News & Analysis as of

Medicare Health Insurance Employee Benefits

J.S. Held

All Is Not What It Seems, Or When Is A Dollar A Dime?

J.S. Held on

Welcome to the strange and mysterious world of medical billing. If ever there was an industry in which the charges and the payments have no correlation, the medical industry is it. Medical billing can indeed be quite...more

Weber Gallagher Simpson Stapleton Fires &...

I’m Getting Divorced. What Happens to My Health Insurance?

One of the biggest issues in this country is healthcare. Specifically, the cost and payment for healthcare and directly related to that, health insurance. Under most family situations at least one family member works for an...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

McDermott Will & Schulte

How PPM Health Plans Can Solve the MEWA Problem

While a physician practice management (PPM) structure allows for compliance with corporate practice of medicine laws and ease of administration, it often creates inadvertent health plan issues that should be navigated...more

Maynard Nexsen

Second Trump Administration in the Health and Welfare Space: What’s to Come

Maynard Nexsen on

In the first month of the second Trump presidency, the administration has focused on several executive orders and policy changes that may have significant implications for employer health and welfare plans. In a sweeping...more

Woodruff Sawyer

Reminder: RxDC Reporting Due June 1st

Woodruff Sawyer on

With the 2024 reference year RxDC reporting deadline approaching in June, plan sponsors should re-familiarize themselves with the reporting requirements. The 2024 reference year RxDC Reporting Instructions have been released,...more

Morgan Lewis - ML Benefits

Medicare Part D Creditable Coverage Online Disclosure Due March 1

Each year, employers that provide prescription drug coverage to Medicare-eligible individuals through a group health plan must complete a two-step process regarding the prescription drug coverage they offer to active...more

Ballard Spahr LLP

Final Section 1557 Rules: Highlights for Health Plan Sponsors

Ballard Spahr LLP on

The U.S. Department of Health and Human Services (HHS) has issued final regulations on the nondiscrimination rules set forth in Section 1557 of the Affordable Care Act. The new rules apply to certain group health plans, as...more

McDermott Will & Schulte

The ACA 1557 Final Regulations: Plans and Plan Sponsors as Covered Entities

In a recent On the Subject (available here), we reported on the impact of the final rule (final rule) interpreting Section 1557 of the Affordable Care Act (ACA) on self-funded group health plans that contract with licensed...more

Hall Benefits Law

Health Care Stakeholders Support Passage of The Value in Health Care Act

Hall Benefits Law on

Seventeen healthcare stakeholder groups have come together to support The Value in Health Care Act, a bill that a bipartisan coalition reintroduced in Congress this summer. The bill supports a shift in the medical care...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

Groom Law Group, Chartered

CAA 2023 Includes HSA Telehealth Relief, MHPAEA, Medicare, and Medicaid Changes

Last week the Senate passed the Continuing Appropriations Act, 2023 (“CAA23”).  The House of Representatives will likely consider the measure today, and President Biden is expected to sign the bipartisan measure into law...more

Venable LLP

REMINDER: October 15 Is the Deadline for Prescription Drug Notices and the Extended Deadline for Form 5500s

Venable LLP on

Does your company's health plan provide prescription drug coverage? If so, you have until October 15, 2022 to send a notice to individuals who are enrolled in Medicare Part A or Part B and are eligible for the company's...more

Smith Anderson

ARPA COBRA Subsidy's Impact on Employer Health Plans

Smith Anderson on

The American Rescue Plan Act of 2021 (ARPA) provides temporary COBRA continuation coverage premium assistance for certain eligible qualified beneficiaries. On April 7, 2021, the Department of Labor issued a FAQ and model...more

McDermott Will & Schulte

American Rescue Plan Act of 2021: Key Healthcare Provisions

On March 10, 2021, US Congress finalized and passed the American Rescue Plan of 2021 (ARPA), the latest COVID-19 relief package that largely tracks President Joe Biden’s initial $1.9 trillion proposal. The ARPA extends...more

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

New COVID-19 Relief Law Includes Full COBRA Premium Subsidy

The American Rescue Plan Act of 2021 (ARPA), which became law on March 11, 2021, provides a 100 percent subsidy of premiums under the Consolidated Omnibus Budget Reconciliation Act (COBRA) beginning on April 1, 2021, through...more

Patrick Malone & Associates P.C. | DC Injury...

The health insurance mess: Worker costs jump anew, as kids’ coverage falls

The Covid-19 pandemic has forced many Americans to reconsider their transportation options, what with fears of infection and the slashing of public transit systems’ routes and schedules. That has made used cars, motorcycles,...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: New York Court Rejects Claim that Health Insurer Violated the Parity Act

In Julie L. v. Excellus Health Plan, Inc., 2020 U.S. Dist. LEXIS 47734 (W.D.N.Y. March 19, 2020), a New York district court rejected the plaintiff's claims that a health insurer improperly imposed stricter medical necessity...more

Perkins Coie

US Department of Labor Issues Updated COBRA Model Notices and Related FAQS

Perkins Coie on

The U.S. Department of Labor (DOL) issued revised model general and election notices on Friday, May 1, 2020. The notices can be used by plan administrators to address the notification requirements imposed by the Consolidated...more

Littler

DOL Releases New Model COBRA Notices Amid Continued Wave of Litigation

Littler on

On May 1, 2020, the Department of Labor released new versions of its model COBRA notices, adding a new action item for employers facing a contracting workforce and a growing wave of participant litigation....more

Brownstein Hyatt Farber Schreck

Health Plan Coverage of Coronavirus Testing and Treatment

With the news about the spread of the 2019 novel coronavirus (“COVID-19”) in the U.S. and the world rapidly evolving, group health plan sponsors need to address how the plan will provide virus-related benefits. ...more

Seyfarth Shaw LLP

Deadline is Approaching for Group Health Plan Service Agreement Updates

Seyfarth Shaw LLP on

Seyfarth Synopsis: Recent changes to the federal rules governing confidentiality of substance use disorder (SUD) patient records may require updates to agreements between group health plans and their third-party vendors....more

Carlton Fields

Retiree Medical Not Restricted by Medicare Secondary Payer Rules

Carlton Fields on

This article should interest employers who are offering or thinking about offering retiree medical coverage and should especially interest local governmental entities that are required to offer retiree medical coverage under...more

Ballard Spahr LLP

Bipartisan Budget Act of 2018 Enacts Changes to Employee Retirement and Health Benefit Plans, and Medicare

Ballard Spahr LLP on

Following a brief shutdown of the federal government, on February 9, Congress passed and President Donald J. Trump signed into law the Bipartisan Budget Act of 2018 (Budget Act), which provides Congress until March 23 to...more

Chambliss, Bahner & Stophel, P.C.

How Medicare and Employer Coverage Coordinate

Medicare benefits start at age 65, but many people continue working past that age, either by choice or need. It is important to understand how Medicare and employer coverage work together....more

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