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Employer Group Health Plans Employer Liability Issues

Husch Blackwell LLP

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

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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

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

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

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

McDermott Will & Emery

Special Report - Examining Group Health Coverage Alternatives for Small Employers

McDermott Will & Emery 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 & Emery

Special Report: Examining Group Health Coverage Alternatives for Small Employers

McDermott Will & Emery 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 & Emery

Complying With the ‘Relevant Data’ Requirement Under the Final 2024 Mental Health Parity and Addiction Equity Act: A Proposal for...

McDermott Will & Emery on

The Mental Health Parity and Addiction Equity Act (MHPAEA) generally requires group health plans and health insurance issuers to ensure that financial requirements (such as copays and deductibles), quantitative treatment...more

McDermott Will & Emery

Employee Benefit Plans: Important Considerations for Year-End and 2025

McDermott Will & Emery on

For calendar-year plans, the 2025 plan year is right around the corner. And even for non-calendar-year plans, January 1, 2025, is a key implementation date for certain plan features. This is the ideal time for plan sponsors...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

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

McDermott Will & Emery

Election 2024: Gender-Affirming Care in the US

McDermott Will & Emery on

On the issue of gender-affirming care, how would a Harris-Walz administration affect clients in your practice? Bottom line: A Harris-Walz administration would likely provide health plans and health plan sponsors with...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

Schwabe, Williamson & Wyatt PC

Year-End Compliance Considerations for Employee Benefit Plans

Open enrollment is right around the corner (at least for employers that run calendar-year health benefit plans), so many employers will be updating their benefit communication plans. Though not comprehensive, the following is...more

Schwabe, Williamson & Wyatt PC

Is Your Group Health Plan “Affordable,” According to the IRS? ‎

The 2025 open enrollment season for employee benefits is swiftly approaching. With newly released IRS guidance, employers should review the cost of their group health plan(s) to ensure affordability. Companies that rely on...more

Epstein Becker & Green

Final Mental Health Parity Rules Released: Next Steps for Employers

Epstein Becker & Green on

On September 23, 2024, the U.S. Departments of Health and Human Services, Labor, and the Treasury (collectively, the “Departments”) issued a final rule (“Final Rule”) implementing amendments made by the Consolidated...more

Mayer Brown

United States: Health and Welfare Hot Topics

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At A Glance - In recent months, there have been a number of important developments in the United States relating to health and welfare plans. This list of hot topics identifies the key areas for employers and plan sponsors to...more

Butler Snow LLP

Discriminatory or Just Cheap? Eleventh Circuit Panel Rules that Employer-Sponsored Health Plans Must Cover Gender-Affirming Care;...

Butler Snow LLP on

In its 2020 decision in Bostock v. Clayton County, the United States Supreme Court ruled that Title VII of the Civil Rights Act of 1964 prohibits covered employers from discriminating against employees based on their...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - August 2024

The August Monthly Minute highlights new IRS guidance addressing student loan matching programs, HHS’s increases to civil monetary penalties and Form 5330 paper filing updates....more

McDermott Will & Emery

The Case for the Welfare Plan Fiduciary Committee

Recent lawsuits filed against the group health plans of two large US employers underscore the importance of implementing formal welfare benefit plan governance structures that include fiduciary committees comparable to the...more

Bricker Graydon LLP

Summer's Hot Debate: Does a Self-Funded Group Health Plan Cover Gender-Affirming Care?

Bricker Graydon LLP on

As the temperatures continue to rise, regulations and litigation related to employer-sponsored group health plans have followed suit. As these new rules continue to evolve, we are often asked whether a self-insured group...more

Littler

July is Still the New January! Littler’s Workplace Policy Institute’s Mid-Year Legislative Report

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Hot off the press – here is Littler’s mid-year report!  As federal regulators, states and cities continue to pass new workplace regulations through the calendar year, we summarize each state’s notable labor and employment law...more

McDermott Will & Emery

Group Medical Captives, Level Funding and US Healthcare Policy

McDermott Will & Emery on

In a recent article in Managed Healthcare Executive, Peter Wehrwein examines the trend of self-funding of group health benefits by smaller employers who used to depend mainly or entirely on fully insured programs....more

Fisher Phillips

Appeals Court Hands Victory to Transgender Employee Seeking Health Benefits: Key Takeaways and 3 Steps Employers Can Take Now

Fisher Phillips on

A federal appeals court recently held that an employer’s health insurance plan wrongly excluded coverage for gender-affirming care in violation of federal civil rights law – offering a warning to employers across the country...more

Akerman LLP - HR Defense

Employers Must Keep Reproductive Health Information About Their Plan Participants Private Under New HIPAA Privacy Rule

Imagine you are a corporate Human Resources/Total Rewards leader who receives a request from a state’s law enforcement agency for health plan records about a plan participant’s abortions or other reproductive health care. How...more

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