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Patient Protection and Affordable Care Act (PPACA) › Employee Benefits › Insurance Industry

The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal... more +
The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal subsidies to reduce the number of uninsured citizens. less -
McDermott Will & Schulte

Key updates on the US health benefits and reimbursement landscape

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The world of health benefits is constantly evolving. Recent policy shifts and legislative developments are expected to impact the economic landscape and have significant implications for employer plan sponsors, insurers,...more

Warner Norcross + Judd

U.S. Supreme Court Preserves Preventive Care Coverage Under the ACA

Warner Norcross + Judd on

On June 27, 2025, the U.S. Supreme Court issued its decision in Kennedy v. Braidwood Management, Inc., rejecting a constitutional challenge to the Affordable Care Act’s (ACA) preventive services mandate. The Supreme Court...more

Verrill

The GLP-1 Coverage Conundrum: Managing Costs for Group Health Plans

Verrill on

Many employers are facing challenges in incorporating high-cost GLP-1 medications, such as Mounjaro, Ozempic, Rybelsus, Trulicity, and Wegovy, into their group health plans, as they must balance the cost to the group health...more

Saul Ewing LLP

Trump on Transparency: Making America Healthy Again Through Executive Order 14221; How Plan Sponsors Can Respond

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One mandate under the PPACA required health care providers, non-grandfathered health insurance issuers and self-insured group health plans to provide consumers with access to information about the cost of services before they...more

McDermott Will & Schulte

Special Report: Examining Group Health Coverage Alternatives for Small Employers

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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

Faegre Drinker Biddle & Reath LLP

Affordable Care Act Penalty and Reporting Relief

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The Employer Reporting Improvement Act and the Paperwork Burden Reduction Act (PBA), each signed into law in December 2024, provide the following penalty and reporting relief for plan sponsors required to provide minimum...more

Foley & Lardner LLP

The Telehealth Extension Has Ended…For Now

Foley & Lardner LLP on

During the COVID-19 crisis, newly-created relief allowed first dollar coverage for telehealth services under a high deductible health plan (HDHP) without ruining health savings account (HSA) eligibility. That relief was...more

Verrill

ACA Compliance When Employees Move from Full-Time to Part-Time Mid-Year

Verrill on

We are well into the Affordable Care Act (“ACA”) information reporting season. Forms 1095-B/1095-C must be provided to employees by March 1, 2024, and the deadline for electronic transmittal of Forms 1094-B/1094-C to the IRS...more

Bass, Berry & Sims PLC

UPDATE: Planning for Open Enrollment? Note the ACA Affordability Threshold Drop

Bass, Berry & Sims PLC on

This post was updated on February 6, 2024, to reflect the 2024 Federal Poverty Level announced in January 2024. On August 23, 2023, the Internal Revenue Service issued Rev. Proc. 2023-29, announcing that the Affordable...more

McDermott Will & Schulte

Special Report - Funding Employer-Sponsored Group Health Coverage: The Group Captive Solution - November 2023

McDermott Will & Schulte on

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

Bradley Arant Boult Cummings LLP

DOL Regulations on Association Health Plans: How Will They Affect the Health Insurance Marketplace?

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Last year, the President issued an Executive Order directing the Secretary of the Department of Labor (DOL) to issue regulations to expand access to association health plans (AHPs). Earlier this year, the DOL issued final...more

Bass, Berry & Sims PLC

Action Needed by Certain ERISA Plans – New Disability Claims Procedures Apply Beginning April 2018

Bass, Berry & Sims PLC on

In January 2018, the U.S. Department of Labor (DOL) announced that final regulations affecting how some ERISA plans process claims and appeals will apply beginning April 1, 2018. As explained below, the final regulations...more

Akerman LLP - Health Law Rx

House Republican Health Care Bill: Good News for Health Insurance Executives

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An Affordable Care Act (ACA) provision that is often-overlooked by the media, but has impacted the ability of insurers and their non-insurance related entities, in their role as employers, to take tax deductions for certain...more

Downs Rachlin Martin PLLC

News from the Vermont State House - An analysis from DRM's Government & Public Affairs Team - February 2017

Downs Rachlin Martin PLLC on

The Agency of Transportation has submitted a proposal to the House Transportation Committee that would allow the agency to seek damages from a utility that fails to move or adjust a utility line that is in a state or local...more

Franczek P.C.

