News & Analysis as of

Employer Group Health Plans Self-Insured Health Plans

Woodruff Sawyer

REMINDER: PCORI Fees Due By July 31, 2025

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Employers that sponsor self-insured group health plans, including health reimbursement arrangements (HRAs) should keep in mind the upcoming July 31, 2025 deadline for paying fees that fund the Patient-Centered Outcomes...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

Woodruff Sawyer

​​​​​​​​IRS Releases PCORI Fee For Plan Years Ending Before October 1, 2025

Woodruff Sawyer on

​The IRS has released Notice 2024-83, which sets the applicable PCORI fee for plan years ending between October 1, 2024 and September 30, 2025 at $3.47 per covered life. ​The PCORI fee helps fund the Patient-Centered...more

Bricker Graydon LLP

Five Year End To Dos for Your Self-Insured Health Plan

Bricker Graydon LLP on

Santa is not the only person who should be making a list and checking it twice this December. All sponsors of self-insured medical plans should also make sure that they double-check their year end to do lists....more

Verrill

Cross-Plan Offsetting in Group Health Plans—The DOL Makes its Position Clear

Verrill on

Under Section 404 of ERISA, plan fiduciaries must act for the exclusive benefit of plan participants and beneficiaries and use plan assets only to provide benefits and defray reasonable expenses of administering the plan. In...more

Bricker Graydon LLP

Departments Roll Back Enforcement Discretion in New Guidance on Transparency in Coverage Rules.

Bricker Graydon LLP on

Well, it was good while it lasted. On September 27th, the Departments issued new FAQs regarding implementation of provisions of The Transparency in Coverage Final Rules (TiC Final Rules). ...more

Warner Norcross + Judd

Group Health Plan PCORI Fees Due by July 31

Warner Norcross + Judd on

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

Woodruff Sawyer

Compliance Alert: Reminder PCORI Fees Due By July 31, 2023

Woodruff Sawyer on

Employers that sponsor self-insured group health plans, including health reimbursement arrangements (HRAs) should keep in mind the upcoming July 31, 2023 deadline for paying fees that fund the Patient-Centered Outcomes...more

Woodruff Sawyer

Claims Cost Transparency: Using Data to Optimize Medical Benefits Costs

Woodruff Sawyer on

How much would you get back in your budget if you could save up to 10% on your medical and Rx benefits costs? Employee benefits are the second largest budget item in employee compensation, with medical benefits consuming the...more

Amundsen Davis LLC

Employee Benefit Plan Considerations Post-Roe

Amundsen Davis LLC on

The U.S. Supreme Court's decision last month to overturn Roe v. Wade presents new challenges for employee benefit plans. By overturning the case establishing a constitutional right to abortion, the Court's decision in Dobbs...more

Fox Rothschild LLP

The Supreme Court’s Dobbs Ruling Creates a Variety of Significant Legal Issues

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The Supreme Court of the United States held in Dobbs v. Jackson Women’s Health Organization, that the Constitution does not confer a right to abortion, overruling long-standing precedent in Roe v. Wade and Planned Parenthood...more

Woodruff Sawyer

Compliance Alert: Reminder PCORI Fees Due By July 31, 2022

Woodruff Sawyer on

Employers that sponsor self-insured group health plans, including health reimbursement arrangements (HRAs) should keep in mind the upcoming July 31, 2022 deadline for paying fees that fund the Patient-Centered Outcomes...more

Verrill

Self-Insured Group Health Plan Sponsors: Action Steps to Mitigate Risk Under the Mental Health Parity and Addiction Equity Act

Verrill on

The Mental Health Parity and Addiction Equity Act (“MHPAEA”) provisions of the Consolidated Appropriations Act, 2021 (“CAA”) introduced a requirement that group health plans and insurance providers offering both medical and...more

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

Initial No Surprises Act Regulations Provide Some Clarity for Employer Plans

Plan participants can be hit with surprise medical bills when they receive care from out-of-network providers. Sometimes, this happens when participants do not know that the care they are receiving is from an out-of-network...more

Snell & Wilmer

For the Long Haul: SCOTUS Ruling Means ACA Coverage and Reporting Rules Here to Stay

Snell & Wilmer on

Despite myriad legal challenges, the Affordable Care Act (“ACA”) remains the law of the land. We previously reported on the Supreme Court’s latest validation of the law in our SW Benefits Update, “Three Strikes You’re Out –...more

Jackson Walker

Coronavirus Relief Guidance Continues to Cascade Out

Jackson Walker on

The Coronavirus Aid, Relief And Economic Security (CARES) Act and the Setting Every Community Up for Retirement Enhancement (SECURE) Act both made changes to required minimum distribution rules. The SECURE Act changes the age...more

Perkins Coie

COVID-19: Employee Health Plan Administration Considerations

Perkins Coie on

As federal and state governments respond to COVID-19, employers and plan fiduciaries must also address the evolving issues arising under employer-sponsored health plans. The specific considerations covered in this update are...more

Troutman Pepper Locke

COVID-19 Employee Benefits: FAQs for Employers Focus on Health and Welfare Benefit Plans

Troutman Pepper Locke on

It is hard to find a sector of the American workforce that has not been affected by the COVID-19 emergency. Employees are being asked to work from home if they are able, businesses are being forced to close, and employers are...more

Parker Poe Adams & Bernstein LLP

Can Temporarily Laid Off Workers Remain on a Company's Medical Insurance Plan?

We have had a number of questions from clients about their ability to maintain group medical and other employer-provided benefits for employees affected by temporary layoffs and working hours reductions related to COVID-19....more

Holland & Hart - The Benefits Dial

You’ve Got Another PCORI Fee Coming!: Congress revives the PCORI fee and filing obligations

In the wee hours of December 2019, Congress revived the PCORI fee and filing obligations of employer sponsors of self-insured group health plans. In accordance with the requirements of the Affordable Care Act, employer...more

Parker Poe Adams & Bernstein LLP

Delaying COBRA Notice Past Eligibility Date Risks Insurer Refusing to Pay Claims

During the past year, we have encountered a number of situations where employers have allowed current and former employees to remain on their group medical insurance plans well past the date that they should have been placed...more

Eversheds Sutherland (US) LLP

Transparency in coverage rule - Potential implications for self-insured health plans

On November 15, the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury (collectively, the “Agencies”) issued a proposed "Transparency in Coverage" rule that would require most...more

Snell & Wilmer

The Family Medical Leave Act and Benefit Plans: What comes first – the Law or the Employer’s Established Policy?

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An employer that employs 50 or more employees for each working day during each of 20 or more calendar workweeks in the current or preceding calendar year is subject to the Family Medical Leave Act (“FMLA”). Therefore, often...more

Jones Day

Direct Contracting 101: Collaborations Between Employers and Health Care Providers

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As employers continue to encounter escalating health care costs, many are exploring the "direct contracting" option, which allows for direct service and pricing negotiations with health care providers. While the direct...more

Mintz - Employment Viewpoints

Association Health Plans: Self-Funded vs. Fully-Insured

Recently proposed Department of Labor (Department) regulations governing Association Health Plans (AHPs) would, if made final, permit small employers to be regulated under more favorable, large group rules. The proposed...more

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