news

Policy Alerts

The National Business Group on Health's public policy activities provide members with the latest information and analysis of federal legislative and regulatory developments in health care that impact employers.

The Business Group issues Public Policy Alerts when Congress or the states pass new or major laws, agencies finalize regulations, or the Supreme Court or Federal Appellate Courts issue rulings that significantly affect employers’ health benefits or health care programs. These Alerts describe the key details of the government action, how it may impact employers, and include background information and links to available resources.

Given the level of interest and uncertainty surrounding the actions of the Trump Administration, the Business Group issues Washington Alerts, as developments warrant, to help keep members informed about major new developments that could affect employer-sponsored health benefits and health care delivery.

November 26, 2018
IRS Increases Health FSA Contribution Limit for 2019
Yesterday, the IRS released Revenue Procedure 2018-57, which increases for inflation the voluntary employee health FSA contribution limit to $2,700--a $50 increase over the 2018 limit.
November 26, 2018
IRS Updates PCORTF Fees
In IRS Notice 2018-85, the IRS announced that for plan years ending on or after October 1, 2018 and before October 1, 2019 (i.e., the 2018 plan year for calendar year plans), Patient-Centered Outcomes Research Trust Fund (PCORTF) fees will be $2.45 multiplied by the average number of covered lives.
July 27, 2018
Massachusetts to Require Paid Family and Medical Leave
Massachusetts governor Charlie Baker signed into law a number of new tax and workplace provisions, including a new paid family and medical leave benefit for Massachusetts employees.
June 19, 2018
Michigan to Repeal Health Claims Tax
Recently, Michigan passed legislation repealing its Health Insurance Claims Assessment (HICA). This legislation, which the Business Group supported, should result in cost savings for self-insured plan sponsors with Michigan employees.
May 11, 2018
IRS Issues Inflation-Adjusted HSA/HDHP Amounts for 2019
The IRS Issued Inflation-Adjusted HSA/HDHP Amounts for 2019.
May 4, 2018
Rx Alert: CDC Guidelines on Opioid Prescribing
Learn how to work with your pharmacy vendor(s) to reduce risk of opioid addiction.
May 2, 2018
Paid Sick Leave Laws Enacted in NJ & Austin, TX
Today, New Jersey enacted A1827 that, beginning October 29, 2018, requires employers with employees in the state to provide 1 hour of paid sick leave for every 30 hours worked and preempts local paid sick leave ordinances once effective. Meanwhile, in February, the City of Austin, TX passed an ordinance requiring all employers with employees in the city to provide 1 hour of paid sick leave for every 30 hours worked.
May 2, 2018
Public Policy Alert: HSA/HDHP Update
For the 2018 calendar year, taxpayers can retain the $6,900 family HSA contribution limit.
March 8, 2018
Public Policy Alert: HSA/HDHP Update
Effective for the 2018 calendar year, the family HSA contribution limit is $6,850.
March 5, 2018
Governors Author Bipartisan State Health Reform Blueprint
A handful of governors from both parties issue outline for health coverage expansion as well as payment and delivery reform and provider consolidation.
March 5, 2018
Senate Bill Would Impose 3-Day Limit on Initial Opioid Scripts
A bipartisan group of Senators introduced a bill that would limit first prescriptions for opiods to 3 days.
March 5, 2018
States Sue Again Over ACA Constitutionality
Republican Attorneys General from 20 states sue arguing that eliminating individual mandate penalties voids the entire ACA
January 17, 2018
Maryland to Require Paid Sick Leave
Last week, Maryland's House of Delegates and Senate voted to override the governor's veto of the Maryland Healthy Working Families Act. The law, which requires Maryland employers with 15 or more employees to provide paid sick leave, is slated to become effective February 11, 2018.
January 10, 2018
New Disability Claims Rules to Stay
The DOL issued a news release announcing its decision to retain new claims procedures for disability benefits under ERISA.
January 10, 2018
Public Policy Alert: ACA Employer Reporting Deadline Extended
The IRS issued Notice 2018-06, which extends the due date for furnishing Forms 1095-C (or 1095-B, if applicable) to employees to March 2, 2018.
January 10, 2018
Public Policy Alert: Tax Reform Details ? Health & Welfare Benefits
Congress passed a new tax reform bill (H.R. 1)--the most significant change to the U.S. Tax Code since 1986. This bill will have wide-ranging short and long-term effects on employers and employees alike, including in the area of employee benefits. We summarize the provisions that will be most relevant to health and welfare plan sponsors.
January 12, 2018
What Your CEO Is Reading: Tax Reform
In the final weeks of 2017, Congress passed the new tax reform bill (H.R. 1). As the most significant change to the U.S. Tax Code since 1986, this law will have wide-ranging short and long-term effects on employers and employees alike, including in the area of employee benefits. This article provides an overview of how this new law will affect employer-sponsored group health, leave, and fringe benefits.
December 14, 2017
San Francisco Increases Employer Mandate Amount for 2018
Recently, the San Francisco Board of Supervisors increased the amount that employers must spend on health care in 2018 and made other changes to the Health Care Security Ordinance (HCSO).
November 29, 2017
Details on ACA Employer Mandate Penalties
The IRS issued guidance and forms related to ACA employer shared responsibility payments (often referred to as employer mandate penalties).
November 28, 2017
DOL Delays Disability Claims Rules to 4/1/2018
The DOL issued a final rule delaying applicability of new claims procedures for disability benefits under ERISA to claims filed after April 1, 2018.
October 24, 2017
DOL Proposes Delay of Disability Claims Rules to 4/1/2018
The DOL issued a proposed rule that, if finalized, will delay implementation of new claims procedures for disability benefits under ERISA.
October 13, 2017
Public Policy Alert - IRS Issues 2017 ACA Employer Reporting Forms and Instructions
The IRS issued final forms and instructions for Forms 1094-C and 1095-C, which employers use to fulfill the Affordable Care Act's employer reporting requirements.
September 8, 2017
Leave-Based Donations for Hurricane Harvey Victims
Recently, the Internal Revenue Service issued Notice 2017-48 regarding the tax treatment of leave-based donation programs aiding victims of Hurricane and Tropical Storm Harvey.
July 31, 2017
Senate Vote Early This Morning Scraps Health Care Bill
Senate Republican efforts to pass a health care bill came to a surprise end early this morning as Senator John McCain (R-AZ) voted no on a pared down bill to repeal parts of the ACA.
July 14, 2017
Senate Majority Leader Mitch McConnell (R-KY) Releases Revised Draft of ACA Changes Bill
Earlier today, Senate Majority Leader Mitch McConnell released a revised draft of the Better Care Reconciliation Act that keeps most of the favorable changes to the employer requirements of the ACA (including delaying the ACA's excise tax to 2026 and repealing the employer mandate penalty retroactively to 2016) and also allows for the purchase of insurance premiums with HSAs in certain circumstances.
July 12, 2017
Washington Enacts Paid Parental and Family Leave Law
Recently, Washington Governor Jay Inslee (D) signed a bill that, beginning in 2020, will provide employees with paid parental and medical leave for 12 ? 18 weeks depending on the reason for leave.
July 6, 2017
More Agency Guidance on Mental Health Parity
Recently, the Departments of Labor, Health and Human Services, and the Treasury (the "agencies") issued a new FAQ and draft model form under the Mental Health Parity and Addiction Equity Act (MHPAEA).
May 5, 2017
IRS Issues Inflation-Adjusted HSA Amounts for 2018
Yesterday, the Internal Revenue Service (IRS) issued Revenue Procedure 2017-37, which provides inflation-adjusted amounts for health savings accounts (HSAs) paired with high-deductible health plans (HDHPs).
