On July 4, President Trump signed into law the One Big Beautiful Bill Act (the “OBBB”). Below we outline the key provisions impacting plan sponsors related to their health and welfare plans. Many of these provisions are...more
The U.S. District Court for the District of Maine recently dismissed two separate suits alleging that health plans’ coverage exclusion for weight loss drugs constitutes unlawful disability discrimination. Both complaints...more
5/14/2025
/ Affordable Care Act ,
Americans with Disabilities Act (ADA) ,
Appeals ,
Class Action ,
Disability Discrimination ,
Employer Group Health Plans ,
Health Insurance ,
Insurance Litigation ,
Obesity ,
Prescription Drugs ,
Section 1557
On December 2, the IRS issued Notice 2024-83, which increased the PCORI fee from $3.22 per covered life to $3.47 per covered life for policy and plan years that end on or after October 1, 2024 and before October 1, 2025....more
On November 8, the Departments of Labor and Treasury (the “Departments”) issued guidance extending certain deadlines related to retirement, health, and welfare plans in response to Hurricane Helene, Tropical Storm Helene, and...more
On October 17, 2024, the IRS issued two Notices: one regarding preventive care services that an HSA-compatible high deductible health plan (“HDHP”) can cover on a pre-deductible basis and another allowing the cost of condoms...more
There is a new series of putative class action lawsuits in which the plaintiffs allege that employers that sponsor self-funded health plans with health plan premium surcharges related to tobacco use or vaccination status...more
On March 28, 2024, the Departments of Labor, Treasury, and Health and Human Services (the “Tri-Agencies”) issued final regulations on short-term, limited-duration insurance (“STLDI”), hospital and other fixed indemnity...more
On January 16, 2023, the Department of Health and Human Services (“HHS”) dropped its appeal of the U.S. District Court for the District of Columbia’s September 29, 2023 decision that vacated a portion of the 2021 Notice of...more
On October 18, the IRS issued Notice 2023-70, which increased the PCORI fee from $3 per covered life to $3.22 per covered life for policy and plan years that end on or after October 1, 2023 and before October 1, 2024....more
On September 29, 2023, the U.S. District Court for the District of Columbia vacated the 2021 Notice of Benefit and Payment Parameters (“2021 NBPP”) amendments to Affordable Care Act regulations. The amendments permitted (but...more
On July 7, the Departments of Labor, Treasury, and Health and Human Services (the “Tri-Agencies”) published a long-anticipated proposed rule (“Proposed Rule”) that...more
On April 28, 2023, the Internal Revenue Service (“IRS”) Office of Chief Counsel issued a Chief Counsel Advice (“CCA”) explaining the requirements for claim substantiation for health and dependent care flexible spending...more
The COVID-19 Public Health Emergency (“PHE”) and National Emergency (“NE”) have been in place since early 2020. In January 2023, President Biden stated his intention for both to end on May 11, 2023. There have been many...more
4/7/2023
/ Coronavirus/COVID-19 ,
Employee Benefits ,
Employer Liability Issues ,
Enrollment ,
Health Insurance ,
Infectious Diseases ,
Medicaid ,
MHPAEA ,
Public Health Emergency ,
Vaccinations ,
Virus Testing ,
Workplace Safety
On March 30, 2023, the District Court for the Northern District of Texas issued an opinion and order in Braidwood Mgmt. Inc. v. Becerra that vacates the implementation and enforcement of certain preventive service provisions...more
4/3/2023
/ Affordable Care Act ,
Constitutional Challenges ,
Cost-Sharing ,
Employee Benefits ,
Employer Group Health Plans ,
Health Insurance ,
Healthcare ,
Non-Grandfathered Health Plans ,
Preventive Health Care ,
Religious Freedom Restoration Act (RFRA) ,
Vacated
A recent IRS letter ruling provides helpful clarification on the interaction of in-service distributions to active employees (Code section 401(a)(36)) and the requirement that Code section 401(h) accounts provide only retiree...more
Last week the Senate passed the Continuing Appropriations Act, 2023 (“CAA23”). The House of Representatives will likely consider the measure today, and President Biden is expected to sign the bipartisan measure into law...more
12/26/2022
/ Employee Benefits ,
Employer Group Health Plans ,
Health Insurance ,
Health Savings Accounts ,
Healthcare ,
Healthcare Reform ,
HSA ,
Medicaid ,
Medicare ,
Medicare Secondary Payer Act ,
Mental Health Parity Rule ,
Pending Legislation ,
Regulatory Agenda ,
Telehealth
On December 12, 2022, the Department of Treasury (“Treasury”) and the Internal Revenue Service (“IRS”) released final regulations that provide reporting relief for ACA reporting— specifically, Forms 1095-B and 1095-C...more
On September 7, 2022, the District Court for the Northern District of Texas ruled a key component of the Patient Protection and Affordable Care Act’s (“ACA”) preventive services mandate unconstitutional. Braidwood Mgmt. Inc....more
On Tuesday, October 11, Treasury and IRS issued final regulations amending the regulations under the Affordable Care Act (“ACA”) regarding the affordability determination for an employee’s family members of employer-sponsored...more
As a reminder, on Friday July 1, 2022, with respect to plan or policy years beginning on or after January 1, 2022 through July 1, 2022, group health plans (self-funded and insured) and health insurance issuers are required to...more
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
On February 18, 2022, President Biden again formally extended the COVID-19 National Emergency, which was set to expire on March 1, 2022. As explained in detail in our previous alerts, this most recent extension means that...more
On December 2, 2021, President Biden announced new actions to combat COVID-19, given the emergence of the new Omicron variant. As part of his nine-point plan, the President included a directive that “the more than 150...more
Illinois recently enacted the Consumer Coverage Disclosure Act (the “CCDA”), which requires that Illinois employers provide a disclosure to employees regarding how the employer’s group health plan compares with the essential...more
On December 2, 2021, President Biden announced new actions to combat COVID-19, given the emergence of the new Omicron variant. As part of his nine-point plan, the President included a directive that “the more than 150...more