News & Analysis as of

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

McAfee & Taft

Employer health plan surcharges pose litigation risks

McAfee & Taft on

Many employers implement wellness programs into their employee health plan offering. Wellness programs have varying designs but commonly offer premium discounts to participants who are tobacco-free or achieve certain...more

BCLP

Closing the Gap: Health and Welfare Compliance

BCLP on

Even the most well-managed employee benefit plans may have certain compliance blind spots. From outdated documentation to missed filing deadlines, we have highlighted a few areas below where we often see gaps....more

Littler

The Parity Paradox: MHPAEA Compliance for Employers and Insurers During the 2024 Enforcement Pause

Littler on

The U.S. Departments of Labor, Health and Human Services, and Treasury have announced that they will pause enforcement of the 2024 Mental Health Parity and Addiction Equity Act (MHPAEA) Final Rule (the “2024 Final Rule”) for...more

Quarles & Brady LLP

Departments Will Not Enforce 2024 Final Rule under MHPAEA

Quarles & Brady LLP on

The Trump Administration has just announced that it will pause enforcement of the September 2024 final rule (“Final Rule”) under the Mental Health Parity and Addiction Equity Act (“MHPAEA”)....more

Epstein Becker & Green

Federal Regulators Announce Non-Enforcement of the 2024 Rule for Mental Health Parity

Epstein Becker & Green on

On May 9, 2025, the Departments of Labor, Health and Human Services, and Treasury (collectively, “the Departments”) asked the D.C. federal court to suspend litigation while they consider whether to rescind or modify the 2024...more

McDermott Will & Emery

Special Report: Examining Group Health Coverage Alternatives for Small Employers - Update

McDermott Will & Emery on

Originally published in February 2025, this updated report provides new material on physician practice management (PPM) arrangements, reference-based pricing arrangements, minimum essential coverage (MEC) and MEC+ plans, and...more

Morgan Lewis - ML Benefits

Tobacco Surcharge Lawsuits: Considerations for Plan Sponsors

A growing number of class action lawsuits have been filed against employer-sponsored self-insured group health plans alleging that tobacco cessation wellness programs violate key provisions of the Employee Retirement Income...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Employer Group Sues to Block Mental Health Parity Rules

Only weeks after the principal effective date for the final 2024 federal mental health parity rules for employer-sponsored health benefit plans, those rules—and specifically some key features that are frustrating...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

Morgan Lewis - ML Benefits

Fiduciary Considerations Raised By the Use of AI in Group Health Plans

The use of artificial intelligence (AI) in the administration of group health plans is nothing new: AI has been used for a number of years to analyze data, improve risk assessment, identify fraud, and streamline claims...more

Ward and Smith, P.A.

Part 2 in Heatwaves of Drama: A Case Study in "What Not To Do" for Southeastern HR Professionals

Ward and Smith, P.A. on

The session used the firm’s signature Live-Action Role-Play (LARP) technique to feature insights from Ken Gray, leader of the Labor and Employment Law Group, Amy Fitzhugh, a professional licensing attorney, and Hayley Wells,...more

Holland & Hart - The Benefits Dial

Smoke ‘Em One By One … Navigating the Wave of Tobacco Surcharge Lawsuits

Over the past several months, numerous large employers and their health plan fiduciaries have faced lawsuits regarding their health plan’s tobacco surcharge. A tobacco surcharge wellness program typically charges a higher...more

Alston & Bird

2024 Health Benefits Year: A Year to Remember

Alston & Bird on

The year was packed with developments for health and welfare benefits plans. Our Health Benefits Team reviews 2024, from new data privacy rules to disaster tax relief....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

Wiley Rein LLP

PBM Contracting and Administration: What Are the Rules of the Road for Self-Insured Employees?

Wiley Rein LLP on

In February 2024, a group representing (among others) the Johnson & Johnson Group Health Plan and its component plans (Plaintiffs) sued Johnson & Johnson and The Pension & Benefits Committee of Johnson and Johnson (J&J) over...more

Fisher Phillips

Rising ERISA Class-Action Lawsuits Over Tobacco Surcharges in Health Plans: What Employers Need to Know + 6 Steps to Stay...

Fisher Phillips on

A wave of ERISA class-action lawsuits is challenging tobacco surcharge programs in employer-sponsored health plans across the U.S. These cases center on potential fiduciary breaches, with plaintiffs arguing that surcharges...more

UB Greensfelder LLP

What Employers Should Know About Tobacco Surcharge Litigation

UB Greensfelder LLP on

Tobacco surcharges have become the focus of class action litigation in recent months. Although corporate wellness programs are commonplace, employers that impose a tobacco surcharge (or other premium discount) in connection...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

Alston & Bird

Final Mental Health Parity Rules: A Plan Sponsor’s Implementation Guide

Alston & Bird on

Our Employee Benefits & Executive Compensation Group discusses what health plan sponsors need to know about the final rule on nonquantitative treatment limitations (NQTLs) and NQTL comparative analysis under the Mental Health...more

BCLP

Mental Health Parity Final Rule Imposes Year-end Action Items on Group Health Plan Sponsors

BCLP on

On September 9th, the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury (collectively, the “Departments”) issued the much anticipated final rule under the Mental Health...more

Verrill

Final Mental Health Parity Rule Spells Compliance Changes

Verrill on

The long-anticipated final rule under the Mental Health Parity and Addiction Equity Act (MHPAEA) was published on September 9, 2024. The MHPAEA prohibits group health plans that provide mental health and substance use...more

Fishman Haygood LLP

U.S. Fifth Circuit Reverses District Court and Awards Benefits to ERISA Plan Participant for Hospitalization

Fishman Haygood LLP on

Case Background - When she was a preteen, E.D. began experiencing symptoms of anorexia nervosa. Her condition worsened, and her parents, the Dwyers, took her to Avalon Hills, a residential treatment facility....more

Ballard Spahr LLP

Practical Pointers for Compliance With New MHPAEA Regulations

Ballard Spahr LLP on

The Departments of the Treasury, Labor, and Health and Human Services have published final regulations under the Mental Health Parity and Addiction Equity Act that prohibit group health plans and health insurers from imposing...more

Fisher Phillips

Open Enrollment Season in the Workplace: 5 Legal Considerations + Employer Takeaways

Fisher Phillips on

Open enrollment season can put a spotlight on the many complex rules applicable to employer-sponsored health and welfare plans. As you announce your benefit offerings for the upcoming plan year and tirelessly work to inform...more

Bradley Arant Boult Cummings LLP

Group Health Plan Sponsors Take Note: New Developments Relating to the Privacy and Cybersecurity of Plan Participants’ Health...

There have been two important developments in the law applicable to the privacy and cybersecurity of group health plan participants’ health information. Plan sponsors must review plan policies and procedures, provider...more

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