March 1, 2017
Trump Speech Signals Goals for ACA Replacement
In his first speech to Congress, President Trump laid out the priorities of his Administration in a wide range of areas, including the future of the Affordable Care Act (ACA).
February 16, 2017
Trump Nominates R. Alexander Acosta as Labor Secretary
One day after restaurant executive Andrew Puzder withdrew his name from consideration as Labor Secretary, President Trump announced that R. Alexander Acosta, currently Dean of the Florida International University College of Law, will be the new nominee.
February 16, 2017
Trump Labor Secretary Nominee, Andrew Puzder Withdraws
Late today, President Donald Trump's nominee for Labor Secretary, Andrew Puzder, CEO of CKE Restaurants, owner of Hardee's and Carl's Jr. and other fast food brands, withdrew his name from consideration.
December 9, 2016
Mental Health Disclosure Requirements Added to Law to Speed Drug and Medical Device Approval
Today, the Senate passed and the president is expected to sign the 21st Century Cures Act, which will likely speed up FDA approval of new drugs and medical devices but may also raise health care costs.
November 30, 2016
More Agency Guidance on Mental Health Parity
Recently, the Departments of Labor, Health and Human Services, and the Treasury (the ?agencies?) issued new FAQs on various applications of the Mental Health Parity and Addiction Equity Act (MHPAEA) as well as tobacco cessation benefit coverage.
November 23, 2016
ACA Employer Reporting Deadline Extended
Last week the IRS extended the due date for furnishing Forms 1095-C (or 1095-B, if applicable) to employees to March 2, 2017 (previously January 31, 2017)
December 17, 2014
Marijuana Legalization and the Workplace
Over the last 20 years, 23 states and the District of Columbia have passed laws allowing some form of marijuana use, in most cases for medical uses. For example, Alaska, Oregon, and the District of Columbia recently passed laws allowing for some level of recreational marijuana use; Maryland, Minnesota, and New York recently passed laws allowing or expanding medical use. Meanwhile, federal law still prohibits the possession, sale, and distribution of marijuana, with no exception for medical use, and the U.S. Food and Drug Administration has not approved marijuana as a safe or effective drug for any indication. This conflict between laws may create confusion among employers and employees as they consider their workplace drug and alcohol policies. This Employer Alert provides an overview of current laws and provides tips for large employers as they consider the changing legal landscape surrounding marijuana use and its effect on employees and company policies.
November 8, 2016
IRS Updates PCORTF Fees
Fees increase to $2.26 per covered life for 2016, payable in 2017.
November 8, 2016
Agencies Finalize More Excepted Benefits Rules
Recently, the Internal Revenue Service, Department of Labor, and Department of Health and Human Services (collectively, the Agencies) issued final regulations covering several topics, including supplemental health insurance; travel insurance; and short-term, limited-duration insurance.
November 1, 2016
Michigan Governor Snyder Vetoes Bills that Would Repeal Tax on Paid Health Claims
Late last week, Michigan's Governor Rick Snyder (R) vetoed legislation (S987, S988, S989 and S990) that would have repealed Michigan's Health Insurance Claims Tax (HICA) on paid claims beginning in 2017 and reallocated state funding to support the Medicaid program.
October 10, 2016
IRS Issues 2016 ACA Employer Reporting Forms and Instructions
Recently, the Internal Revenue Service (IRS) issued final forms and instructions for Forms 1094-C and 1095-C, which provide additional guidance on the Affordable Care Act?s employer reporting requirements.
June 23, 2016
Agencies Issue Proposed Rules for Expatriate Health Plans
Recently, federal agencies issued proposed regulations covering various topics, including ACA rules for expatriate and inpatriate health plans; supplemental health insurance; travel insurance; hospital indemnity and fixed indemnity insurance; and short-term, limited-duration insurance.
June 17, 2016
Sample EEOC Wellness Program Notice Available
Yesterday, the Equal Employment Opportunity Commission (EEOC) issued a sample notice and questions and answers regarding the new notice requirements that apply to employer-sponsored wellness programs.
June 3, 2016
More Mental Health Parity Guidance
Recently, the Department of Labor (DOL) issued guidance on the non-quantitative treatment limitation (NQTL) parity requirements under the Mental Health Parity and Addiction Equity Act (MHPAEA).
May 17, 2016
EEOC Finalizes ADA & GINA Wellness Incentive Rules
Recently, the Equal Employment Opportunity Commission (EEOC) issued final regulations that amend current guidance on how the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act apply to employer-sponsored wellness programs.
April 27, 2016
San Francisco Requires Employers to Wrap-Around California?s Parental Leave Beginning in 2017
Under the recently enacted ordinance, employers must pay up to $924 of employees? average weekly wages.
April 12, 2016
More Guidance on Exchange Employer Appeals Process
Recently, federal agencies issued guidance on the Federally-Facilitated Marketplaces? (also known as Exchanges) appeals process for employers that receive notices of employees being eligible for premium tax credits to subsidize Exchange coverage.
April 12, 2016
Agencies Issue Final SBC Template
Recently, federal agencies issue final templates, instructions, and other documents for the summary of benefits and coverage (SBC) and Uniform Glossary of Coverage and Medical Terms.
March 15, 2016
Agencies Issue Guidance on ACA Out-of-Pocket Maximums, SBCs, and Other ACA Topics
Last week, the Department of Health and Human Services (HHS), Internal Revenue Service (IRS), and Department of Labor (DOL) (collectively, the Agencies) issued regulations and FAQs on various Affordable Care Act requirements applicable to employer-sponsored group health plans.
March 1, 2016
U.S. Supreme Court Finds ERISA Preempts Vermont Law in Gobeille v. Liberty Mutual Insurance Co.
Today, the U.S. Supreme Court issued its opinion in Gobeille v. Liberty Mutual Insurance Co., finding that ERISA preempts Vermont?s law requiring insurers and third-party administrators to submit claims data to the state?s all-payer claims database.
February 17, 2016
San Francisco Increases Employer Mandate Amount for 2016
Recently, the San Francisco Board of Supervisors increased the amount that employers must spend on healthcare for 2016 and made other changes to the Health Care Security Ordinance (HCSO).
January 13, 2016
USPSTF Updates Breast Cancer Screening Guidelines
Yesterday, the US Preventive Services Task Force (USPSTF) issued an updated recommendation statement on breast cancer screening, which recommends screening mammography every 2 years for women aged 50-74.
December 21, 2015
Congress Delays the ACA?s Cadillac Tax until 2020
Later today, the President is expected to sign a funding bill that will delay the ACA?s Excise (?Cadillac?) Tax from 2018 to 2020 tax year.
December 2, 2015
DOL Proposes Changes to Disability Claims and Appeals Procedures
Recently, the Department of Labor (DOL) issued proposed amendments to claims procedure regulations governing disability benefits under ERISA that if finalized will substantially change the current rules for disability claims and appeals.
November 3, 2015
Congress Repeals ACA Automatic Enrollment Requirement
Congress included the repeal as part a larger budget bill to avoid a government default today by lifting the debt ceiling until March 2017 and increasing budget spending caps for fiscal years 2016 and 2017.
November 3, 2015
EEOC Proposes to Allow Wellness Incentives under GINA for Spouse Health Risk Assessments and Biometric Screenings
Today, the Equal Employment Opportunity Commission issued proposed regulations that amend current guidance on how the Genetic Information Nondiscrimination Act (GINA) applies to spouse incentives offered through employer-sponsored wellness programs.
