News & Analysis as of

Health Insurance Portability and Accountability Act (HIPAA) Employer Group Health Plans Health Insurance

Bricker Graydon LLP

Can you Charge Smokers More for Your Health Plan?  

Bricker Graydon LLP on

Several new lawsuits have been filed recently alleging that employers violated HIPAA’s non-discrimination rule by charging higher health insurance premiums to employees who use tobacco products. ...more

Husch Blackwell LLP

Employers Continue to Face ERISA Tobacco Surcharge Lawsuits, With Mixed Results

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Recently, companies have seen a spate of class action lawsuits challenging the legality of tobacco cessation wellness programs and related tobacco surcharges imposed by their employer-sponsored health benefit plans....more

Bricker Graydon LLP

Why You Can’t Kick High Claimants Off Your Health Insurance

Bricker Graydon LLP on

If your health insurance premiums have gone up again, you are not alone.  For that reason, we frequently get questions from clients on whether there is anything they can do to get high claimants off of their plans....more

Amundsen Davis LLC

Refusing to Quit: Class Actions on Tobacco Surcharges in Health Plans Continue

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Over the past year, numerous class actions have been filed against large employers claiming their health plan surcharge for tobacco use is not in compliance with HIPAA nondiscrimination rules. With yet another lawsuit filed...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

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

Baker Donelson

Health Plan Compliance Concerns for Year-End 2024

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As employers look toward open enrollment for their group health plans, now is a good time to review action items needed for those plans by year-end, as well as upcoming deadlines in the near future. While fully-insured health...more

Hall Benefits Law

HHS Updates HIPAA Privacy Rule to Protect Reproductive Healthcare Privacy: What Group Health Plans Need to Know

Hall Benefits Law on

The U.S. Department of Health and Human Services (HHS) has issued a final rule that modifies the Standards for Privacy of Individually Identifiable Health Information (“the Privacy Rule”) under the Health Insurance...more

Kilpatrick

Changes to the HIPAA Privacy Rules – A Primer for Self-Insured Group Health Plans

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The Office for Civil Rights (“OCR”) of the US Department of Health and Human Services recently released a final rule (“Final Rule”) to update the HIPAA Privacy Rules for reproductive health care information. The Final Rule...more

McDermott Will & Schulte

Group Medical Captives, Level Funding and US Healthcare Policy

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

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

Akerman LLP - Health Law Rx

Attention, Group Health Plans: New HIPAA Privacy Rule Governing Reproductive Health Care Information Imposes Obligations,...

It is critical for employers and plan fiduciaries/administrators to stay informed of HIPAA privacy and security-related legal developments because most employer sponsored group health plans — regardless of the employer’s...more

Woodruff Sawyer

Navigating Mid-Year Benefit Election Changes

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One of the most common questions that we receive is whether an employee can change their benefits elections after the plan year has already started (also referred to as a mid-year change).  The answer is very fact-specific...more

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

HIPAA Privacy Rules Get a Post-Dobbs Refresh on Reproductive Health Care

Employers will soon see the national debate about abortion popping up in some unexpected places: the HIPAA privacy policies and procedures and notices of privacy practices they use for their health benefit plans....more

Akerman LLP - HR Defense

Your Employee Benefit Plans May Need a Check Up: Nearing the End of the COVID-19 Public Health Emergency

Where did the time go? Just a brief 1,199 days after it began, the COVID-19 Public Health Emergency (PHE) is coming to an end. The PHE formally ends on May 11, 2023, short of any unexpected developments. And that means the...more

Harris Beach Murtha PLLC

Normal Timelines Under Employee Benefit Plans Will Resume After the COVID-19 National Emergency Ends

Earlier this year, the Biden Administration announced its intention to end the COVID-19 National Emergency (and the related nationwide Public Health Emergency) at the end of the day on May 11, 2023. On March 29, 2023, the...more

McDermott Will & Schulte

Preparing for the End of the COVID-19 Emergency: Tri-Agencies Issue FAQs to Assist Plans and Issuers

The Biden administration has announced its intention to end the COVID-19 National Emergency (NE) and the COVID-19 Public Health Emergency (PHE) on May 11, 2023 (read our series introduction for more information)....more

Pillsbury - Policyholder Pulse blog

Abortion as an Employee Health Benefit – How to Protect against Potential Liability Post-Dobbs

Amazon. Bank of America. Citigroup. Dick’s Sporting Goods. JP Morgan. Kroger. Meta. Microsoft. Procter & Gamble. Target. Walt Disney Company. These are just a few of what is a growing list of companies that have offered to...more

Benesch

Dialysis & Nephrology Digest - July 2022

Benesch on

SCOTUS sides with OH-based medical plan in dispute with DaVita over dialysis reimbursements - In a 7-2 vote, the Supreme Court ruled in favor of the Marietta Memorial Hospital Employee Benefit Plan in a case that hinged...more

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

Medical Travel Reimbursement Benefits Under the Supreme Court’s New Dobbs Decision

On June 24, 2022, the Supreme Court of the United States issued its highly anticipated decision in Dobbs v. Jackson Women’s Health Organization, No. 19-1392. The Dobbs decision expressly overrules the two key precedents that...more

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

Health Plan Surcharge for Unvaccinated Employees: New Guidance Provides a Roadmap

Employers that are considering imposing health plan premium surcharges to encourage their employees to get vaccinated have clearer guidance on how to do so without running afoul of the nondiscrimination rules under the Health...more

Jackson Lewis P.C.

Money Money Money: How Much Can The Health Plan Surcharge On Unvaccinated Employees Be?

Jackson Lewis P.C. on

In light of the lingering COVID-19 pandemic and its impact on employee productivity and health care expenses, employers are considering imposing a premium surcharge on employees participating in the company’s health plan who...more

Williams Mullen

PODCAST: Williams Mullen's Benefits Companion - Can Employers Impose a Health Insurance Surcharge on Plan Participants Not...

Williams Mullen on

On this episode of Williams Mullen's Benefits Companion, host Brydon DeWitt explores compliance considerations for employers who are considering imposing a health insurance surcharge on plan participants who are not...more

Parker Poe Adams & Bernstein LLP

Can Employers Charge Higher Group Medical Insurance Premiums for Unvaccinated Employees?

As many companies continue to struggle with low employee COVID-19 vaccination rates, some employers are evaluating imposing higher premiums for unvaccinated employees under their group medical plans. These employers see this...more

Seyfarth Shaw LLP

EEOC Wellness Rules Proposed, Water Bottle Enthusiasts Rejoice

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Synopsis: For years, employers have struggled to understand what level of incentives in wellness programs might be considered “voluntary” under the Americans with Disabilities Act (ADA). ...more

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