News & Analysis as of

Employer Group Health Plans Self-Insured Health Plans Health Insurance

McDermott Will & Emery

Special Report: Examining Group Health Coverage Alternatives for Small Employers

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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

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

Woodruff Sawyer

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

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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, 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

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

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

Jones Day on

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

Bass, Berry & Sims PLC

Reminder: November 15 Transitional Reinsurance Program Filing Deadline is Fast Approaching

Bass, Berry & Sims PLC on

To help stabilize the individual insurance market, Section 1341 of the Affordable Care Act introduced the Transitional Reinsurance Program (TRP), which includes the collection of a TRP fee from “contributing entities” for...more

McGuireWoods LLP

Supreme Court: ERISA Pre-empts Vermont’s Health Data Collection Law as Applied to Self-Insured Health Plans

McGuireWoods LLP on

In Gobeille v. Liberty Mut. Ins. Co., No. 14-181, 2016 U.S. LEXIS 1612 (Mar. 1, 2016), the U.S. Supreme Court held that ERISA pre-empts Vermont’s “all-payer database” law – to the extent it is applied to self-insured health...more

Balch & Bingham LLP

PCORI Fee Inflation Adjustment

Balch & Bingham LLP on

In Notice 2015-60 (October 9, 2015), the IRS announced that the PCORI fee will rise to $2.17 per covered life for plan years ending on or after October 1, 2015 and before October 1, 2016. For plan years ending on or after...more

Tucker Arensberg, P.C.

The “Cadillac Tax” is Rollin’ In!

Tucker Arensberg, P.C. on

When healthcare reform was rolled out in 2010, there was a provision included in the law imposing a tax on healthcare benefits provided to employees that exceed a threshold cost. This tax has been referred to as the...more

McAfee & Taft

The ACA’s Toyota tax

McAfee & Taft on

For several years now, employers have spent a great deal of time focusing on the Affordable Care Act’s (ACA) play-or-pay mandate. Numerous articles have been written and numerous educational seminars have been given...more

Best Best & Krieger LLP

BEST IN LAW: Employers need to heed Obamacare Reporting Rules

Compliance with reporting obligations is always important for any employer, but the employer reporting requirements under the Affordable Care Act pack a significant penalty that makes compliance particularly important. ...more

Mintz - Employment, Labor & Benefits...

ACA Countdown to Compliance - 52 Week Series For Employers

In this volume, we have collected the 52 weekly blog posts that comprise the series entitled, The Affordable Care Act—Countdown to Compliance for Employers. The series appeared in the Mintz Levin Employment Matters Blog...more

McDermott Will & Emery

IRS Publishes Final Forms and Instructions on Information Reporting Under the Affordable Care Act

McDermott Will & Emery on

The Internal Revenue Service (IRS) published final forms and instructions addressing information reporting requirements applicable to employers and insurers under Internal Revenue Code Sections 6055 and 6056. The reporting...more

BakerHostetler

FAQs by Employers Regarding the Anthem Breach

BakerHostetler on

Do we have any legal obligations under HIPAA? It depends on your contractual relationship with Anthem and whether the group health plan offered by your company is self-insured. If your company’s group health plan is...more

Baker Donelson

DOL Gives States More Control Over Self-Insured Health Plans

Baker Donelson on

On November 6, 2014, the U.S. Department of Labor, Employee Benefits Security Administration (DOL) published Technical Release 2014-01, which provides technical guidance to States concerning stop-loss insurance. Stop-loss...more

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