October 28, 2015
More Guidance on ACA Preventive Services and Mental Health Parity
The Departments of Labor, Health and Human Services, and Treasury issued a set of frequently asked questions providing additional guidance on the ACA?s preventive services requirements, mental health parity, and other group health plan rules.
September 29, 2015
Federally-Facilitated Exchanges to Begin Notifying Employers of Employees with Premium Tax Credits
CMS issued a set of Frequently Asked Questions announcing that beginning in the spring of 2016, the Federally-Facilitated Marketplace (also known as Exchanges) will begin notifying employers of employees who received premium tax credits subsidizing Exchange coverage.
September 24, 2015
More on ACA Employer Reporting
The IRS issued Notice 2015-68 and final forms and instructions, which provide additional guidance on the Affordable Care Act?s employer reporting requirements
September 2, 2015
IRS Issues Proposed Regulations on ACA Minimum Value
The IRS issued proposed regulations stating that an employer-sponsored plan provides minimum value only if it covers at least 60% of allowed costs and provides ?substantial coverage of inpatient hospital and physician services.?
August 17, 2015
IRS Issues More Guidance on ACA Excise (?Cadillac?) Tax on High Cost Health Coverage
The IRS issued Notice 2015-52, which provides more details on the IRS?s approach to implementing the ACA's excise tax on high cost employer-sponsored health coverage, known as the "Cadillac" tax.
June 29, 2015
U.S. Supreme Court Okays Same-Sex Marriage Nationally
Last Friday, the U.S. Supreme Court issued its decision on Obergefell v. Hodges, deciding that the 14th Amendment requires states to issue marriage licenses to same-sex couples and to recognize same-sex marriages from out-of-state. The ruling has specific implications for health benefits.
June 25, 2015
U.S. Supreme Court Upholds ACA Premium Tax Credits on Federal Exchanges
The U.S. Supreme Court found that individuals who purchase health insurance through federally-facilitated exchanges can continue to receive premium tax credits to subsidize that coverage.
June 2, 2015
Agencies Issue FAQs on Contraceptives and Other ACA Preventive Services
The Departments of Labor, Health and Human Services, and Treasury (the Agencies) issued a set of frequently asked questions (FAQs) that provide additional guidance on the ACA?s requirement that non-grandfathered group health plans cover ?recommended preventive services? without cost-sharing.
May 28, 2015
Departments Confirm ACA Embedded Individual Out-of-Pocket Maximum Applies to Self-Insured Plans and High-Deductible Health Plans
Recently, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury issued a set of frequently asked questions (FAQs) that provides additional guidance on how the ACA out-of-pocket maximum applies to non-grandfathered self-insured and large group health plans.
April 17, 2015
EEOC Issues Proposed Regulations on ADA and Wellness Incentives
The EEOC issued proposed regulations that amend current guidance on how the ADA applies to employer-sponsored wellness programs. If finalized, these regulations will apply to wellness programs that include health risk assessments or biometric screenings, in addition to the current rules under HIPAA.
March 25, 2015
Agencies Issue Final Rules on Limited Wraparound Coverage
The IRS, DOL, and HHS issued final regulations amending the excepted benefits rules to include limited wraparound coverage as an excepted benefit. These regulations allow more flexibility in offering coverage to retirees and part-time employees that supplements individual market coverage, including Exchange coverage.
February 25, 2015
IRS Issues Initial Proposals on Cadillac Tax Implementation
The IRS issued Notice 2015-16, which describes potential approaches to implementing the ACA's excise tax on high cost employer-sponsored health coverage, known as the "Cadillac" tax. This Notice is the first of what is expected to be a series of IRS guidance documents and opportunities to comment before the tax becomes effective in 2018.
February 24, 2015
DOL Finalizes Rules on FMLA and Same-Sex Marriage
Recently, the Department of Labor (DOL) issued final regulations extending Family and Medical Leave Act (FMLA) rights to same-sex spouses nationally, regardless of whether the states where the spouses reside recognize same-sex marriages.
February 20, 2015
IRS Issues More Guidance on Premium Reimbursement & HRAs
The IRS issued Notice 2015-17, which offers additional guidance for employers who wish to offer benefits that supplement Medicare and TRICARE. This guidance is similar to prior agency guidance permitting employers to offer HRAs to active employees and be considered in compliance with the ACA, provided the HRAs are integrated with other health coverage.
February 12, 2015
IRS Issues Final Forms and Instructions for ACA Employer Reporting
The IRS issued final 2014 forms and instructions implementing the ACA?s employer reporting requirements. These forms and instructions will be helpful as employers prepare to furnish statements to employees for the first time by 2/1/2016 and file electronic returns to the IRS for the first time by 3/312016.
November 3, 2014
CMS Delays Health Plan Identifier Requirement
The Centers for Medicare and Medicaid Services announced that it will delay enforcement of the HIPAA health plan identifier (HPID) regulations until further notice.
September 30, 2014
Agencies Finalize Excepted Benefits Regulations
The IRS, DOL, and HHS finalized regulations that amend the excepted benefits rules to: (1) eliminate the requirement that self-insured plans charge an additional participant contribution for limited-scope dental or vision benefits to qualify as excepted benefits; and (2) set standards for employee assistance programs (EAPs) to qualify as excepted benefits.
September 23, 2014
IRS Issues More ACA Guidance on Fees, Full-Time Status
The IRS issued additional guidance on several ACA-related tax rules that apply to plan sponsors and their group health plans, including PCORTF fees, cafeteria plan rules, and employer shared responsibility rules.
July 16, 2014
EEOC Issues Pregnancy Discrimination Act Guidance
The EEOC issued updated guidance on how the Pregnancy Discrimination Act and the Americans with Disabilities Act apply to pregnant workers. Although the PDA and ADA focus primarily on employment discrimination, the new guidance addresses additional topics such as parental leave and protections for nursing mothers.
June 30, 2014
Agencies Finalize ACA Orientation Period Rule
The IRS, DOL, and HHS issued additional final regulations on the ACA?s prohibition on group health plan waiting periods longer than 90 days. Specifically, the regulations address the 1-month orientation period that can apply in addition to a waiting period of up to 90 days.
May 13, 2014
Agencies Issue More ACA FAQs
The Department of Labor, Department of Health and Human Services, and Department of the Treasury (collectively, the Agencies) issued Frequently Asked Questions (FAQs) that provide additional guidance on various Affordable Care Act (ACA) topics, including (1) tobacco cessation as a preventive service, (2) summaries of benefits and coverage (SBCs), and (3) health FSA carryovers.
May 8, 2014
Agencies Update COBRA Guidance
Recently, the Department of Labor, Department of Health and Human Services , and Department of the Treasury issued guidance (1) detailing individuals? special enrollment rights for Exchange coverage, in reference to COBRA, and (2) providing updated COBRA and CHIPRA notices.
March 31, 2014
IRS Issues Guidance on Health FSA Carryovers and HSAs
The Internal Revenue Service?s Office of Chief Counsel issued two memoranda on (1) health flexible spending arrangement (health FSA) carryovers and health savings account (HSA) eligibility and (2) correction procedures for improper health FSA payments
March 11, 2014
IRS Issues Final Regulations on Employer Reporting Requirements under ACA
The IRS issued final regulations implementing the Affordable Care Act?s employer reporting requirements. This reporting, among other things, will allow the IRS to verify employers? liability for employer shared responsibility payments and individuals? eligibility for premium tax credits.
February 12, 2014
IRS Issues Final Regulations on ACA Employer Shared Responsibility Provisions
The Internal Revenue Services (IRS) issued final regulations implementing the Affordable Care Act?s employer shared responsibility provisions (often referred to as the ?employer mandate?). These regulations largely retain the prior proposed rules but do provide some additional flexibility and helpful clarifications for plan sponsors.
