On the last day before the U.S. Supreme Court’s summer recess, the Court issued a decision that left in place the Affordable Care Act (“ACA”) mandate that requires non-grandfathered group health plans and issuers to cover,...more
7/10/2025
/ Affordable Care Act ,
Constitutional Challenges ,
Employer Group Health Plans ,
Health Insurance ,
Insurance Industry ,
Insurance Litigation ,
Kennedy v Braidwood Management Inc ,
Preventive Health Care ,
Regulatory Requirements ,
SCOTUS ,
USPTO
Earlier this year, the Department of Health and Human Services (“HHS”) released a final rule under Section 1557 of the Affordable Care Act (“ACA”), which prohibits discrimination in health programs and activities. The 2024...more
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
8/19/2024
/ Affordable Care Act ,
Anti-Discrimination Policies ,
Compliance ,
Employer Group Health Plans ,
Employment Litigation ,
Fertility Treatments ,
Health Insurance ,
Health Plan Sponsors ,
Human Rights ,
Internal Revenue Code (IRC) ,
Reproductive Healthcare Issues ,
Title VII
At the end of June, the U.S. Court of Appeals for the Fifth Circuit affirmed a district court order invalidating the Affordable Care Act preventive services mandate for “A” or “B” items and services recommended by the United...more
The Departments of Labor, Treasury, and Health and Human Services (the “Departments”) recently issued guidance for group health plans outlining a “therapeutic equivalence” medical management technique for required preventive...more
On Tuesday, the U.S. Court of Appeals for the Fifth Circuit approved the parties’ stipulated agreement to stay enforcement of the district court decision in Braidwood Management Inc. v. Becerra until the appeal is resolved...more
The Departments of Labor, Treasury, and Health and Human Services (the “Departments”) recently released guidance for group health plans on required preventive services coverage. The guidance was issued in response to a...more
4/26/2023
/ ACIP ,
Affordable Care Act ,
Centers for Disease Control and Prevention (CDC) ,
Compliance ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
HDHP ,
HRSA ,
SBC ,
U.S. Treasury
On the heels of several recent court decisions concerning gender-affirming care, a federal district court in Washington concluded that the denial of benefits for gender-affirming care by a third-party administrator (“TPA”)...more
On October 11, 2022, the IRS and the Treasury Department released final regulations relating to premium tax credit eligibility for families, along with companion cafeteria plan guidance in Notice 2022-41. The final...more
Editor's Overview -
Happy New Year. We wrap-up 2019 with an article that reflects on significant developments in ERISA litigation during 2019, and takes a look at what's on the horizon for 2020. The courts (at all levels)...more
1/17/2020
/ 401k ,
Affordable Care Act ,
American Arbitration Association ,
Arbitration ,
Article III ,
Benefit Plan Sponsors ,
Best Practices ,
Breach of Duty ,
Cadillac Tax ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Liability Issues ,
Individual Mandate ,
Intel Corp. Investment Policy Committee v. Sulyma ,
IRS ,
Loss Causation ,
Multiemployer Plan ,
Pleading Standards ,
Retirement Plan ,
SCOTUS ,
Standing ,
Thole v U.S. Bank ,
Venue
In this edition of our Newsletter, we take a look at a pair of cases that, while unrelated, together remind us of the importance of having clear plan rules in place that reflect the plan sponsor’s intention. The first article...more
10/11/2019
/ 401k ,
403(b) Plans ,
Affordable Care Act ,
Benefit Plan Sponsors ,
Breach of Duty ,
Class Action ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Fiduciary Duty ,
Foreign Nationals ,
Hardship Distributions ,
Health Insurance ,
IRS ,
Mental Health Parity Rule ,
Multiemployer Pension Plan Amendments Act (MPPAA) ,
Pensions ,
Retirement Plan ,
Safe Harbors ,
Standing ,
Statute of Limitations ,
Withdrawal Liability
New regulations issued by the Departments of Labor, Treasury, and Health and Human Services (the “Departments”) have expanded the use of health reimbursement arrangements (“HRAs”), including permitting the use of HRAs to...more
8/12/2019
/ Affordable Care Act ,
COBRA ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Contributions ,
Employer Group Health Plans ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Health Savings Accounts ,
HRA ,
New Regulations ,
U.S. Treasury
New regulations issued by the Departments of Labor, Treasury, and Health and Human Services have expanded the use of health reimbursement accounts (“HRAs”) by allowing reimbursements for individual market insurance premiums....more
7/16/2019
/ Affordable Care Act ,
Benefit Plan Sponsors ,
COBRA ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Disclosure Requirements ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Final Rules ,
HRA ,
Safe Harbors ,
U.S. Treasury
Editor's Overview -
As the summer heats up, so too has the U.S. Supreme Court's docket for next term where it has already agreed to hear three ERISA cases and more may be in the works. On the docket already are ERISA...more
7/16/2019
/ 401k ,
Affordable Care Act ,
Anti-Assignment Clauses ,
Benefit Plan Sponsors ,
Certiorari ,
Collective Bargaining Agreements (CBA) ,
Department of Labor (DOL) ,
Employee Retirement Income Security Act (ERISA) ,
Federal Rules of Civil Procedure ,
Final Rules ,
HRA ,
IBM ,
Retirement Plan ,
Roth IRA ,
SCOTUS ,
Statute of Limitations ,
Stock Drop Litigation
As we closed the door on 2018, we were met by two surprising decisions—one from a panel of the Second Circuit addressing employer stock drop litigation, and one from a federal district court in Texas declaring the entire...more
1/11/2019
/ 403(b) Plans ,
Affordable Care Act ,
Amgen v Harris ,
Breach of Duty ,
Constitutional Challenges ,
Disclosure Requirements ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
FIfth Third Bancorp v Dudenhoeffer ,
Hardship Distributions ,
Health Insurance ,
IRS ,
Plan Administrators ,
Proposed Regulation ,
Section 409A ,
Securities and Exchange Commission (SEC) ,
Stock Drop Litigation ,
Tax Cuts and Jobs Act