Only weeks after the principal effective date for the final 2024 federal mental health parity rules for employer-sponsored health benefit plans, those rules—and specifically some key features that are frustrating...more
2/21/2025
/ Administrative Procedure Act ,
Benefit Plan Sponsors ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Final Rules ,
Mental Health ,
MHPAEA ,
Pending Litigation ,
Regulatory Requirements
Even as high-priority issues such as diversity, equity, and inclusion (DEI), immigration, and Ukraine take center stage in the first months of the new presidential administration, many employers are wondering what the next...more
Employers that cover Florida employees under their prescription drug plans are now prohibited from imposing mandatory mail-order requirements and are required to provide a sixty-day continuity of care period following midyear...more
On June 24, 2022, the Supreme Court of the United States issued its highly anticipated decision in Dobbs v. Jackson Women’s Health Organization, No. 19-1392. The Dobbs decision expressly overrules the two key precedents that...more
6/24/2022
/ Abortion ,
Affordable Care Act ,
Benefit Plan Sponsors ,
COBRA ,
Criminal Code ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Equal Employment Opportunity Commission (EEOC) ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medical Reimbursement ,
Mental Health ,
Mental Health Parity Rule ,
Pharmacy Benefit Manager (PBM) ,
Preemption ,
Roe v Wade ,
SCOTUS ,
Telehealth
Employers and their benefit administrators have more detail and a more convenient way to submit “top 50” lists and other data - but no more time to comply with - daunting prescription drug cost reporting requirements in the...more
12/16/2021
/ Benefit Plan Sponsors ,
Consolidated Appropriations Act (CAA) ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Drug Pricing ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Interim Final Rules (IFR) ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Rebates ,
Reporting Requirements ,
U.S. Treasury ,
Year-End Compliance Checklist
Although the fate of the Occupational Safety and Health Administration’s (OSHA) rules remains in limbo, many employers are moving ahead with efforts to comply with the OSHA emergency temporary standard (ETS) that requires...more
11/18/2021
/ CARES Act ,
Coronavirus/COVID-19 ,
Corporate Counsel ,
Employee Assistance Programs ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Employer Mandates ,
Health Insurance Portability and Accountability Act (HIPAA) ,
OSHA ,
Vaccinations ,
Virus Testing ,
Workplace Safety
Employer-sponsored health plans can add air ambulance claims reporting to the list of required disclosures that will go into effect in the next several years.
Under proposed regulations published September 16, 2021, by...more
9/30/2021
/ Ambulance Providers ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Disclosure Requirements ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Enforcement ,
Insurance Claims ,
Out of Network Provider ,
Penalties ,
Surprise Medical Bills
More than a year into the COVID-19 pandemic, employers are happy to be more focused on vaccine issues than on issues relating to furloughs and layoffs.
As record numbers of vaccinations take place daily, many employers...more
4/22/2021
/ Americans with Disabilities Act (ADA) ,
Best Practices ,
CARES Act ,
Civil Rights Act ,
Coronavirus/COVID-19 ,
Employee Assistance Programs ,
Employee Incentive Plans ,
Employee Retirement Income Security Act (ERISA) ,
Employment Policies ,
Incentives ,
Infectious Diseases ,
Paid Time Off (PTO) ,
Title VII ,
Vaccinations ,
Wellness Programs ,
Workplace Safety
Beginning in 2022, employer-sponsored health plans will be required to pay providers certain emergency and out-of-network charges that would have otherwise been balance billed to participants.
That is the centerpiece of...more
Employers now have greater clarity on how the new federal requirements covering COVID-19 testing and diagnosis apply to their group health plans, under guidance issued by the U.S. Department of Labor, U.S. Department of...more
Under a California law that took effect on January 1, 2020, employers will have to provide extra notices to California employees enrolled in flexible spending accounts (FSAs) explaining the “use it or lose it” federal tax...more
Behavioral health claims administrators and plan sponsors alike may be looking more closely at their care guidelines—and how they are applied—after a federal court ruled in a California class action that a claims...more
Employers may soon find themselves reviewing and revising health plan master documents and summary plan descriptions (SPDs) and administrative service agreements with respect to an obscure claims administration practice known...more
Any privately held, for-profit company could potentially be exempt from the Affordable Care Act’s (ACA) requirement to provide comprehensive contraceptive coverage without cost-sharing based on the company’s “sincerely held...more