January 9, 2014
Agencies Issue FAQs on ACA Out-of-Pocket Maximums and Wellness Program Rules
The DOL, HHS, and Treasury issued FAQs on a number of group health plan topics, including: ACA rules for group health plans? out-of-pocket maximums; wellness program rules; coverage of breast cancer medications as ACA preventive services; fixed indemnity insurance and other supplements to health coverage as excepted benefits; and expatriate health insurance coverage under ACA.
December 18, 2013
IRS Issues Guidance on Cafeteria Plan and HSA Rules for Same-Sex Spouse Benefits
On December 16, 2013, IRS issued Notice 2014-1, which provides additional guidance on the federal tax treatment of same-sex spouse benefits under cafeteria plans and HSAs.
December 2, 2013
IRS Issues Final Regulations on Additional Medicare Tax
The IRS issued final regulations implementing the Additional Medicare Tax, an additional 0.9% in Medicare tax that applies to higher-income individuals beginning with the 2013 tax year.
November 14, 2013
Agencies Issue Final Regulations Implementing Mental Health Parity and Addiction Equity Act of 2008
IRS, DOL, and HHS issued final regulations implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, which provide guidance on coordination with ACA requirements, a general exemption for EAPs from MHPAEA requirements, and acceptable non-quantitative treatment limits, among other topics.
November 4, 2013
IRS Issues Guidance on Health FSA Use-or-Lose Rule
The IRS issued guidance permitting plan sponsors to modify the ?use-or-lose? rule for health FSAs to allow a $500 carryover of unused health FSA funds into the following plan year, provided the health FSA does not also have a 2½ month grace period for incurring and submitting claims the following plan year.
September 19, 2013
HHS Provides HIPAA Model Notice of Privacy Practices
HHS issued a new model Notice of Privacy Practices NPP that group health plans can use in complying with HIPAA requirements.
September 16, 2013
Agencies Issue Guidance on ACA, Health Accounts, and EAPs
The IRS, DOL, and HHS issued guidance clarifying how certain Affordable Care Act provisions apply to HRAs, health FSAs, and employee assistance programs EAPs.
September 10, 2013
IRS Clarifies HSA/HDHP Arrangements Can Cover ACA Recommended Preventive Services without Deductible
The IRS issued Notice 2013-57, which clarifies that a HSA/HDHP arrangement can cover recommended preventive services under the Affordable Care Act without violating HDHP rules.
September 3, 2013
IRS Issues Guidance Recognizing All Legal Same-Sex Marriages for Federal Tax Purposes, Regardless of Domicile
The IRS issued a revenue ruling holding that (1) legally married same-sex couples will be treated as married for federal tax purposes, even if they live in states that do not recognize same-sex marriage and (2) individuals in domestic partnerships, civil unions, or other relationships that are not denominated "marriage" under state law will not be treated as married for federal tax purposes.
July 18, 2013
HHS Issues Final Regulations on Individual and Employer Interactions with Exchanges under ACA
HHS has issued final regulations implementing certain Affordable Care Act provisions related to Affordable Insurance Exchanges, including rules for verifying individuals? access to employer-sponsored coverage.
July 8, 2013
Agencies Issue Guidance on Affordable Care Act?s Individual Mandate, Exchanges, and Contraceptive Coverage
HHS, DOL, and IRS issued guidance implementing a number of ACA provisions, including: final regulations on the ACA?s individual mandate and certain Exchange functions; guidance on reporting related to premium tax credits, guidance on the interaction between employer-sponsored health coverage, government-sponsored health coverage, and the individual mandate; and final regulations on coverage of women?s preventive services.
July 1, 2013
U.S. Supreme Court Rules DOMA Definition of Marriage Unconstitutional
On June 26th, the U.S. Supreme Court issued decisions on two cases related to the legal status of same-sex marriage: U.S. v. Windsor and Hollingsworth v. Perry. Plan sponsors will need to review tax status and benefits administration for same-sex partners.
June 6, 2013
IRS Issues New Form for Patient-Centered Outcomes Research Trust Fund Fees
The IRS has issued a revised form with instructions, for filing and paying Patient-Centered Outcomes Research Trust Fund fees.
May 9, 2013
DOL Issues Model Notice to Employees of Coverage Options Required by Affordable Care Act
The DOL issued guidance and model notices for the Notice to Employees of Coverage Options, which employers must distribute to employees by 10/1/2013. The DOL also issued a revised Model COBRA Continuation Coverage Election Notice that incorporates information about Exchanges.
May 6, 2013
Agencies Issue Additional Guidance on ACA Requirements for Plans and Insurers and Early Retiree Reimbursement Program
HHS, DOL, and Treasury issued Frequently Asked Questions providing additional guidance on several plan and insurer requirements under the Affordable Care Act. CMS also issued guidance for plan sponsors in anticipation of the January 1, 2014 end of the Early Retiree Reimbursement Program.
April 26, 2013
Agencies Issue FAQs on Summary of Benefit and Coverage
HHS, DOL, and Treasury issued Frequently Asked Questions providing guidance on additional Summary of Benefits and Coverage language for the second year of applicability.
March 13, 2013
OPM Issues Final Regulations on Multi-State Plans for Exchanges
Recently, the Office of Personnel Management (OPM) issued final regulations implementing the Multi-State Plan Program (MSPP). These regulations provide a framework for multi-State plans (MSPs), which will become available beginning in 2014 for individuals and certain small employers through state insurance Exchanges.
March 12, 2013
Agencies Issue FAQ on ACA and Expatriate Plans
HHS, DOL, and Treasury issued a Frequently Asked Question providing guidance on how the Affordable Care Act applies to expatriate health plans.
March 5, 2013
HHS Issues Final Regulations on ACA Transitional Reinsurance Program
The Department of Health and Human Services has issued final regulations implementing a number of Affordable Care Act provisions, including those related to the ACA?s transitional reinsurance program. These regulations provide guidance for determining the amount and process for self-insured plans? and insurers? contributions to this program.
February 25, 2013
HHS Issues Final Regulations on Minimum Value, Essential Health Benefits, and Other ACA Rules
HHS issued final regulations implementing a number of Affordable Care Act requirements, including rules for: (1) determining whether employer-sponsored coverage provides ?minimum value? for purposes of the ACA?s employer shared responsibility penalties, (2) cost-sharing limits for group health plans, and (3) the definition of ?essential health benefits.?
February 25, 2013
Agencies Issue FAQs on Out-of-Pocket Maximums and Required Preventive Services under Affordable Care Act
HHS, DOL, and Treasury issued Frequently Asked Questions that provide additional guidance on various Affordable Care Act topics, including more details on compliance with preventive services coverage requirements.
February 12, 2013
HHS Issues Final Regulations under HIPAA, HITECH Act, and GINA
HHS issued final regulations implementing a number of provisions under HIPAA, the HITECH Act, and GINA. This Public Policy Alert summarizes the provisions that most affect group health plans.
February 11, 2013
DOL Issues New FMLA Regulations
The DOL issued final regulations clarifying rules for calculating intermittent or reduced schedule FMLA leave. These regulations also implement FMLA provisions in the National Defense Authorization Act for Fiscal Year 2010 and the Airline Flight Crew Technical Corrections Act.
February 7, 2013
IRS Issues Additional Final Regulations on Premium Tax Credit under Affordable Care Act
The IRS issued final regulations clarifying that for purposes of individuals? eligibility for premium tax credits, affordability of employer-sponsored coverage is based on whether the portion of the annual premium the employee must pay for self-only coverage exceeds 9.5% of household income.
