News & Analysis as of

Employer Group Health Plans Compliance Employee Retirement Income Security Act (ERISA)

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

McAfee & Taft

Challenge to copay assistance strategy, another PBM ERISA preemption lawsuit, and other compliance issues for 2025

McAfee & Taft on

The end of 2024 gave group health plan sponsors several new lawsuits to watch in 2025. Gurwitch v. SAVE ON SP LLC - On December 26, 2024, a class action complaint was filed in the U.S. District Court for the Northern District...more

Holland & Knight LLP

Understanding the Recent Wave of Litigation Targeting Tobacco-Free Wellness Programs

Holland & Knight LLP on

The Employee Retirement Income Security Act (ERISA) prohibits employers who offer health and welfare benefit plans from discriminating against plan participants on the basis of a health status-related factor, such as a...more

Williams Mullen

Annual Employee Benefits Compliance Checklists: Plan Administrators of Governmental and Church Plans

Williams Mullen on

Administrators of governmental plans and church plans that are not subject to the Employee Retirement Income Security Act of 1974 (ERISA) should review the following actions to be taken before the end of 2024 and address what...more

Verrill

Deciphering First Circuit’s Thirty-page Primer on NQTL Analysis and ERISA Information Requests

Verrill on

The widely publicized 2022 Report to Congress regarding the Mental Health Parity and Addiction Equity Act (“Parity Act”) forewarned greater enforcement efforts by the Department of Labor and highlighted suspected deficiencies...more

Sheppard Mullin Richter & Hampton LLP

State, Federal, and Private Enforcement of Mental Health Parity Compliance

Six months ago, we cautioned health plans and plan sponsors that states, the federal government, and private litigants were laser focused on Mental Health Parity and Addiction Equity Act (“MHPAEA”) compliance. The United...more

Morgan Lewis

A Survival Guide to DOL Group Health Plan Mental Health Parity Audits

Morgan Lewis on

The Consolidated Appropriations Act of 2021 mandates that employers offering medical/surgical and mental health/substance use disorder coverage provide comparative analyses and any supporting documentation demonstrating...more

Bass, Berry & Sims PLC

DOL to Focus on Red Flags in Mental Health Parity Requests

Bass, Berry & Sims PLC on

Last week, the Department of Labor (DOL) announced that it will focus on requesting information from employers where there are potential “red flags” of non-compliance with the provisions and rules of the Mental Health Parity...more

Bradley Arant Boult Cummings LLP

DOL Actively Enforcing Newly Required Mental Health Comparative Analysis

Group health plans and insurers have been required since 2008 to ensure that any “nonquantitative treatment limitations” (NQTLs) imposed on mental health or substance use disorder (MH/SUD) benefits are comparable and no more...more

Faegre Drinker Biddle & Reath LLP

Fee Disclosure Rules Will Soon Apply to Group Health Plans

Buried in the year-end Consolidated Appropriations Act (CAA) is a provision that requires group health plan brokers and consultants to make comprehensive fee disclosures similar to those that apply to retirement plans. As...more

McDermott Will & Schulte

EEOC Proposes New Rules on Wellness Programs

On January 7, 2021, the Equal Employment Opportunity Commission (EEOC) issued proposed guidance regarding employer-sponsored wellness programs and the level of incentives employers may offer employees who participate in these...more

Proskauer - Employee Benefits & Executive...

Agencies Issue Final Regulations on the Summary of Benefits and Coverage (SBC) Requirements

As promised in the FAQ issued on March 30, 2015, the U.S. Departments of the Treasury, Labor and Health and Human Services (the Departments) have issued final regulations regarding the summary of benefits and coverage (SBC)...more

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