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One Big Beautiful Bill – Plan Sponsor-Related Health and Welfare Provisions

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

Plaintiffs Double Down on Challenges to PBM Arrangements in Class Action Lawsuits Involving Johnson & Johnson and JPMorganChase

On March 10, 2024, the plaintiffs filed an amended complaint in a much-followed putative class action lawsuit against Johnson & Johnson (“J&J”) alleging that the plan fiduciaries for J&J’s group health plan violated ERISA by...more

The IRS Issues Two Notices Regarding Preventive Care and Medical Care

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

DOL Finalizes Rescission of Association Health Plan Rule

On April 29, 2024, the Department of Labor (“DOL”) released a final regulation (the “Final Rule”) that rescinded the Trump Administration rule that expanded the availability of association health plans (“AHPs”) (“Trump DOL...more

Tri-Agencies Finalize Rule on STLDI, but Kick the Can Down the Road on Fixed Indemnity and the Health Plan Tax Exclusion

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

HHS Drops Appeal in Drug Coupon Case

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

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

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

[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

Update! Departments Issue More Guidance Addressing Coverage of Over-the-Counter COVID-19 Tests

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

Departments Issue Guidance Addressing Coverage of Over-the-Counter COVID-19 Tests

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

Surprise! Tri-Agencies Meet Deadline with First Set of Surprise Billing Rules, With More to Come

On July 1, 2021, the Office of Personnel Management, Department of the Treasury, Department of Health and Human Services (“HHS”), and Department of Labor (“DOL”) (collectively, the “Departments”), released the interim final...more

[Webinar] Surprise Billing Law Imposes New Requirements for Plans and Issuers - January 13th, 2:00 pm - 3:30 pm ET

This webinar will include a discussion on the various provisions of the new surprise billing law, how it interacts with current law, expected guidance from the Biden Administration, and implications for health insurance...more

The Supreme Court Narrows ERISA Preemption in Rutledge v. PCMA

In the recently-decided Rutledge v. Pharmaceutical Care Management Association (“PCMA”), the Supreme Court found 8–0 (Justice Barrett did not take part) that ERISA did not preempt an Arkansas state law that established...more

Post-Election 2020: Healthcare Priorities Under a Biden Administration

The dust has settled and the 2020 election has concluded with former Vice President Biden poised to become president. At the same time, Democratic control of the House of Representatives has narrowed to the smallest margin...more

The Return to the Supreme Court

Regular readers of this Benefits Brief will recall that there is a case challenging the constitutionality of the Patient Protection and Affordable Care Act (ACA) percolating through the courts. ...more

Employers Get Bit: Flurry of Class Action Lawsuits Allege Deficiencies in COBRA Election Notices

Recently, plaintiffs’ firms have filed a flurry of class action lawsuits against employers, alleging violations of COBRA’s election notice requirements and seeking statutory and other penalties. ...more

Texas, et. al., v. U.S. – The Fifth Circuit Rules

As you may recall, in late September, we expected a decision from the Fifth Circuit in Texas v. United States—the case challenging the constitutionality of the Patient Protection and Affordable Care Act (ACA)—in the fall of...more

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