Federal regulators recently indicated they will not enforce parts of the final regulations issued in September 2024 under the Mental Health Parity and Addiction Equity Act (MHPAEA) and may soon propose new rules altogether....more
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
The wait is over, and now the work begins for health plan sponsors.
Much-anticipated final rules implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) were...more
9/19/2024
/ Benefit Plan Sponsors ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
Health Insurance ,
HMOs ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
Out of Network Provider ,
Outpatient Services ,
Substance Abuse
Employers will soon see the national debate about abortion popping up in some unexpected places: the HIPAA privacy policies and procedures and notices of privacy practices they use for their health benefit plans....more
5/6/2024
/ Abortion ,
Benefit Plan Sponsors ,
Compliance ,
Covered Entities ,
Dobbs v. Jackson Women’s Health Organization ,
Employer Group Health Plans ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HIPAA Privacy Rule ,
Notice Requirements ,
Reproductive Healthcare Issues ,
Substance Abuse
Employers often target benefit offerings to specific groups of workers—think dependent care accounts or student loan repayment matching contributions—so maybe it was inevitable....more
Now you know.
It could not be any clearer to employers that compliance with the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) will be a—maybe the—top health and welfare benefit priority for federal...more
8/4/2023
/ Benefit Plan Sponsors ,
Centers for Medicare & Medicaid Services (CMS) ,
Consolidated Appropriations Act (CAA) ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
Health Insurance ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
Proposed Rules ,
Regulatory Agenda ,
U.S. Treasury
Employers have some new clarity on the No Surprises Act rules on out-of-network providers and charges under new guidance from the U.S. Department of Labor, U.S. Department of the Treasury, and the U.S. Department of Health...more
Employers, at least for now, may have some relief from some of the Affordable Care Act (ACA) requirements to cover preventive care services without cost sharing under a nationwide injunction issued March 30, 2023, by a...more
4/20/2023
/ ACIP ,
Affordable Care Act ,
Appointments Clause ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Employer Group Health Plans ,
Health Insurance ,
HRSA ,
HSA ,
Injunctions ,
Preventive Health Care ,
Screening Procedures
Employers are facing increasing - and conflicting - pressures over health plan coverage of puberty-blocking medications used to treat some minors for gender dysphoria. Several states have restricted the use of...more
9/27/2022
/ Bostock v Clayton County Georgia ,
Child Abuse ,
Child Protective Services ,
Corporate Equality Index (CEI) ,
Discrimination ,
Employer Group Health Plans ,
Fourteenth Amendment ,
Gender Dysphoria ,
Health Insurance ,
Human Rights ,
Minors ,
Title VII ,
Transgender
Employers can’t say they weren’t warned.
For the second time in six months, frequently asked question (FAQ) guidance from federal regulators is calling attention to the requirement that employer-sponsored health...more
8/5/2022
/ Affordable Care Act ,
Benefit Plan Sponsors ,
Contraceptive Coverage Mandate ,
Contraceptives ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employer Group Health Plans ,
Health Insurance ,
New Guidance ,
Preemption
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
On February 4, 2022, the U.S. Department of Labor (DOL), U.S. Department of the Treasury, and U.S. Department of Health and Human Services (HHS) issued subregulatory guidance that provides greater flexibility and clarifies a...more
2/9/2022
/ Coronavirus/COVID-19 ,
Corporate Counsel ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
Families First Coronavirus Response Act (FFCRA) ,
Flexible Savings Accounts (FSAs) ,
Guidance Update ,
Health Insurance ,
HSA ,
Over The Counter Drugs (OTC) ,
Reimbursements ,
Virus Testing
Employer health plans and health insurers will be required to cover over-the-counter (OTC) COVID-19 tests, even without a health care provider’s order or an individualized clinical assessment, and generally without cost...more
1/12/2022
/ Benefit Plan Sponsors ,
Biden Administration ,
Coronavirus/COVID-19 ,
Corporate Counsel ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
Health Insurance ,
New Guidance ,
Popular ,
Virus Testing ,
Workplace Safety