HHS Issues Final Rule on ACA Nondiscrimination in Health Programs and Activities

Franczek P.C. on

On May 18, 2016, the Department of Health and Human Services (“HHS”) issued final regulations interpreting the nondiscrimination provisions of Section 1557 of the Affordable Care Act (“ACA”). The rule mainly impacts insurers...more

Carlton Fields

Solicitors Argue to U.S. Supreme Court That Vermont Health Care Reporting Law Is Not Preempted By ERISA

Carlton Fields on

The Supreme Court will soon consider whether, as applied to self-insured health benefit plans or their third-party administrators, ERISA preempts a Vermont law requiring health care payers to report claims and other data to a...more

Cadwalader, Wickersham & Taft LLP

Budget Legislation Repeals Affordable Care Act’s Automatic Enrollment Requirement for Large Employers

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The Bipartisan Budget Act of 2015, Pub. L. No. 114-74, which was signed by President Obama on November 2, 2015, included a little-publicized provision that repealed the Affordable Care Act’s automatic enrollment requirement. ...more

FordHarrison

2016 Cost of Living Increases are Rare

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On October 21, 2015, in Information Release 2015-118, the IRS announced cost-of-living adjustments to various dollar limitations under the Internal Revenue Code (the "Code") for pension plans and other related items for the...more

FordHarrison

The PACE Act – Changes to the Definition of Small Group for Purposes of ACA Market Reforms

FordHarrison on

On October 7, 2015, the Protecting Affordable Coverage for Employees Act ("PACE Act") was enacted, and on October 19, 2015, the Department of Health and Human Services released FAQs providing further guidance on the Act's...more

K&L Gates LLP

HHS Proposes Rules for Nondiscrimination in Health Care

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On September 8, 2015, the U.S. Department of Health and Human Services (“HHS”) proposed new regulations implementing Section 1557 of the Patient Protection and Affordable Care Act (“ACA”). Section 1557 prohibits...more

Franczek P.C.

IRS Provides Updated Guidance on Electronic Filing of ACA Information Returns

Franczek P.C. on

As 2016 approaches, the IRS is issuing more detailed guidance on how employers will need to comply with the upcoming ACA information reporting requirements. As a reminder, the ACA information reporting rules require employers...more

Franczek P.C.

Employee Benefits Alert - August 2015

Franczek P.C. on

Retirement Plans - IRS Issues Guidance on Benefit Suspension Voting under MPRA - As we have written in prior alerts, the Multiemployer Pension Reform Act of 2014 (MPRA) permits trustees of financially troubled...more

Ballard Spahr LLP

IRS Issues New Forms for ACA Reporting; Congress Increases Penalties for Failure to Meet Requirements

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The IRS has completed drafts of the 2015 forms and instructions for employers, insurers, and other health plan sponsors to use to meet their reporting obligations for the employer and individual mandates under the Affordable...more

Franczek P.C.

Employee Benefits Alert - July 2015

Franczek P.C. on

Major Revisions to Qualified Plan Determination Letter Process Announced - Effective January 1, 2017, the staggered five-year determination letter remedial amendment cycles for individually designed plans will be...more

K&L Gates LLP

In an Opinion with Far-Reaching Implications, the Second Circuit Finds Insurance Coverage for an ERISA Claim

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When a general liability policy expressly provides coverage for employee benefits liability and the plaintiff in the underlying suit alleges a violation of the Employee Retirement Income Security Act of 1974 (“ERISA”), does...more

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