January 29, 2013
Agencies Issue FAQs on Notice to Employees and Other Affordable Care Act Issues
HHS, DOL, and Treasury issued Frequently Asked Questions that provide additional guidance on various Affordable Care Act topics, including a delay of the notice to employees regarding Exchanges until DOL issues regulations.
December 7, 2012
IRS Issues Final Regulations on Patient-Centered Outcomes Research Trust Fund Fees
The Internal Revenue Service released final regulations providing details on the types of group health plans subject to Patient-Centered Outcomes Research Trust Fund fees, how plan sponsors will calculate the fees based on the number of covered lives, and how the IRS will process fee payments. These final regulations confirm most of the rules from the April 2012 proposed regulations but provide some useful clarifications and additional guidance.
IRS Issues Guidance on "Free Rider" Assessment and 90-Day Waiting Period Limitation under ACA
The IRS has released guidance and requests for comment on determining whether employees are full-time for purposes of the "free rider" assessment and the 90-day waiting period limitation under the ACA.
U.S. Supreme Court Decision Rules Affordable Care Act Constitutional
The U.S. Supreme Court upholds all provisions of the Affordable Care Act.
May 31, 2012
IRS Issues Guidance on $2500 Health FSA Limit
The IRS recently released guidance on the Affordable Care Act's $2500 limit on salary reduction contributions to health flexible spending arrangements.
Agencies Issue More Guidance on Summary of Benefits and Coverage under the Affordable Care Act
HHS, DOL, and Treasury have issued additional guidance, in the form of FAQs, on the ACAs Summary of Benefits and Coverage requirements.
April 5, 2012
EEOC Issues Final Regulations on Employers' Defense in ADEA Disparate Impact Claims
The EEOC has released final regulations explaining the "reasonable factors other than age" defense to ADEA disparate impact claims.
April 3, 2012
Federal Trade Commission (FTC) Okays Merger of Express Scripts, Inc. and Medco Health Solutions, Inc
Though the merged company will increase the concentration in the PBM services market, the FTC says it is not likely to decrease competition.
More on HHS's Exchange Regulations under the Affordable Care Act
This Public Policy Alert focuses on HHS's final exchange regulations that set forth minimum standards for establishing and participating in Exchanges and basic standards that employers must meet to participate in the Small Business Health Options Program (SHOP).
Agencies Issue Additional Guidance on Summary of Benefits and Coverage under Affordable Care Act
HHS, DOL, and Treasury have issued additional guidance, in the form of FAQs, on the ACAs Summary of Benefits and Coverage requirements.
HHS Issues Final Regulations Implementing Exchanges under Affordable Care Act
The Department of Health and Human Services (HHS) recently released final regulations implementing Exchanges under the Patient Protection and Affordable Care Act.
February 10, 2012
Federal Agencies Issue Additional Guidance on Employer Free Rider Assessment, 90-Day Waiting Period Limitation, and Automatic Enrollment under Affordable Care Act
HHS, DOL, and Treasury have issued additional guidance on the employer free rider assessment, 90-day waiting period limitation, and automatic enrollment provisions of the Affordable Care Act.
Federal Agencies Issue Final Regulations on Summary of Benefits and Coverage Required under Affordable Care Act
HHS, DOL, and Treasury have issued final regulations, compliance guidance, and templates implementing the Summary of Benefits and Coverage requirement under the Affordable Care Act.
January 13, 2012
HHS Issues Additional Regulations for Retiree Drug Subsidy Program
HHS has issued additional regulations on how employers should report payments to PBMs for purposes of the Retiree Drug Subsidy Program.
IRS Issues Additional Guidance on W-2 Reporting Requirement under the Affordable Care Act
The IRS has issued additional guidance on how employers should report the costs of health coverage on Forms W-2.
January 4, 2012
San Francisco Issues New Guidance on Health Care Security Ordinance
San Francisco's Office of Labor Standards Enforcement has issued guidance on new Health Care Security Ordinance provisions.
December 19, 2011
HHS Guidance Proposes to Let Each State Define Essential Health Benefits
The Department of Health and Human Services (HHS) issued a Bulletin outlining a proposed regulatory approach to defining "essential health benefits" under the Affordable Care Act.
December 12, 2011
Centers for Medicare and Medicaid Services' (CMS) Final Rule Paves the Way for Release of Medicare Claims Data
CMS released a final rule on Medicare claims data sharing that allows qualified entities (employers, data warehouses/integrators, insurers, nonprofit organizations, consumer groups, etc.) to combine Medicare claims data with commercial claims data to evaluate physicians' efficiency and measure their performance on specific quality measures at the individual physician, physician group, or integrated delivery system levels.
October 18, 2011
EEOC Regional Office Raises GINA Concerns for Employers Providing Spouse Incentives to Complete Health Assessments
At least one EEOC regional office has interpreted the Genetic Information Nondiscrimination Act (GINA) as prohibiting an employer from providing an incentive for a spouse to complete a health assessment, but the Business Group disagrees with this interpretation.
CMS Issues Additional Medicare Secondary Payer Guidance on Health Reimbursement Arrangements
Recently, the Centers for Medicare and Medicaid Services issued guidance that eases the Medicare Secondary Payer reporting burden for many health reimbursement arrangements.
August 2, 2011
New Regulations Requiring Coverage of Women's Preventive Services under PPACA
Recently, the Health Resources Services Administration (HRSA) released guidelines that require that non-grandfathered group health plans and insurers cover women's preventive services without cost-sharing under the Patient Protection and Affordable Care Act.
Department of Health and Human Services (HHS) Releases Initial Rules Giving States Flexibility to Establish Insurance Exchanges
The Department of Health and Human Services (HHS) released initial rules which offer the states flexibility in establishing insurance exchanges that includes some important details for employers; however, other details await future guidance.
July 5, 2011
Connecticut Becomes First State to Mandate Paid Sick Leave to Service Employees
Recently, Gov. Dannel P. Malloy (D-CT) signed a law that will require most Connecticut employers with more than 50 employees, except those in manufacturing, to provide paid sick leave to service employees beginning January 1, 2012.
June 24, 2011
Federal Agencies Release Amended Rules and New Guidance for Internal Claims and Appeals and External Review Processes under PPACA
The Internal Revenue Service (IRS), Department of Labor (DoL) and Health and Human Services (HHS) issued an amendment to the interim final regulations and technical release for internal claims and appeals and external review processes.
June 6, 2011
CMS to Release Medicare Claims Data
Recently, the government took the first step toward making Medicare claims data available to employers and consumers by issuing a proposed rule on the release and use of this information.
June 3, 2011
New Medicare Part D Creditable Coverage Notice Requirements and OTC Drug Plan Amendment Deadline
Because the Patient Protection and Affordable Care Act (ACA) changed the Medicare Part D election period to October 15 - December 7, plan sponsors now, beginning in 2011, must provide notices of creditable and non-creditable coverage to Medicare-eligible individuals before October 15th each year. Also, the deadline for adopting Cafeteria Plan Amendments to prohibit reimbursement of over-the-counter drugs is June 30, 2011.
May 13, 2011
Vermont Law Aims to Establish Single-Payer Health Coverage
The law is currently not funded and would require a federal waiver to apply to ERISA plans.
EEOC Issues Final Rule Implementing Americans with Disabilities Act (ADA) Expansion
The U.S. Equal Employment Opportunity Commission (EEOC) released the final rule implementing the Americans with Disabilities Act (ADA) Amendments Act of 2008 (ADAAA) that maintains the definition of disability, but it interprets it more broadly.
