News & Analysis as of

Employee Benefits Compliance Insurance Industry

McDermott Will & Schulte

Key updates on the US health benefits and reimbursement landscape

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

Bass, Berry & Sims PLC

Reminder – Annual Deadline (July 31) to Report and Pay PCORI Fee is Approaching (UPDATED)

The annual filing (and fee payment) for applicable self-insured health plans and specified health insurance policies used to fund the Patient-Centered Outcomes Research Institute (PCORI fee) is due by Thursday, July 31, 2025....more

Husch Blackwell LLP

MHPAEA July 2025 Update: What Employers and Plans Need to Know about Federal Non-Enforcement

Husch Blackwell LLP on

The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) was enacted to ensure that group health plans and health insurance issuers offering mental health and substance use disorder (MH/SUD) benefits do not impose...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

Goldberg Segalla

Georgia Court's Ruling on Rycroft Defense Signals Key Limitation for Employers

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Unfortunately, not everything is always peachy in the Peach State. Historically, the Rycroft defense has allowed employers to deny workers’ compensation benefits when a worker makes false representations about their physical...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

Snell & Wilmer

Mental Health Parity Compliance: What Steps Should an Employer Take Next?

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The Mental Health Parity and Addiction Equity Act (“MHPAEA”) and its implementing rules require group health plans to ensure that financial requirements (e.g., co-pays, deductibles, and coinsurance), quantitative treatment...more

McDermott Will & Schulte

How PPM Health Plans Can Solve the MEWA Problem

While a physician practice management (PPM) structure allows for compliance with corporate practice of medicine laws and ease of administration, it often creates inadvertent health plan issues that should be navigated...more

Jackson Lewis P.C.

Updates for Employers Using Private Plans to Comply with Minnesota’s Paid Leave Law

Jackson Lewis P.C. on

Minnesota is one of a dozen states that have enacted a statewide program providing compensation to employees during family and medical leaves. Minnesota’s law provides job protection and payment of benefits through a...more

Faegre Drinker Biddle & Reath LLP

Affordable Care Act Penalty and Reporting Relief

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

Warner Norcross + Judd

Holy Smokes: Is Your Tobacco Surcharge Program Compliant?

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A “tobacco surcharge” is part of many employers’ wellness programs, where the employer charges tobacco users higher health insurance premiums than non-tobacco users. A typical tobacco surcharge program will ask an employee if...more

Goldberg Segalla

Pennsylvania Department of Labor & Industry Bureau of Workers’ Compensation has created the Direct Deposit Payment Authorization...

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Following the signing of Senate Bill 1232 amending the Pennsylvania Workers’ Compensation Act to require that employers and insurers offer claimants the option to receive their Workers’ Compensation payments by way of direct...more

Carlton Fields

A Summary of Predicted Litigation Under the DOL’s Proposed Fiduciary Rule

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The Department of Labor’s recent Proposed Rule, which defines the term "fiduciary" as it applies to persons who provide "investment advice" to ERISA plans and IRAs, will impact the likelihood and severity of fiduciary...more

K&L Gates LLP

HHS Proposes Rules for Nondiscrimination in Health Care

K&L Gates LLP on

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

Ballard Spahr LLP

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

Ballard Spahr LLP on

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

Carlton Fields

For Life Insurers and Agents – A Summary of Predicted Litigation Under the DOL’s Proposed Fiduciary Rule

Carlton Fields on

The Department of Labor’s recent Proposed Rule (the “Proposal”), which defines the term “fiduciary” as it applies to persons who provide “investment advice” to ERISA plans and IRAs, will impact the likelihood and severity of...more

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