Originally published in February 2025, this updated report provides new material on physician practice management (PPM) arrangements, reference-based pricing arrangements, minimum essential coverage (MEC) and MEC+ plans, and...more
4/23/2025
/ Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Employer Liability Issues ,
Health Insurance ,
Healthcare Reform ,
ICHRA ,
Insurance Industry ,
Minimum Essential Coverage ,
Regulatory Agenda ,
Small Business
Small employers seeking to offer robust major medical coverage to employees and their dependents face daunting price and transparency hurdles. Employers with 50 or fewer full-time equivalent employees, so-called “small...more
While a physician practice management (PPM) structure allows for compliance with corporate practice of medicine laws and ease of administration, it often creates inadvertent health plan issues that should be navigated...more
2/24/2025
/ Compliance ,
Corporate Governance ,
Employee Benefits ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Insurance Industry ,
Medicare ,
Physicians ,
Reporting Requirements ,
Risk Management
Small employers seeking to offer robust major medical coverage to employees and their dependents face daunting price and transparency hurdles. Employers with 50 or fewer full-time equivalent employees, so-called “small...more
2/17/2025
/ Affordable Care Act ,
Association Health Plans ,
Employee Benefits ,
Employer Group Health Plans ,
Employer Liability Issues ,
Health Insurance ,
Healthcare ,
Insurance Industry ,
Risk Management ,
Self-Insured Health Plans ,
Small Employers
Beginning in the first quarter of 2025, California healthcare service plans, health insurers, Medi-Cal managed care plans, and PACE organizations must ensure that staff who have direct enrollee contact receive evidence-based...more
1/20/2025
/ California ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Legislative Agendas ,
Medicaid ,
New Legislation ,
PACE ,
Regulatory Requirements ,
Training ,
Transgender
For calendar-year plans, the 2025 plan year is right around the corner. And even for non-calendar-year plans, January 1, 2025, is a key implementation date for certain plan features. This is the ideal time for plan sponsors...more
12/11/2024
/ Benefit Plan Sponsors ,
Cybersecurity ,
Employee Benefits ,
Employer Group Health Plans ,
Employer Liability Issues ,
Health and Welfare Plans ,
Health Insurance ,
Mental Health ,
Mental Health Parity Rule ,
Regulatory Agenda ,
Regulatory Requirements ,
Retirement Plan
On August 19, 2024, the Internal Revenue Service (IRS) issued Notice 2024-63 (the Notice), providing guidance regarding the implementation of Section 110 of the SECURE 2.0 Act of 2022 (SECURE 2.0), which permits employers...more
In late December 2023, the Internal Revenue Service (IRS) issued Notice 2024-2 (the Notice), providing guidance on key provisions of the SECURE 2.0 Act of 2022 (SECURE 2.0). SECURE 2.0, which was passed in December 2022,...more
Employer-sponsored health insurance covers almost 159 million non-elderly US workers and their dependents, and employees and jobseekers alike view group health coverage as the single most important non-cash job-related...more
11/28/2023
/ Affordable Care Act ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employees ,
Employer Group Health Plans ,
Employer Liability Issues ,
Fiduciary Duty ,
Health Insurance ,
Insurance Industry ,
Regulatory Agenda
In December 2022, Congress enacted groundbreaking legislation as part of the SECURE 2.0 Act (SECURE 2.0) codifying an opportunity for employers to provide matching contributions within a tax-qualified retirement plan based on...more
In light of recent Internal Revenue Service (IRS) guidance, employers should carefully examine any supplemental health plan, program or arrangement (which may or may not claim to leverage fixed indemnity insurance) that...more
In a recently issued Chief Counsel Advice memorandum, the Internal Revenue Service (IRS) reminded sponsors of health and dependent care flexible spending arrangements (FSAs) of their obligation to properly substantiate claims...more
The Biden administration previously announced its intent to end the COVID-19 National Emergency (NE) and the COVID-19 Public Health Emergency (PHE) on May 11, 2023 (read our series introduction for more information). On April...more
5/17/2023
/ Benefit Plan Sponsors ,
Biden Administration ,
COBRA ,
Coronavirus/COVID-19 ,
Deadlines ,
