News & Analysis as of

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

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 -
Saul Ewing LLP

Navigating the New Normal: Top Employee Benefits Risks for Healthcare Employers in 2025

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As the healthcare industry grapples with the impact of the 2025 Comprehensive Reform Act, which was signed into law on July 4, 2025, offering benefits to its own employees continues to be both a tool for employee retention...more

Bricker Graydon LLP

Is My Health Plan Affordable Enough?

Bricker Graydon LLP on

As employers increasingly struggle with rising health plan costs, the IRS has provided some good news. Recently, the IRS announced that the Affordable Care Act (ACA) affordability threshold will increase to 9.96% of household...more

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

Woodruff Sawyer

IRS Issues Affordability Percentage Adjustment for 2026

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The Internal Revenue Service (IRS) has released Rev. Proc. 2025-25, which contains the inflation adjusted amounts for 2026 used to determine whether employer-sponsored coverage is “affordable” for purposes of the Affordable...more

Eversheds Sutherland (US) LLP

Benefits Catch-Up - Q2 2025

Eversheds Sutherland (US) LLP on

With so much happening in the employee benefits world over the last few months, we bring you Benefits Catch-Up, our catch-up contribution to help you keep up with recent developments. Eversheds Sutherland’s US Employee...more

Fisher Phillips

SCOTUS Allows Enforcement of ACA’s Preventive-Care Mandates But Opens Door for Political Influence: Key Points for Group Health...

Fisher Phillips on

The federal government may continue to enforce the Affordable Care Act’s preventive-care mandates, thanks to the Supreme Court’s recent decision in Kennedy v. Braidwood Management. In a 6-3 bipartisan opinion written by...more

Ice Miller

Big Beautiful Benefits: A Look at the Employee Benefits Provisions of the One Big Beautiful Bill

Ice Miller on

On July 4, 2025, President Trump signed into law the One Big Beautiful Bill Act (the Act), Public Law 119-21. While the Act contains several tax and law changes, this article focuses on the employee benefits provisions within...more

McDermott Will & Schulte

A win for telehealth providers, health plans, and participants: HDHP telehealth safe harbor permanently reinstated

McDermott Will & Schulte on

On July 4, 2025, the president signed the One Big Beautiful Bill Act (H.R. 1) into law. Among many other healthcare provisions, the bill permanently extends the telehealth safe harbor for high-deductible health plans (HDHPs)...more

Seyfarth Shaw LLP

From Telehealth to Trump Accounts: Breaking Down the One Big Beautiful Bill’s Impact on Employee Benefits

Seyfarth Shaw LLP on

On July 4, 2025, Donald Trump signed the One Big Beautiful Bill (OBBB) into law. Although most have focused on the sweeping tax reform included in the OBBB, a number of key employee benefits provisions are included in the...more

Warner Norcross + Judd

Group Health Plan PCORI Fees Due by July 31 - UPDATED JULY 2025

Warner Norcross + Judd on

As a reminder, the deadline for submitting Patient-Centered Outcomes Research Institute (PCORI) fees is July 31. Employers who sponsor self-insured group health plans should report and pay PCORI fees using the most recently...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

Pullman & Comley - Labor, Employment and...

Federal Court Decision Reshapes ACA Enforcement by HHS and IRS

Pullman & Comley - Labor, Employment and... on

The recent federal district court decision in Faulk Company, Inc. v. Xavier Becerra, et al., No. 24-cv-00609-P (N.D. Tex. 2025) significantly alters the primary mechanism used by the U.S. Department of Health and Human...more

Troutman Pepper Locke

Navigating Legal Strategies for Covering GLP-1s in Self-Insured Medical Plans — Employee Benefits and Executive Compensation...

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In this episode of Troutman Pepper Locke's Employee Benefits and Executive Compensation podcast, hosts Lydia Parker and Lynne Wakefield explore the complex legal landscape surrounding the coverage of GLP-1s prescribed for...more

Verrill

Preventive Services vs. Preventive Care

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In the context of medical coverage, the terms “Preventive Services” and “Preventive Care” are often used interchangeably. The two terms, however, have very different meanings. Understanding the difference can have significant...more

Amundsen Davis LLC

Court Ruling Hamstrings IRS Enforcement of ACA Employer Mandate

Amundsen Davis LLC on

On April 10, 2025, a federal court in Texas issued an opinion in the case of Faulk Co. v. Becerra that significantly impacts how the Affordable Care Act’s (ACA) employer mandate can be enforced. The ruling effectively...more

Pullman & Comley, LLC

IRS Announces HSA and HDHP Dollar Limits for 2026

Pullman & Comley, LLC on

The IRS has announced the 2026 cost-of-living adjustments to the applicable dollar limits for health savings accounts (HSAs), high-deductible health plans (HDHPs), and excepted benefit health reimbursement arrangements...more

Weber Gallagher Simpson Stapleton Fires &...

I’m Getting Divorced. What Happens to My Health Insurance?

Weber Gallagher Simpson Stapleton Fires &... on

One of the biggest issues in this country is healthcare. Specifically, the cost and payment for healthcare and directly related to that, health insurance. Under most family situations at least one family member works for an...more

Bricker Graydon LLP

What, Me PCORI? - Fee Update for Self-Funded Plans

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While the Patient-Centered Outcomes Research Initiative (“PCORI”) fee was updated at the turn of the year, the fee is not actually paid until July.  For those of you that forgot about the fee, this is your reminder to start...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

Seyfarth Shaw LLP

HHS’ Withdrawal of 2022 Guidance Raises Questions about Coverage for Gender-Affirming Care

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In a move with potentially significant implications for entities subject to the Affordable Care Act, the Department of Health and Human Services (HHS) has reversed course and now contends that Section 1557 of the Affordable...more

Maynard Nexsen

IRS Publishes New ACA Reporting Guidance for Employer Distribution of 1095-B and 1095-C

Maynard Nexsen on

On February 21, 2025, the Internal Revenue Service (“IRS”) released Notice 2025-15, providing guidance to employers and insurers regarding the alternative manner of furnishing certain health insurance coverage statements to...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

Venable LLP

IRS Issues Guidance Regarding ACA Reporting

Venable LLP on

Laws enacted at the end of 2024 made important changes to the ACA reporting requirements. The laws codified an alternative option for furnishing certain forms to individuals and authorized the IRS to issue new guidance on the...more

Jackson Lewis P.C.

The Guidance Has Arrived! More Information from the IRS on ACA Forms 1095-B and 1095-C

Jackson Lewis P.C. on

Takeaways- Employers may post a notice on their website instead of automatically furnishing Forms 1095-B and 1095-C to all full-time employees. The first due date for such a notice is March 3 for 2024 forms, and the notice...more

Warner Norcross + Judd

IRS Releases ACA Reporting Relief Guidance

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At the end of last year, we told you about new legislation that provides employers with a little Affordable Care Act (ACA) reporting relief. Specifically, under the Paperwork Burden Reduction Act, applicable large employers...more

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