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IRS Increases PCORI Fee

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

10/24/2023  /  Fees , Health Insurance , IRS , PCORI

Court Ruling Calls Into Question Whether Plans and Issuers Can Exclude Drug Coupons Towards the MOOP

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

California to Potentially Implement a Long-Term Care Payroll Tax

In 2019, California passed a law that created the Long Term Care Insurance Task Force (“Task Force”) to examine how to design and implement a long-term care insurance program. The Task Force recommended a payroll tax to fund...more

Tri-Agencies Issue Proposed Rule on Short-Term, Limited-Duration Insurance, Excepted Benefits, and Level-Funded Plans

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

Proposed Rule Has Serious Implications on the Taxation of Fixed Indemnity and Other Similar Coverages

On July 7, the Departments of Labor, Treasury, and Health and Human Services published a proposed rule (“Proposed Rule”) regarding, among other things, the requirements for fixed and hospital indemnity insurance to be...more

IRS Issues Guidance on HDHP Relief for COVID-19 Services and Preventive Care

On June 23, 2023, the IRS issued Notice 2023-37 (the “2023 Notice”) regarding COVID-19-related coverage for HSA-compatible high-deductible health plans (“HDHPs”) and preventive care for HDHP purposes in light of the district...more

IRS Chief Counsel Advice Says Wellness Indemnity Payments Are Taxable If No Unreimbursed Medical Expenses Related to the Payment

On June 8, 2023, the IRS released Chief Counsel Advice 202323006 (the “CCA”) addressing the tax treatment of wellness indemnity payments made by employer-funded fixed indemnity insurance policies. The CCA generally provides...more

Seventh Circuit Affirms Plan Sponsor’s Discretion for Severance Benefits

A recent opinion out of the U.S. Court of Appeals for the Seventh Circuit provides additional support for ERISA-governed severance plans to incorporate a “discretionary component” as a factor in determining eligibility for...more

IRS Explains FSA Substantiation Rules

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 End of the COVID-19 Public Health Emergency and National Emergency Are Near – Are You Ready?

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

ACA Preventive Service Requirements Partially Vacated

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

IRS Provides An “Electric Shock” By Lowering Mandatory Electronic Filing Threshold

On February 23, 2023, the IRS published final regulations (the “Final Rule”) that materially expand which reporting entities must file electronically rather than on paper.  These requirements apply to a number of tax returns,...more

IRS Rules That Payment of 401(h) Account Benefits to Pension-Eligible Active Participants Won’t Jeopardize Plan Qualification

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

CAA 2023 Includes HSA Telehealth Relief, MHPAEA, Medicare, and Medicaid Changes

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

SECURE 2.0 Hitches a Ride Just in the St. Nick of Time

Yesterday, the Senate passed the Consolidated Appropriations Act of 2023 (the “CAA”) to fund the government through September 30, 2023. Division T of the legislation is the SECURE 2.0 Act of 2022 (“SECURE 2.0”), which builds...more

Vermont and New Hampshire Employers Take Note: New State Voluntary Paid Family and Medical Leave Programs

This month, Vermont adopted the Vermont Family and Medical Leave Insurance Plan (“Vermont Program”), a voluntary paid family and medical leave program.  The Vermont Program is substantially similar to the New Hampshire...more

Happy Holidays from the IRS: The IRS Finalizes the ACA Reporting Relief and Deadline Extensions!

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

IRS Guidance Priorities for 2022-23 Reflect Few New Projects

For many years now, IRS and Treasury have jointly developed a list of areas in which they intend to release guidance – such as regulations, revenue rulings, notices and other published official authority – during the coming...more

Top 5 Most Important Rules to Remember About the Interaction Between COBRA and Medicare

The COBRA rules and Medicare rules are complex on their own. Navigating the interaction between the rules is even more complex and can lead to an inadvertent compliance issue. Given today’s highly litigious COBRA world and...more

Braidwood: A Challenge to the ACA’s Preventive Services Mandate

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

2023 Benefit and Contribution Limits

The IRS recently announced that substantially all of the key retirement plan and health and welfare plan limits will increase next year – some significantly due to higher inflation. Notice 2022-55 (Oct. 21, 2022); Rev. Proc....more

Fixing the “Glitch” – The IRS Releases Final Rule Addressing the “Family Glitch”

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

Biden Administration Proposal Restores, Updates Obama-Era Affordable Care Act Section 1557 Rules

On August 4, 2022, the Biden Administration published its long-anticipated proposed rulemaking on Affordable Care Act (“ACA”) Section 1557’s nondiscrimination in health programs and activities requirements (“Proposed Rule”)....more

Surplus Plan Assets Continue to Puzzle IRS and Frustrate Plan Sponsors

Over the years, many plan sponsors have accumulated surplus assets in their pension and welfare benefit programs for various reasons. Typically, surplus assets have been generated in these mature programs through some...more

7/1/2022  /  Excise Tax , IRS , Pensions , Retirement Plan

July 1 Deadline for Transparency Machine-Readable Files Posting Requirement

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

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