IRS Says People May Use Health Accounts to Pay for Breast Pumps and Lactation Supplies
Recently, the IRS announced that people may use their health accounts [flexible spending accounts (FSAs), health reimbursement arrangements (HRAs), or health savings accounts (HSAs)] to pay for breast pumps and lactation supplies.
Internal Revenue Service (IRS) Permits the Use of Health Account Debit Cards for Prescribed Over-the-Counter (OTC) Medicines
The IRS revised recent rules to allow people to continue to use flexible spending account (FSA) and health reimbursement arrangement (HRA) debit cards to purchase prescribed OTC medicines and drugs.
Reminder, Beginning in 2011, Internal Revenue Service (IRS) Rules Restrict the Use of Health Accounts for Over-the-Counter (OTC) Medicines to Those with Prescriptions
Beginning January 1st, 2011 people may use health flexible spending accounts (FSAs), health savings accounts (HSAs), or health reimbursement arrangements (HRAs) to pay for OTC medicines only if they have prescriptions for them.
November 18, 2010
EEOC Issues Final Genetic Information Nondiscrimination Rules for Employers
Recently, the Equal Employment Opportunity Commission (EEOC) issued final regulations under Title II of the of the Genetic Information Nondiscrimination Act of 2008 (GINA)
November 16, 2010
Agencies Modify Regulations on Grandfathered Plans
Recently, the Departments of Labor (DoL), Health and Human Services (HHS), and Treasury (IRS) issued rules that modify the previous regulations on grandfathered plans.
October 19, 2010
Public Policy Alert: The Department of Labor Clarifies More Questions on Health Care Law
The Department of Labor (DoL) responded to a number of questions employers have on the grandfathered plan rules, the conflict between rescissions and COBRA, the preventive benefits requirements for non-grandfathered plans and the treatment of dental and vision plans.
September 21, 2010
Government Provides Some Relief and Added Flexibility on Internal Appeals Changes and Expands External Review
Recently, the Departments of Labor (DoL), Health and Human Services (HHS), and Treasury issued technical guidance in several forms with the goal of easing some of the requirements of the new health care law for health plans, including employer-sponsored health plans.
Internal Revenue Service Releases Guidance on Use of Health Accounts for Over-the-Counter Drugs in 2011
The Internal Revenue Service (IRS) released guidance on the Patient Protection and Affordable Care Act's (Affordable Care Act) provision that revises the definition of qualified "medical expenses" to exclude over-the-counter (OTC) medicines or drugs, unless prescribed by physicians, for employer-provided plans including health flexible spending accounts (FSAs), health reimbursement arrangements (HRAs) or Health Savings Accounts (HSAs).
July 30, 2010
Department of Labor (DoL) Eases Mental Health Parity Compliance Somewhat
The DoL modified the requirements for determining parity in treatment limits and cost-sharing and other financial requirements for outpatient services. Until the government issues final regulations, plans may divide outpatient services (both in- and out-of-network) into 1) office visits and 2) all other outpatient items and services.
July 29, 2010
Department of Labor Issues Fact Sheet on New Break Time Requirements for Nursing Mothers
The Department of Labor (DoL) issued a Fact Sheet providing guidance for employers on the requirements of the Patient Protection and Affordable Care Act's (Affordable Care Act) amendment of the Fair Labor Standards Act (FLSA) that requires employers to provide break times to nursing mothers.
July 15, 2010
Federal Agencies Release Regulations on Health Plan Requirements for Preventive Services
Non-grandfathered plans must cover the preventive services with no cost-sharing.
June 28, 2010
Supreme Court Denies Review of San Francisco's Employer Health Coverage Ordinance
The U.S. Supreme Court recently announced that it will not review the U.S. Ninth Circuit Court of Appeals' decision that San Francisco's "pay or play" ordinance does not violate the Employee Retirement Income Security Act (ERISA).
June 24, 2010
Agencies Release Regulations on Annual and Lifetime Limits and Pre-Existing Conditions Exclusions
The Departments of Labor (DoL), Health and Human Services (HHS), and Treasury (IRS) released regulations on various aspects of the Patient Protection and Affordable Care Act (PPACA) including rules clarifying allowable annual and lifetime limits and prohibited pre-existing conditions exclusions.
Department of Labor (DoL) Clarifies FMLA Eligibility for Employees Taking Leave for Children
Employees may take FMLA leave if they have either day-to-day responsibility for care of children or if they financially support them.
June 14, 2010
Agencies Release Regulations on Grandfathered Plans
The Departments of Labor (DoL), Health and Human Services (HHS), and Treasury (IRS) released regulations earlier today on allowable benefit changes group health plans can make while continuing to maintain their grandfathered plan status.
May 11, 2010
Federal Agencies Release Rules for Extending Dependent Coverage to Age 26
The rules clarify allowable employee contribution differentials for adult dependent coverage, prohibited dependent eligibility criteria and employer notification requirements.
April 9, 2010
Department of Defense Issues Final Rules on Law Prohibiting Employers from Encouraging TRICARE-Eligible Employees to Drop Employer Coverage
The Department of Defense issued final rules on the interaction between employer-sponsored health coverage (for employers with at least 20 employees) and TRICARE.
March 30, 2010
Public Policy Alert - Congress Passes Landmark Health Insurance Changes
The law has both immediate and long-term implications for employer-sponsored group health plans.
February 24, 2010
Department of Labor Introduces New Medicaid and SCHIP Premium Assistance Model Notice
The Department of Labor (DoL) has released a model notice employers can use to notify employees when premium assistance is available through Medicaid and SCHIP in their states of residence. Employers are not required to send notifications to employees if they do not reside in states where premium assistance is available.
Federal Agencies Release Rules for the Mental Health Parity and Addiction Equity Act (MHPAEA)
The Mental Health Parity and Addiction Equity Act (MHPAEA) rules outline how employers can provide benefits at parity for mental health and substance use disorders (MH/SUD) if they offer them.
November 2, 2009
National Defense Authorization Act (NDAA) Expands Military Family FMLA Leave
President Obama recently signed the 2010 National Defense Authorization Act (NDAA) that expands the circumstances under which people can take military family FMLA leave.
HHS Releases Rules for Breaches of Unsecured Protected Health Information
The Department of Health and Human Services (HHS) issues risk assessment, notification and reporting rules for breaches of unsecured protected health information (PHI) and also clarifies the safe harbor to avoid the rules by securing PHI.
The Internal Revenue Service (IRS) Releases Additional Rules on HSA Comparable Contributions
IRS Clarifies Comparable Contribution Rules for Health Savings Accounts (HSAs) and Announces Filing Requirements for Excise Tax Penalties.
HHS Guidance on Acceptable Methods to Secure Personal Health Information (PHI)
HHS publishes guidance, under the new stimulus bill, to assist health plans in securing personal health information and prevent triggering notification requirements for breaches of personal health information.
President to Sign SCHIP Expansion Today
President Barack Obama signed a law to extend and expand the State Children's Health Insurance Program (SCHIP) with implications for employer plan administrators beginning April 1st.
January 22, 2009
CMS Adds to Never Events Policy, Will Stop Paying for Three "Never Events"
Centers for Medicare & Medicaid Services issued three National Coverage Determinations (NCDs) to protect patients from preventable surgical errors.
November 25, 2008
Department of Labor Updates Rules for Family and Medical Leave (FMLA)
The Department of Labor (DoL) recently updated rules on implementing FMLA and issued rules on Military Family Leave
October 17, 2008
New Law Extends Coverage for Certain Dependents
Law requires health plans to cover college students who become seriously ill longer.
