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Patient Protection and Affordable Care Act (PPACA) › Insurance Industry › Employer Group Health Plans

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

Proskauer - Employee Benefits & Executive...

Supreme Court Decision Leaves ACA Preventive Services Mandate Intact

Proskauer - Employee Benefits & Executive... on

On the last day before the U.S. Supreme Court’s summer recess, the Court issued a decision that left in place the Affordable Care Act (“ACA”) mandate that requires non-grandfathered group health plans and issuers to cover,...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

Saul Ewing LLP on

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

McDermott Will & Schulte on

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

McDermott Will & Schulte

[Webinar] Gender-Affirming Benefits: Best Practices for Group Health Plans - February 29th, 1:00 pm - 1:30 pm EST

McDermott Will & Schulte on

Employers and plan sponsors are facing growing – and often conflicting – pressures related to the coverage of gender-affirming care. Join McDermott lawyers Sarah G. Raaii and Alden J. Bianchi for a webinar to review recent...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

ACA Preventive Services Mandate Partially Vacated: What’s Affected, What’s Not, and What’s Next

Bradley Arant Boult Cummings LLP on

A federal judge has struck down a provision of the Affordable Care Act (ACA) mandating group health plans and insurers to cover a long list of preventive services without cost-sharing from participants. The March 30 decision...more

Goodwin

Federal District Court Ruling May Jeopardize Insurance Coverage of More Than 50 Recommended Procedures, Screenings, and Treatments

Goodwin on

Under the Affordable Care Act, group health plans and health insurance issuers are required to provide health insurance coverage based on recommendations made by healthcare coverage professionals. The covered categories...more

Bradley Arant Boult Cummings LLP

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

Bradley Arant Boult Cummings LLP on

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

Hogan Lovells

Trump administration issues proposed health insurance market stabilization rule: Will it be enough to stabilize exchange...

Hogan Lovells on

On 15 February 2017, the Centers for Medicare & Medicaid Services (CMS) took a step toward addressing concerns about the stability of the individual and small group health insurance markets by proposing a modicum of...more

Epstein Becker & Green

Nondiscrimination Standards Under ACA Section 1557: Now Is the Time to Act

Epstein Becker & Green on

Health insurers and group health plan sponsors must closely review the final rule titled “Nondiscrimination in Health Programs and Activities” (“Final Rule”) implementing Section 1557 of the Affordable Care Act (“ACA”) that...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

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

McDermott Will & Emery

IRS Publishes Final Forms and Instructions on Information Reporting Under the Affordable Care Act

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The Internal Revenue Service (IRS) published final forms and instructions addressing information reporting requirements applicable to employers and insurers under Internal Revenue Code Sections 6055 and 6056. The reporting...more

Proskauer - Employee Benefits & Executive...

HIPAA Certificates Are No Longer Required As of January 1, 2015

Proskauer - Employee Benefits & Executive... on

Effective January 1, 2015, group health plans and insurers are no longer required to issue a certificate of creditable coverage (“HIPAA Certificate”) to individuals who lost group health plan coverage. As a reminder, HIPAA...more

Proskauer - Employee Benefits & Executive...

California Repeals 60-Day Limit on Waiting Periods

Proskauer - Employee Benefits & Executive... on

On August 15, 2014, California passed Senate Bill 1034, which repealed an insurance law (Assembly Bill 1083) that prohibited insurance companies from including waiting periods in excess of 60 days in their group health...more

Polsinelli

Health Care Reform Update: Proposed Rules Issued On 90-Day Limit Placed On Waiting Periods For Health Coverage

Polsinelli on

Beginning in 2014, the Affordable Care Act of 2010 (the "Act") will prohibit group health plans and group health insurers from imposing waiting periods greater than 90 days of employment....more

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