News & Analysis as of

Health Insurance Regulatory Requirements Patient Protection and Affordable Care Act (PPACA)

Foley & Lardner LLP

CMS Finalizes Rule Change Applying Preponderance of the Evidence Standard to Agent, Broker, and Web-Broker Exchange Agreement...

Foley & Lardner LLP on

In its recently issued Final Rule (CMS-9884-F; 90 FR 27074-01; the Final Rule), the Centers for Medicare and Medicaid Services (CMS) finalized revisions to 45 C.F.R. § 155.220(g)(2) to specify a standard of proof for...more

McDermott Will & Schulte

Key updates on the US health benefits and reimbursement landscape

The world of health benefits is constantly evolving. Recent policy shifts and legislative developments are expected to impact the economic landscape and have significant implications for employer plan sponsors, insurers,...more

Proskauer - Employee Benefits & Executive...

Supreme Court Decision Leaves ACA Preventive Services Mandate Intact

On the last day before the U.S. Supreme Court’s summer recess, the Court issued a decision that left in place the Affordable Care Act (“ACA”) mandate that requires non-grandfathered group health plans and issuers to cover,...more

Warner Norcross + Judd

U.S. Supreme Court Preserves Preventive Care Coverage Under the ACA

On June 27, 2025, the U.S. Supreme Court issued its decision in Kennedy v. Braidwood Management, Inc., rejecting a constitutional challenge to the Affordable Care Act’s (ACA) preventive services mandate. The Supreme Court...more

Pullman & Comley - Labor, Employment and...

Federal Court Decision Reshapes ACA Enforcement by HHS and IRS

The recent federal district court decision in Faulk Company, Inc. v. Xavier Becerra, et al., No. 24-cv-00609-P (N.D. Tex. 2025) significantly alters the primary mechanism used by the U.S. Department of Health and Human...more

Troutman Pepper Locke

Navigating Legal Strategies for Covering GLP-1s in Self-Insured Medical Plans — Employee Benefits and Executive Compensation...

Troutman Pepper Locke on

In this episode of Troutman Pepper Locke's Employee Benefits and Executive Compensation podcast, hosts Lydia Parker and Lynne Wakefield explore the complex legal landscape surrounding the coverage of GLP-1s prescribed for...more

Ballard Spahr LLP

Section 1557: Deadlines Approach, But Long-Term Prognosis Unclear Under Executive Orders

Ballard Spahr LLP on

Section 1557 of the Affordable Care Act mandates nondiscrimination in health care programs managed or funded by the Department of Health and Human Services (HHS), with upcoming deadlines for compliance set for May and July...more

Maynard Nexsen

NAIC Spring Meeting Update Part Two

Maynard Nexsen on

As discussed in last week’s article, along with almost 3,000 regulators and insurance industry leaders, the Maynard Nexsen Insurance Regulatory team of attorneys attended the National Association of Insurance Commissioners...more

Mintz - Health Care Viewpoints

CMS’s ACA Marketplace Integrity and Affordability Proposed Rule – What it may mean for Health Plans

Earlier this month, the Centers for Medicare & Medicaid Services (CMS) released its 2025 Marketplace Integrity and Affordability Proposed Rule (Proposed Rule), proposing a number of enrollment and eligibility policies...more

McGuireWoods Consulting

Marketplace Integrity And Affordability Rule Proposed

On March 10, 2025, the Centers for Medicare and Medicaid Services (CMS) proposed a rule that in many respects reverts to pre-Biden administration rules and definitions for health care marketplaces across the country. The...more

Bricker Graydon LLP

What Goes Around Comes Around: White House Signals Increased Transparency in Coverage Enforcement

Bricker Graydon LLP on

On February 25, 2025, the White House issued a new executive order aimed at implementing many of the Administration's previously issued directives to health plans. ...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

Sheppard Mullin Richter & Hampton LLP

May the Coverage Be With You: Navigating CMS’s Changes to the Health Insurance Marketplace

The Department of Health and Human Services (“HHS”) Centers for Medicare & Medicaid Services (“CMS”) recently issued the final “HHS Notice of Benefit and Payment Parameters for 2026” (hereinafter referred to as the “Rule”)...more

Proskauer - Health Care Law Brief

The Surprises Continue: The Biden Administration Delays Implementation of Certain Provisions of the No Surprises Act and...

In a FAQ published on August 20, 2021, the Departments of Labor, Health and Human Services, and the Treasury (collectively, the “Departments”) significantly delayed implementation of statutory requirements on surprise billing...more

Morgan Lewis - ML Benefits

DOL’s ERISA Enforcement Activities Focus on Health Plan Compliance

In recent years, reports have indicated robust, and in some respects increasing, enforcement activities by the US Department of Labor (DOL) related to ERISA. The DOL recently issued its enforcement statistics for fiscal year...more

Ballard Spahr LLP

Association Health Plan Regulations Invalidated

Ballard Spahr LLP on

The U.S. District Court for the District of Columbia has set aside the most significant portions of the U.S. Department of Labor's (DOL) regulations on Association Health Plans (AHPs)....more

Bradley Arant Boult Cummings LLP

DOL Regulations on Association Health Plans: How Will They Affect the Health Insurance Marketplace?

Last year, the President issued an Executive Order directing the Secretary of the Department of Labor (DOL) to issue regulations to expand access to association health plans (AHPs). Earlier this year, the DOL issued final...more

Troutman Pepper Locke

Iowa Farm Bureau Health Plans to Deny Coverage for Preexisting Conditions

Troutman Pepper Locke on

As litigation surrounding the Affordable Care Act and its mandates abounds, the Iowa Farm Bureau announced three new health plans that will deny coverage to individuals with preexisting conditions (a denial prohibited under...more

Ballard Spahr LLP

Final Regulations Expand Availability of Individual Insurance Not Meeting ACA Requirements

Ballard Spahr LLP on

The U.S. Departments of the Treasury, Labor, and Health and Human Services have jointly issued final rules modifying the definition of short-term, limited-duration insurance (STLDI). STLDI provides health coverage that is...more

Best Best & Krieger LLP

DOL Exempts Franchise Business Owners from Joint-Employer Liability - New Rule a Welcome Change to Franchise Owners and Small...

Under a recent Department of Labor ruling, franchise business owners that band together to form Association Health Plans are precluded from joint-employer liability that may arise from that relationship....more

Bricker Graydon LLP

Association Health Plans: Another tool for small employers to manage health care costs and increase employee access to affordable...

Bricker Graydon LLP on

Following last fall’s Executive Order 13813, which directs regulatory agencies to improve access to affordable employer coverage, the Department of Labor (DOL) recently released the final regulations on small business...more

Ballard Spahr LLP

DOL Releases Final Regulation Expanding Association Health Plans

Ballard Spahr LLP on

The U.S. Department of Labor (DOL) on Tuesday released final regulations modifying the Association Health Plan (AHP) rules to expand their availability for small and large employers and to address their affordability by...more

Stinson LLP

DOL Issues Final Association Health Plan Rule

Stinson LLP on

On June 19, 2018, the Department of Labor (DOL) released a final rule that offers new options for associations to sponsor health plans for their members. These new options allow more small businesses to come together to...more

Littler

Association Health Plans: How Do You Solve a Problem Like a MEWA?

Littler on

On June 19, 2018, the Department of Labor issued its highly anticipated final rule expanding the availability of association health plans (“AHPs”). ...more

Stinson - Benefits Notes Blog

DOL Issues Final Association Health Plan Rule

On June 19, 2018, the Department of Labor (DOL) released a final rule that offers new options for associations to sponsor health plans for their members. These new options allow more small businesses to come together to...more

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