October 14, 2008
IRS Finalizes Guidance on FSA and Active Duty Reservists
The IRS recently issued guidance that allows Flexible Spending Account (FSA) plans to distribute unused account balances to military reservists called to active duty.
October 3, 2008
President Signs Law Expanding Coverage of Mental Health and Substance Abuse Treatments
The President signed a law requiring employer group health plans that offer mental health and substance abuse benefits to provide cost-sharing, service limits and out-of-network coverage as good as or better than medical and surgical benefits.
September 30, 2008
9th Circuit Rules On San Francisco's Employer Health Coverage Mandate
Federal Appeals Court Rules that San Francisco's Employer Health Coverage Mandate Does Not Violate ERISA.
September 18, 2008
President Signs Americans with Disabilities Act (ADA) Expansion
The President signs into law the ADA Amendments Act of 2008 that expands the definition of "disability" in ADA claims
IRS HSA Guidance on Worksite Clinics and Other Issues
New IRS guidance on health savings accounts formalizes view that limited care at on-site clinics is ok. The Treasury Department/IRS announces new limits for HSAs in 2009.
June 24, 2008
New Law Allows Distribution of Unused FSA Balances to Active Duty Reservists
New law allows FSA plans to waive "use-it-or-lose-it" rule for military reservists called to active duty for longer than 6 months.
June 20, 2008
Supreme Court Rules that Plan Administrator's Potential Conflict of Interest Is a Factor in Suits Over Benefit Denials
In a 6-3 decision, the US Supreme Court backed a lower court ruling that said that courts should consider a plan administrator's potential conflict of interest when it denies a claim for health or disability benefits if the reviewer has a financial incentive to deny a claim.
SEC Provides Inconsistent Advice on Excluding Health Care Resolutions from Proxy Materials
The SEC has recently sent inconsistent advisory opinions to companies on including resolutions on health care in proxy materials for annual shareholder meetings. The petitions are designed to pressure employers on health reform.
New Jersey Paid FMLA Law
Provides details on employee eligibility and employer requirements.
IRS Rules on HSA Employer Contributions
The Internal Revenue Service (IRS) published final regulations on meeting the employer comparable contributions requirement when employees have either not established their HSA accounts by December 31st or have not notified their employers that they have opened their HSA accounts.
January 10, 2008
San Francisco Employer Health Coverage Mandate Can Go Forward While Court Considers Appeal
Federal appeals court says San Francisco employer health coverage mandate can go forward while court considers appeal. The 9th Circuit expects to rule by fall and hints that it may say that city ordinance does not violate ERISA.
December 27, 2007
EEOC Finalizes Rule on Coordinating Retiree Benefits with Medicare
The Equal Employment Opportunity Commission (EEOC) officially okays employers to coordinate employer-sponsored retiree health benefits with Medicare without violating the Age Discrimination in Employment Act of 1967 (ADEA).
December 18, 2007
Congress Expands Family Leave Related to Military Service
New law expands FMLA for certain employees with family members on active duty, called to active duty, or who are injured and the employees are caregivers.
October 12, 2007
New California Military Spouse Leave Law
New California Law Provides Up to 10 Days of Unpaid Leave for Certain Military Spouses.
Medicare Will No Longer Pay for Some Medical Errors in Hospitals
CMS announced that Medicare will not pay hospitals for the costs of treating 'conditions that could reasonably have been prevented' or 'serious preventable events.' This action could help accelerate our patient safety initiative and other private sector moves.
August 10, 2007
Proposed Cafeteria Plan Rules Affect Health Benefits
Policy Alert - August 10, 2007
July 16, 2007
Medicare Prescription Drug Subsidy Guidance
Policy Alert - July 16, 2007
June 6, 2007
EEOC OK to Exempt Retiree Health Benefits from ADEA
The US Court of Appeals has the legal authority to go ahead with planned regulations exempting employers' coordination of retiree health benefits with Medicare from the Age Discrimination in Employment Act (ADEA). AARP had filed suit to stop the Equal Employment Opportunity Commission (EEOC) from issuing the regulations.
May 22, 2007
Washington Adopts Paid Family Leave Law
Policy Alert - May 22, 2007
IRS and Treasury Issue Guidance on Rollovers from FSAs and HRAs to HSAs
New IRS/Treasury Department guidance provides details to employers on how to amend their health flexible spending account (FSA) and health reimbursement arrangement (HRA) plans to permit a one-time roll over to health savings account (HSA) before 2012.
December 11, 2006
Congress Passes Legislation Enhancing HSAs; President Signs
The Tax Relief and Health Care Act of 2006 includes the following provisions that improve health savings accounts (HSA): increases HSA contribution limits, requires earlier cost of living adjustment for HSA limits and describes rules for HSA coverage during flexible spending account (FSA) 2-1/2 month grace period, contributions for mid-year enrollment, employer contributions for lower paid fees, and rollovers from other accounts to HSAs.
November 13, 2006
6th Circuit Decision Lowers Requirements for EEOC to Bring Successful Discrimination Cases under ADEA
A recent ruling by the Sixth Circuit Court of Appeals lowers the bar for successful disability discrimination cases, making it easier for the Equal Employment Opportunity Commission (EEOC) to bring successful discrimination suits against employers' disability benefits plans under the Age Discrimination in Employment Act (ADEA). Specifically, the court changed the requirements from producing evidence of the intention to discriminate against individuals on the basis of age to only requiring that a policy be written in a discriminatory manner.
October 23, 2006
Provisions in Defense Appropriations Bill May Affect Relationship Between Employer-Sponsored Health Plans and TRICARE-Eligible Employees
The Department of Defense Appropriations Act of 2006 contains provisions affecting the relationship between group health plans and TRICARE, the federal government's health care program for certain active-duty and retired service members and dependents.
Sixth Circuit Holds that Morbid Obesity is Not an ADA Impairment in Most Circumstances
A three-judge panel from the Sixth Circuit Court of Appeals upholds a ruling by a district court that morbid obesity is not an impairment under the Americans with Disabilities Act of 1990 (ADA) if it is not the result of a medical condition.
August 23, 2006
HRA Tax Break Sacrificed if Plan Permits Transfers of Unused Balance Beyond Employee's Spouse or Dependents
Policy Alert - August 23, 2006
August 22, 2006
IRS Clarifies Guidelines on the Use of Debit Cards for FSAs and HRAs and the Submission of Receipt by Employees
Policy Alert - August 22, 2006
August 22, 2006
New Pension Law Makes It Easier to Use Excess Pension Funds for Retiree Health
Policy Alert - August 22, 2006
August 3, 2006
HHS Permits Hospitals and Others to Donate Health Information Technology to Physicians
Policy Alert - August 3, 2006
IRS Finalizes HSA Comparable Contributions Rules
Details of the final rules for employer contributions to employees' health savings accounts (HSAs).
April 21, 2006
CMS Updates Guidance on Notices of Creditable and Non-Creditable Prescription Drug Coverage to Medicare Beneficiaries
Policy Alert - April 21, 2006
April 5, 2006
Massachusetts Law Requires all Residents to Have Health Insurance; Employers Must Offer Coverage or Pay State
The Massachusetts Legislature passed a health care financing reform law that requires all state residents to have health coverage and requires employers to either offer coverage or pay the state.
January 6, 2006
Department of Labor Releases Final Regulations of USERRA, January 6, 2006
Policy Alert - January 6, 2006
Katrina Tax Bill Clarifies that the Same Definition of Dependent Used for Health Plans Applies to HSAs
Congress recently passed a tax bill that includes a provision that exempts Health Savings Accounts (HSAs) from the new (2004) definition of dependent, created by the Working Families Tax Relief Act of 2004.
