement bill through the Senate, saying “I don’t know how we get to 50 (votes) at the...more
6/8/2017
/ Affordable Care Act ,
American Health Care Act (AHCA) ,
Congressional Budget Office ,
Employer Mandates ,
Essential Health Benefits ,
Health Insurance ,
High Risk Pools ,
Individual Mandate ,
Legislative Agendas ,
Medicaid ,
Medicaid Expansion ,
Medicare ,
Proposed Legislation ,
Tax Credits ,
Trump Administration
In an effort to make up for a funding shortfall in the Commonwealth of Massachusetts’ Medicaid program, state policymakers have proposed solutions that include a “play-or-pay” option under which employers who fail to offer...more
5/30/2017
/ Children's Health Insurance Program (CHIP) ,
Deficit Reduction ,
Employee Retirement Income Security Act (ERISA) ,
Employer Contributions ,
Employer Group Health Plans ,
Health Insurance ,
Healthcare Reform ,
Medicaid ,
Pay or Play ,
Preemption ,
State Legislatures
The stunning failure of the U.S. House of Representatives to pass the American Health Care Act (AHCA) (which we previously reported on here) has political and policy implications that we cannot forecast. Nor it is it clear to...more
3/28/2017
/ Affordable Care Act ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Health Insurance ,
Large Employer ,
Legislative Agendas ,
Medicaid ,
Medicaid Expansion ,
Preemption ,
Proposed Legislation ,
Repeal ,
State Health Plans ,
Trump Administration
On March 6, 2017, after years of promising, GOP lawmakers in the House of Representatives introduced the “American Health Care Act” (AHCA), the first concrete legislative proposal detailing the initial provisions designed to...more
3/22/2017
/ Affordable Care Act ,
Cadillac Tax ,
Congressional Budget Act of 1974 ,
Dependent Coverage ,
Employer Mandates ,
Flexible Spending Accounts ,
Health Insurance ,
Health Savings Accounts ,
Individual Mandate ,
Medicaid Expansion ,
Medical Device Tax ,
Medicare Part D ,
Minimum Essential Coverage ,
Over-the-Counter Sales ,
Premium Subsidies ,
Prescription Drugs ,
Proposed Legislation ,
Repeal ,
Small Business ,
Tax Credits