News & Analysis as of August 25, 2025

Third Party Administrators

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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 +

Key updates on the US health benefits and reimbursement landscape

McDermott Will & Schulte on 7/28/2025

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

Employer Checklist for New Health Plan Price Transparency Rules and CAA

Foley & Lardner LLP on 12/1/2021

The effective date is fast approaching for certain provisions of the Consolidated Appropriations Act of 2021 (“CAA”) and related regulations, and the Transparency in Coverage Rule. You can access previous articles written...more

Health and Welfare Plan Year-End Reminders

Morgan Lewis on 11/9/2021

Permissible Flexibility under Code Section 125 Pursuant to IRS Notice 2021-15 Notice 2021-15 offered plan sponsors the flexibility to adopt any of the following options despite the longstanding rules under Section 125 of the...more

Strategies for Addressing Reference-Based Plans

King & Spalding on 12/13/2019

The move by some employer plans to a “reference-based” pricing model has created a need for healthcare providers to develop a strategy to confront payment challenges that these plans create. A prevalent model of...more

Transparency in coverage rule - Potential implications for self-insured health plans

Eversheds Sutherland (US) LLP on 12/4/2019

On November 15, the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury (collectively, the “Agencies”) issued a proposed "Transparency in Coverage" rule that would require most...more

ERISA Alert: An Update on Health and Welfare and Retirement Plans

Jackson Walker on 4/4/2019

Health and Welfare Plan Update - It is 9:00 p.m., do you know where your health plan data is? As IT systems continue to expand, and data is accessed, moved and stored in many new and different ways, the Office for Civil...more

Eighth Circuit Grants Slight Reprieve To Mother Of Transgender Son In ACA Discrimination Suit

Seyfarth Shaw LLP on 5/31/2017

Seyfarth Synopsis: The Eighth Circuit upheld dismissal of Title VII claims challenging an employee benefit plan’s blanket transgender exclusion because the exclusion impacted the employee’s transgender son, not the employee....more

HHS Issues Final ACA Nondiscrimination in Health Programs and Activities Regulation

McDermott Will & Schulte on 5/26/2016

In Depth - On Friday, May 13, 2016, the US Department of Health and Human Services (HHS) Office for Civil Rights (OCR) finalized regulations that provide explicit protections from discrimination on the basis of gender...more

Suing Not Too Wisely

Seyfarth Shaw LLP on 5/19/2016

Seyfarth Synopsis: A district court in Minnesota recently found an employee could not challenge a plan’s blanket transgender exclusion under Title VII, when the employee was not transgender but her son was. The Court went on...more

Simple ACA Rules for Simple (But Not Small) Employers

Balch & Bingham LLP on 7/22/2015

If you had at least 50 but less than 100 full-time employees (on an aggregated basis, including full-time equivalents) in an average month in 2014, then you are an ACA “Applicable Large Employer” with ALE reporting...more

Government Finalizes Religious Accommodation, But What About Health Plans, TPAs and PBMs?

Mintz - Health Care Viewpoints on 7/21/2015

In a set of rules published last week, the government finalized a July 2010 interim final rule (“IFR”) related to coverage of certain preventive services and an August 2014 IFR regarding the definition of an eligible...more

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