News & Analysis as of

Employer Group Health Plans Reporting Requirements

Warner Norcross + Judd

Group Health Plan PCORI Fees Due by July 31 - UPDATED JULY 2025

As a reminder, the deadline for submitting Patient-Centered Outcomes Research Institute (PCORI) fees is July 31. Employers who sponsor self-insured group health plans should report and pay PCORI fees using the most recently...more

Bricker Graydon LLP

Is My Group Health Plan Covered by State PBM Reporting Laws?

Bricker Graydon LLP on

State laws seeking to regulate pharmacy benefit managers (PBMs) have increased significantly over the past few years. As it stands, all 50 states have laws that regulate PBMs in some way, but all are unique. However, most of...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 From outdated documentation to missed filing deadlines, we have highlighted a few areas below where we often see gaps....more

Lathrop GPM

Administration Issues Cross-Agency Guidance Targeting Health Care Pricing and Focusing on Hospitals and Health Plans

Lathrop GPM on

On May 22, 2025, the U.S. Department of Health and Human Services, Department of Treasury and Department of Labor (the “Agencies”) announced new steps intended to “strengthen healthcare price transparency.” ...more

Venable LLP

Government Issues Nonenforcement Statement on Mental Health Parity Rules

Venable LLP on

The government recently stated that it will delay enforcement of the 2024 final rules on the Mental Health Parity and Addiction Equity Act (MHPAEA). (Our previous alert regarding the 2024 final rules can be found here.) This...more

Venable LLP

June 1, 2025 Prescription Drug Reporting Deadline for Group Health Plans

Venable LLP on

Employer group health plans must make an annual disclosure of the plan's prescription drug and healthcare spending to the Centers for Medicare & Medicaid Services (CMS). The disclosure, called the Prescription Drug Data...more

Jackson Lewis P.C.

Make America Healthy Again: New Executive Order Revisits Group Health Plan Price Transparency

Jackson Lewis P.C. on

On February 25, 2025, President Trump signed “Making America Healthy Again with Clear, Accurate, and Actionable Healthcare Pricing Information,” an Executive Order with the stated purpose of making group health plans and...more

Warner Norcross + Judd

IRS Releases ACA Reporting Relief Guidance

Warner Norcross + Judd on

At the end of last year, we told you about new legislation that provides employers with a little Affordable Care Act (ACA) reporting relief. Specifically, under the Paperwork Burden Reduction Act, applicable large employers...more

Pillsbury Winthrop Shaw Pittman LLP

IRS Eases Form 1095-C Burden for Employers

President Biden recently signed two new laws that significantly reduce the ACA compliance burden for employers by streamlining Form 1095 reporting and minimizing penalties for failure to file and distribute Form 1095s to...more

Venable LLP

March 1 Deadlines for Group Health Plans

Venable LLP on

March 1 brings two annual deadlines for employers that sponsor a group health plan for their employees....more

Polsinelli

Complying with the ACA Disclosure Requirements Just Got a Whole Lot Easier!

Polsinelli on

New legislation liberalizing certain disclosure requirements under the Affordable Care Act (“ACA”) was passed at the end of 2024.  Effective for 2024 reporting, mailing a paper copy of Forms 1095-C/1095-B is no longer...more

Verrill

The Gag Clause Quandary for Self-Insured Group Health Plans—New FAQ Guidance

Verrill on

The Departments of Labor, Health and Human Services, and the Treasury, with the Office of Personnel Management (the “Departments”) jointly released FAQs About Consolidated Appropriations Act, 2021 Implementation Part 69...more

Bricker Graydon LLP

New ACA Reporting Rules Provide Employer Relief

Bricker Graydon LLP on

Just before the holidays, two bills impacting reporting under the Affordable Care Act (“ACA”), H.R. 3801 (EMPLOYER REPORTING IMPROVEMENT ACT) and H.R. 3797 (PAPERWORK BURDEN REDUCTION ACT), passed both houses and were sent to...more

Kaufman & Canoles

ESOPs, Benefits & Compensation Q4 2024 Client Update

Kaufman & Canoles on

We hope you enjoyed the holidays and are settling back in refreshed and recharged for 2025. With a new year comes new rules; please find our thoughts on some of them below....more

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

2025 ACA Compliance Updates: Essential Insights for Employers

As we turn the page to 2025, employers and HR professionals are turning their attention to ensuring compliance with the reporting and disclosure requirements of the Affordable Care Act (ACA). ...more

Venable LLP

Year-End Deadlines and Dates for Employee Benefit Plans

Venable LLP on

The end of 2024 brings important deadlines and dates for employers that sponsor 401(k) plans, 403(b) plans, governmental 457(b) plans, and group health plans....more

Epiq

The ‘Blind’ Medicare Reporting Conundrum: Clinical Trials Sponsor Compliance with MMSEA Section 111 Mandatory Insurer Reporting

Epiq on

Organizations have an obligation to report claims for individuals who have coverage under group health plans (GHPs) and non-group health plans (NGHPs) when a settlement has been paid or when the plan pays for ongoing medical...more

Venable LLP

June 1 Prescription Drug Reporting Deadline for Group Health Plans

Venable LLP on

Employer group health plans must make an annual disclosure of the plan's prescription drug and healthcare spending to the Centers for Medicare & Medicaid Services (CMS). The disclosure, called the Prescription Drug Data...more

Verrill

RxDC Reporting in Light of June 1, 2024 Deadline and Recent PBM Litigation

Verrill on

Under the Consolidated Appropriations Act of 2021 (“CAA”), employer-sponsored group health plans, including medical-only plans, must submit information about their prescription drugs and health care spending. This submission...more

Woodruff Sawyer

Compliance Alert: Reminder: RxDC Reporting Due June 1st

Woodruff Sawyer on

As a reminder, the Consolidated Appropriations Act, 2021 includes a provision that requires group health plans and health insurance issuers (collectively “plans and issuers”) to report certain specified data related to...more

Pullman & Comley - Labor, Employment and...

Group Health Plans and Medicare Secondary Payer Rules: Do the Mandatory Reporting Obligations Apply to You?

The Medicare Secondary Payer provisions (MSP) apply to group health plans sponsored by employers with 20 or more employees, in both the private and public sectors. MSP’s mandatory reporting requirements are designed to...more

Snell & Wilmer

2023 End-of-Year Plan Sponsor “To Do” Lists (Part 1) Health and Welfare

Snell & Wilmer on

We are pleased to present our annual End of Year Plan Sponsor “To Do” Lists. This year, we present our “To Do” Lists in four separate Employee Benefits Updates. This Part 1 covers year-end health and welfare plan issues....more

Bradley Arant Boult Cummings LLP

Making the First “Gag Clause” Attestations: A Quick Reference Guide

Under the Consolidated Appropriation Act of 2021 (CAA), group health plans and health insurance issuers are prohibited from entering into agreements with service providers restricting certain information that the plan may...more

Verrill

Gag Clauses – New Guidance and Litigation Will Inform Compliance

Verrill on

Certain provisions of the Transparency in Coverage Final Regulations and the Consolidated Appropriation Act, 2021 (“CAA”) require group health plans and/or their vendors to report information to federal agencies. On December...more

Stinson - Benefits Notes Blog

Departments Provide Relief for 2020 and 2021 Prescription Drug Reporting

On December 23, 2022, the Departments of Labor, Health and Human Services and Treasury (the “Departments”) issued FAQs providing relief from prescription drug and health care spending reporting requirements. The FAQs are...more

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