On December 2, 2021, President Joe Biden made comments announcing the White House’s plan for combating COVID-19 and the emerging new variant, Omicron. As part of the nine-step plan, President Biden announced an initiative...more
Employers that are considering imposing health plan premium surcharges to encourage their employees to get vaccinated have clearer guidance on how to do so without running afoul of the nondiscrimination rules under the Health...more
10/7/2021
/ Affordable Care Act ,
CARES Act ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employer Group Health Plans ,
Guidance Update ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Non-Discrimination Rules ,
Plan Participants ,
Surcharges ,
Vaccinations
New regulatory guidance from three federal agencies that enforce private-sector benefits laws will make employers’ daunting 2021 health benefit to-do lists slightly - but only slightly - more manageable heading into 2022....more
8/24/2021
/ Affordable Care Act ,
Consolidated Appropriations Act (CAA) ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
Health Insurance ,
Mental Health Parity Rule ,
New Guidance ,
Reporting Requirements ,
Surprise Medical Bills ,
U.S. Treasury
The new 100 percent premium subsidy applies to individuals eligible for Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage due to either a reduction in hours or an involuntary termination of employment, and it...more
4/28/2021
/ American Rescue Plan Act of 2021 ,
COBRA ,
Coronavirus/COVID-19 ,
Corporate Counsel ,
Department of Labor (DOL) ,
Employee Benefits ,
Employer Group Health Plans ,
Health Insurance ,
New Guidance ,
Notice Requirements ,
Premium Subsidies ,
Relief Measures ,
Tax Credits
Less than a month after the American Rescue Plan Act of 2021 (ARPA) was signed into law, new U.S. Department of Labor (DOL) guidance and model forms are clearing up a number of employer concerns about the 100 percent COBRA...more
4/12/2021
/ American Rescue Plan Act of 2021 ,
COBRA ,
Coronavirus/COVID-19 ,
Corporate Counsel ,
Department of Labor (DOL) ,
EBSA ,
Employee Benefits ,
Employer Group Health Plans ,
Health Insurance ,
IRS ,
New Guidance ,
Premium Subsidies ,
Premiums ,
Relief Measures ,
Tax Credits
The American Rescue Plan Act of 2021 (ARPA), which became law on March 11, 2021, provides a 100 percent subsidy of premiums under the Consolidated Omnibus Budget Reconciliation Act (COBRA) beginning on April 1, 2021, through...more
3/18/2021
/ American Rescue Plan Act of 2021 ,
Benefit Plan Sponsors ,
Biden Administration ,
COBRA ,
Coronavirus/COVID-19 ,
Employee Benefits ,
Employer Group Health Plans ,
Families First Coronavirus Response Act (FFCRA) ,
Health Insurance ,
Medicare ,
Notice Requirements ,
Popular ,
Premium Subsidies ,
Relief Measures ,
Tax Credits
A federal court ruling staying key parts of new Affordable Care Act (ACA) regulations in light of the landmark Supreme Court of the United States ruling on sexual orientation and gender identity will provide little certainty...more
Employers have more clarity on COVID-19 testing coverage requirements - including new details on at-home tests, return-to-work testing, and out-of-network pricing - under new guidance that the U.S. Department of Health and...more
Most employer-sponsored health plans will be exempt from the primary Affordable Care Act (ACA) provision governing race, color, age, sex, disability, and national origin discrimination under new final rules issued by the U.S....more
Employer plans will still be able to exclude the value of drug manufacturer coupons from annual out-of-pocket maximums, even when no generic equivalent is available, under new guidance from the Department of Labor, Department...more
8/28/2019
/ Affordable Care Act ,
Benefit Plan Sponsors ,
Co-payments ,
Deductibles ,
Department of Health and Human Services (HHS) ,
Generic Drugs ,
Health Insurance ,
IRS ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
U.S. Treasury
Starting in 2020, employers will be able to offer health reimbursement arrangements (HRAs) that work in conjunction with individual coverage or Medicare without running afoul of the Affordable Care Act’s (ACA) market reform...more
The Department of Labor (DOL), the Department of the Treasury, and the Department of Health and Human Services (HHS) are making good on their promise to issue more guidance and to aggressively enforce the federal Mental...more
5/14/2018
/ 21st Century Cures Initiative ,
Affordable Care Act ,
Benefit Plan Sponsors ,
Comment Period ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Health Insurance ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
New Guidance