IRS Issues Guidance on Coordinating HSAs with FSA Two and a Half Month Grace Period
The IRS issued long-awaited guidance that gives employers who have elected to extend employees' health care flexible spending accounts (FSAs) into the next year an option that will not disqualify employees from also contributing to a health savings account (HSA) during the FSA grace period.
October 26, 2005
Federal Trade Commission (FTC) Wins Landmark Hospital Antitrust Case
Policy Alert - October 26, 2005
June 28, 2005
Congress Passes Patient Safety Law
Policy Alert - June 28, 2005
November 4, 2011
CMS Guidance Details How HRAs May Qualify for the Employer Subsidy under the Medicare Prescription Drug Benefit
CMS issued guidance on the treatment of health accounts 1) to qualify for the employer subsidy and 2) to calculate the beneficiary out-of-pocket limits for the catastrophic prescription drug benefit.
CMS Guidance Details How HRAs may Qualify for the Employer Subsidy under the Medicare Prescription Drug Benefit
The Centers for Medicare and Medicaid Services (CMS) issues guidance on the treatment of health accounts 1) to qualify for the employer subsidy and 2) to calculate the beneficiary out-of-pocket limits for the catastrophic prescription drug benefit.
May 19, 2005
IRS Extends FSA Reimbursement for 2.5 Months Beyond End of Year
Policy Alert - May 19, 2005
April 14, 2005
New IRS Guidance Clarifies HSA Eligibility When Spouse Carries Non-High Deductible Family Coverage
Policy Alert - April 14, 2005
CMS Clarifies Actuarial Equivalence Calculation Rules for Employer Subsidy under Medicare Prescription Drug Benefit
The Centers for Medicare and Medicaid Services (CMS) provides employers and retiree plan actuaries with more information on determining whether their retiree prescription drug benefits are at least as valuable as those provided under the Medicare prescription drug benefit.
April 12, 2005
New IRS Guidance Reaffirms That Cash-Out Option Makes HRA Taxable
Policy Alert - April 12, 2005
CMS Issues Third Round of Guidance on Employer Waivers for Medicare Prescription Drug Benefit
The Centers for Medicare and Medicaid Services (CMS) releases its third round of guidance on waivers for retiree prescription drug coverage which provides waivers for Medicare Part D bid submissions, group enrollment and other requirements for employer direct contract plans and group MA-PD and PDP Plans.
March 30, 2005
New Health Coverage Options for Certain Military Reservists, March 30, 2005
Policy Alert - March 30, 2005
CMS Offers More Guidance on Employer Waivers for Medicare Prescription Drug Benefits
The Centers for Medicare and Medicaid Services (CMS) offers additional guidance on employer waivers which provide employers significant flexibility in choosing options for their retiree prescription drug programs.
CMS Guidance on Employer Waivers for Retiree Prescription Drug Coverage
The Centers for Medicare and Medicaid Services (CMS) released initial guidance on waivers for employer-sponsored retiree prescription drug coverage which focuses on an employer's option to provide customized retiree Part D coverage through an MA-PD (a Medicare Advantage plan covering prescription drugs) or PDP plan (a stand-alone prescription drug plan), or by contracting with CMS to become an MA-PD or PDP plan.
March 1, 2012
Final HIPAA Portability Regulations Introduce Certificate and Notice Requirements and Clarify Other Provisions
The final regulations do not differ significantly from the interim final regulations the Departments issued in April 1997. However, they do include clarifications and requirements that affect employers? plan administration.
CMS Issues Rules for Implementing Prescription Drug Benefit
The Centers for Medicare and Medicaid Services (CMS) issues final regulations for implementing the new Medicare prescription drug benefit which provides new details on determination of actuarial equivalence, employer subsidy and employer requirements regarding creditable coverage.
March 25, 2014
Law Expands Military Reservists? Options for Continued Health Coverage and Introduces Employer Notice Requirement
The Act contains changes in military reservists? options for continued health coverage and a notice requirement for employers.
December 15, 2004
New Law Expands Military Reservist's Options for Continued Health Coverage
The Veterans' Benefits Improvement Act contains changes in military reservists' options for continued health coverage and a new notice requirement for employers.
November 2, 2004
New Tax Law Changes Definition of Dependent and May Affect the Taxation of Certain Dependent Health Benefits
Policy Alert - November 22, 2004
July 27, 2004
Treasury Department and IRS Release Final Guidance on Health Savings Accounts (HSAs)
Policy Alert - July 27, 2004
Supreme Court Rules that ERISA Broadly Preempts State Liability Laws
The US Supreme Court rules unanimously that two separate cases against health plans, initially brought to state courts in Texas, fall under ERISA and should be heard in federal courts.
June 3, 2004
Final Guideline on Accounting and Disclosure Requirements for the New Medicare Law for Retiree Health Plans Released by the Federal Accounting Standards Board (FASB)
Policy Alert - June 3, 2004
May 14, 2004
Treasury Department and IRS Issue Guidance on Coordination of Health Savings Accounts (HSAs) with Other Health Accounts
Policy Alert - May 14, 2004
April 23, 2004
EEOC Rules that Coordinating Retiree Benefit Plans with Medicare Benefits Does Not Violate ADEA
The Equal Employment Opportunity Commission (EEOC) issued a regulation officially stating that employers' common practice of coordinating retiree health benefits with Medicare-reducing benefits upon Medicare eligibility-does not violate the Age Discrimination in Employment Act (ADEA).
April 15, 2004
Department of Labor Says HSAs are Generally Exempt from ERISA
Policy Alert - April 15, 2004
Treasury Department and IRS Issue Additional Guidance on Health Savings Accounts (HSAs)
This second set of guidance on Health Savings Accounts (HSAs) covers preventive care, prescription drug coverage, and special circumstances for HSAs opened in 2005.
February 25, 2004
Supreme Court Rules That ADEA Does Not Cover Reverse Age Discrimination
The Supreme Court ruled that the Age Discrimination in Employment Act (ADEA) does not protect younger workers from company benefit changes that favor older workers.
Initial IRS Guidance on Health Savings Accounts Released
This first round IRS guidance, released last month, provides general information and primarily covers the non-controversial aspects of HSAs.
December 4, 2003
Just-Passed Medicare Law Creates New Tax Favored Health Accounts Beginning
Policy Alert - December 4, 2003
Recent Supreme Court Decision Clarifies Rules for Disability Determinations under ERISA
The Supreme Court rules that an ERISA plan administrator's physician has the final word in plan disability determinations.
February 3, 2003
Military Reservists and Health Benefits: What You Need to Know
Guidance for employers on requirements for health benefits for military reservists and their dependents based on the 1994 Uniformed Services Employment and Reemployment Rights Act (USERRA).
August 14, 2002
Clarification of IRS Rules on Tax Deductibility of Weight Loss Programs and Health Club Fees for Obesity
Policy Alert - August 14, 2002
June 25, 2002
IRS Rules Favorably on Employer-Paid Health Care Accounts
Policy Alert - June 25, 2002
Divided Supreme Court Rules That State Independent Review Laws Apply to Insured ERISA Health Benefits Plans
The Supreme Court rules in a 5-4 decision that ERISA does not exempt employer-sponsored insured health plans from state independent review laws dealing with plan determinations of medical necessity.
Supreme Court Ruling Limits ADA when Workers Health & Safety in Question
The US Supreme Court rules that the Americans with Disabilities Act (ADA) does not require employers to hire workers with serious illnesses for positions that might jeopardize their health.
LinkedIn Twitter