Defending HIMP-1 Claims in New York
The No Surprises Act: A Cost Saving Opportunity for Employer Plan Sponsors
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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