Deductibles ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
EBSA ,
Employee Benefits ,
Employer Liability Issues ,
Health Insurance ,
Public Health Emergency ,
U.S. Treasury
The Biden administration originally announced its intent to end the COVID-19 National Emergency (NE) and the COVID-19 Public Health Emergency (PHE) on May 11, 2023 (read our prior article for more information). Although the...more
5/2/2023
/ Biden Administration ,
Coronavirus/COVID-19 ,
Deductibles ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employer Liability Issues ,
Health Insurance ,
HSA ,
Public Health Emergency ,
U.S. Treasury ,
Vaccinations
In response to Braidwood Mgmt. Inc. v. Becerra, a recent case striking down part of the Affordable Care Act (ACA) preventive services mandate, the US Departments of Labor, Health and Human Services, and the Treasury...more
4/18/2023
/ Affordable Care Act ,
Appeals ,
Contraceptive Coverage Mandate ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
Health Insurance ,
Motion To Stay ,
Preventive Health Care ,
Religious Exemption ,
U.S. Treasury
The Biden administration has announced its intention to end the COVID-19 National Emergency (NE) and the COVID-19 Public Health Emergency (PHE) on May 11, 2023 (read our series introduction for more information)....more
4/4/2023
/ Benefit Plan Sponsors ,
Biden Administration ,
COBRA ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employees ,
Employer Group Health Plans ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HSA ,
Public Health Emergency ,
U.S. Treasury ,
Vaccinations ,
Virus Testing
The Biden administration has announced its intention to end the COVID-19 National Emergency (NE) and the COVID-19 Public Health Emergency (PHE) on May 11, 2023 (read our series introduction for more information). Among other...more
The Biden administration has announced its intent to end the COVID-19 National Emergency (NE) and the COVID-19 Public Health Emergency (PHE) on May 11, 2023 (read our prior article for more information). In response to the...more
3/22/2023
/ Affordable Care Act ,
Biden Administration ,
CARES Act ,
Consolidated Appropriations Act (CAA) ,
Coronavirus/COVID-19 ,
Employee Benefits ,
HDHP ,
HSA ,
IRS ,
Medicare ,
Public Health Emergency ,
Relief Measures ,
Telehealth
The Biden administration has announced its intent to end the COVID-19 National Emergency (NE) and the COVID-19 Public Health Emergency (PHE) on May 11, 2023 (read our prior article for more information). In response to the...more
Since the Biden administration announced its intention to end the COVID-19 National Emergency (NE) and the COVID-19 Public Health Emergency (PHE) on May 11, 2023, a topic of great debate has been the requirement and the...more
The Biden administration has announced its intent to end the COVID-19 National Emergency (NE) and the COVID-19 Public Health Emergency (PHE) on May 11, 2023 (read our prior article for more information). A topic of great...more
On January 30, 2023, the Biden administration announced its intention to make final extensions of both the COVID-19 National Emergency (NE) and the COVID-19 Public Health Emergency (PHE) through May 11, 2023, at which point...more
3/3/2023
/ Benefit Plan Sponsors ,
Biden Administration ,
COBRA ,
Coronavirus/COVID-19 ,
Employer Liability Issues ,
Health and Welfare Plans ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medicaid ,
Medicare ,
Public Health Emergency ,
Telehealth ,
Vaccinations
On January 30, 2023, the Biden administration announced its intention to make final extensions of both the COVID-19 National Emergency (NE) and the COVID-19 Public Health Emergency (PHE) through May 11, 2023, at which point...more
2/24/2023
/ Biden Administration ,
CARES Act ,
Centers for Medicare & Medicaid Services (CMS) ,
COBRA ,
Consolidated Appropriations Act (CAA) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Employee Benefits ,
IRS ,
Medicare ,
Mental Health ,
Public Health Emergency ,
Telehealth ,
Vaccinations ,
Virus Testing
The Biden administration has announced its intention to end the COVID-19 National Emergency (NE) and the COVID-19 Public Health Emergency (PHE) on May 11, 2023 (read our series introduction for more information). A key...more
On October 11, 2022, the US Department of Treasury (Treasury) and the Internal Revenue Service (IRS) issued final regulations to modify how affordability under the Affordable Care Act (ACA) is determined for an offer of...more