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
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
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 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
Two days before the one-year anniversary of the official start of the COVID-19 outbreak, the US Department of Labor (DOL) issued a last-minute notice clarifying its prior guidance that relaxed the deadlines for the Employee...more
3/4/2021
/ Benefit Plan Sponsors ,
COBRA ,
Coronavirus/COVID-19 ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Employer Liability Issues ,
Enrollment ,
Health and Welfare Plans ,
Health Insurance