News & Analysis as of

Healthcare Employer Group Health Plans Employee Benefits

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

McDermott Will & Schulte

A win for telehealth providers, health plans, and participants: HDHP telehealth safe harbor permanently reinstated

On July 4, 2025, the president signed the One Big Beautiful Bill Act (H.R. 1) into law. Among many other healthcare provisions, the bill permanently extends the telehealth safe harbor for high-deductible health plans (HDHPs)...more

Seyfarth Shaw LLP

Supreme Court Upholds Tennessee Transgender Care Ban

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In a widely awaited for decision, the Supreme Court in a 6-3 opinion authored by Justice Roberts held that a Tennessee law which prohibits certain medical treatments (puberty blockers and hormones) for transgender minors,...more

Quarles & Brady LLP

Departments Will Not Enforce 2024 Final Rule under MHPAEA

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The Trump Administration has just announced that it will pause enforcement of the September 2024 final rule (“Final Rule”) under the Mental Health Parity and Addiction Equity Act (“MHPAEA”)....more

Seyfarth Shaw LLP

Cutting Out the Middle Man

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Arkansas has become the first state in the nation to enact legislation, effective starting in 2026, prohibiting pharmacy benefit managers (PBM’s) from owning or operating actual pharmacies within the state. We take a look at...more

ArentFox Schiff

Anthem Set to Settle Five-Year Long Mental Health Coverage Class Action

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Anthem Inc. has agreed to settle a class action lawsuit brought by participants in employee health plans administered by the insurer....more

Saul Ewing LLP

Trump on Transparency: Making America Healthy Again Through Executive Order 14221; How Plan Sponsors Can Respond

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One mandate under the PPACA required health care providers, non-grandfathered health insurance issuers and self-insured group health plans to provide consumers with access to information about the cost of services before they...more

McDermott Will & Schulte

Special Report: Examining Group Health Coverage Alternatives for Small Employers

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

Quarles & Brady LLP

Final Rule under MHPAEA Clarifies NQTL Comparative Analysis Requirement

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On September 23, 2024, the Departments of Labor, Treasury, and Health and Human Services (together, “Departments”) issued a final rule (“Final Rule”) under the Mental Health Parity and Addiction Equity Act (“MHPAEA”). The...more

Alston & Bird

Final Mental Health Parity Rules: A Plan Sponsor’s Implementation Guide

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Our Employee Benefits & Executive Compensation Group discusses what health plan sponsors need to know about the final rule on nonquantitative treatment limitations (NQTLs) and NQTL comparative analysis under the Mental Health...more

Seyfarth Shaw LLP

Agencies Release 2026 Out-of-Pocket Limits and 2025 Limits for Health FSAs

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Recently HHS issued a memorandum announcing the maximum annual limitation on cost sharing (a/k/a out-of-pocket maximum) for 2026 and the IRS issued Rev. Proc. 2024-40 announcing the cost-of-living adjustments to certain...more

McDermott Will & Schulte

Election 2024: Gender-Affirming Care in the US

McDermott Will & Schulte on

On the issue of gender-affirming care, how would a Harris-Walz administration affect clients in your practice? Bottom line: A Harris-Walz administration would likely provide health plans and health plan sponsors with...more

Seyfarth Shaw LLP

Final Rules Related to the Mental Health Parity and Addiction Equity Act May Drive You Wild

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Seyfarth Synopsis: On September 9, 2024, the Departments of the Treasury, Labor, and Health and Human Services (the “Departments”) released highly anticipated Final Rules under the Mental Health Parity and Addiction Equity...more

Seyfarth Shaw LLP

Agencies Release Final Mental Health Parity Rule

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On Monday, September 9, 2024, the Departments of Health and Human Services, Labor and Treasury (the “Departments”) issued their final rule regarding the nonquantitative treatment limitation (NQTL) comparative analysis...more

Hall Benefits Law

Biden’s Proposed FFY 2025 Budget Seeks Mental Health Access Expansion

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The Biden administration unveiled its FFY 2025 budget, which calls for $7.3 trillion in spending. In the proposed budget, Biden maintains his pledge to focus on expanding and transforming the nation’s mental health system. He...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

Akerman LLP - HR Defense

On the Basis of Sex… Discrimination in Group Health Plans and What Employers Should Know

In just a few days’ time, recently promulgated federal final rules addressing sex-based nondiscrimination in the administration of health care benefits have created a flurry of healthcare industry activity. The angst arises...more

McDermott Will & Schulte

Gender-Affirming Benefits: Best Practices for Group Health Plans

Federal legislative and regulatory activity related to employer-sponsored group health plans shows no signs of slowing, particularly with the issuance of interpretive guidance regarding the transparency and surprise-billing...more

Littler

Sponsoring a Group Health Plan for Employees? What Employers Need to Know About the Consolidated Appropriations Act

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Many employers offer health insurance as a way to recruit and retain talent. Sponsoring a group health plan, however, can subject the employer plan sponsor to significant legal and regulatory burdens deriving from laws such...more

Ballard Spahr LLP

HHS Announces Temporary Copay Accumulator Non-Enforcement Policy

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The United States Department of Health and Human Services (HHS) has filed court pleadings stating that it does not intend to initiate enforcement actions against plans that maintain copay accumulator programs....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

Ballard Spahr LLP

Attestation to Consolidated Appropriations Act’s “Anti-Gag Rules” Due by Year’s End

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By December 31, 2023, health plans and insurers must submit an attestation of compliance with the “anti-gag rules” of the Consolidated Appropriations Act of 2021 (CAA). The rules apply to all agreements entered into on or...more

Seyfarth Shaw LLP

OMG! OMB Reviewing Long-Awaited Mental Health Parity Regulations – Public Release Imminent

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Seyfarth Synopsis: Employer health plan sponsors, administrators, and insurers have been eagerly awaiting the U.S. Department of Labor’s upcoming guidance on mental health parity.  According to recent reports, newly proposed...more

Ballard Spahr LLP

Preventive Care Rules Remain in Place for Now

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The Fifth Circuit Court of Appeals has stayed the broad application of a district court decision that would have invalidated a number of preventive care requirements under the Affordable Care Act. As a result, health plans,...more

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