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Employee Retirement Income Security Act (ERISA)



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Comments to NJ Dept. of Banking & Insurance in Response to an Advanced Notice for Implementing the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act
The National Business Group on Health urges the New Jersey Department of Banking & Insurance to take into account the legal and administrative concerns of self-insured group health plans.
Sep 4, 2018
Comment Letter to DOL, HHS, and IRS on MHPAEA Guidance
The Business Group, in response to the agencies' request for comments, recommended that future MHPAEA guidance clarify plan sponsor obligations for parity analysis.
Jun 22, 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.
Jan 8, 2018
Comments to DOL on Disability Claims Procedure Regulations
The Business Group, in response to the DOL's proposed rule, submitted comments recommending that the agency rescind its 2016 disability claims procedure regulations.
Dec 14, 2017
Joint Letter to Senate HELP Chair Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) Urging Maintaining ERISA Preemption of State Innovation Waivers
The National Business Group on Health sent a joint letter to Senate HELP Committee leadership urging preservation of ERISA preemption of state innovation waivers.
Dec 5, 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.
Nov 28, 2017
Comments to DOL on Proposed Delay of Disability Claims Procedure Regulations
The Business Group, in response to the DOL's proposed rule, submitted comments supporting delayed implementation of the agency's new disability claims procedure regulations and efforts to solicit additional public input.
Oct 27, 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.
Oct 24, 2017
Testimony to the Department of Labor on Reducing the Burden and Increasing the Effectiveness of Mandated ERISA Disclosures
The National Business Group on Health testified to the ERISA Advisory Council on ways to reduce the burden and increase the effectiveness of mandated disclosures from employer-sponsored group health plans.
Aug 24, 2017
State Vaccine Assessments and Other Fees on Employer Plans
This chart tracks states that have enacted vaccine assessments or other fees on employer plans.
May 12, 2017
Outsourcing ERISA Group Health Plan Appeals
The purpose of this survey is to determine whether employers outsource ERISA group health plan appeals and if so, who they partner with.
Jan 17, 2017
National Business Group on Health's Position Statement on Preserving ERISA
National Business Group on Health's position on preserving ERISA in order to support efficient plan administration and allow plan sponsors to devote more resources to employee compensation and benefits.
Jan 7, 2017
Comments to DOL, IRS, and PBGC on Proposed Revisions to Form 5500
The Business Group, in response to proposed regulations regarding revisions to Form 5500, submitted comments encouraging agencies to maintain compliance flexibility for employer-sponsored group health plans.
Dec 5, 2016
Comments to U.S. Department of Labor Requesting an Extension of the Comment Period and a Public Hearing on Changes to Form 5500
The Business Group, in response to the Department of Labor's request for comments regarding proposed changes to Form 5500 and implementing regulations, requested an extension of the comment period and public hearing.
Sep 19, 2016
Public Policy Webinar: Regulatory Update on Reporting Rules for Employers
During this webinar, we provide an overview of upcoming reporting changes for group health plans, including proposed Form 5500 changes, ACA employer reporting, and other regulatory topics.
Aug 26, 2016
Appellate Court Okays Michigan’s Claims Tax Again to Dismay of Employers
The Sixth Circuit recently ruled again that ERISA does not preempt a Michigan law imposing a 1% tax on paid health claims to fund its Medicaid program.
Jul 28, 2016
Joint Letter to House Budget, Education and Workforce, Energy and Commerce and Ways and Means Chairmen Urging Their Support for Strengthening the Employer-Sponsored Health Care System
As the House considers health care reform alternatives, the National Business Group on Health sent a joint letter to House Committee Chairmen (Tom Price, John Kline, Fred Upton, and Kevin Brady) expressing support for employer-sponsored coverage in America and the federal Employee Retirement Income Security Act (ERISA) law that protects and enables coverage.
Mar 18, 2016
Supreme Court Orders Circuit Court to Review Its Decision that ERISA Does Not Preempt Michigan’s Claims Tax
The Supreme Court recently ordered the Sixth Circuit Court of Appeals to reconsider its decision that ERISA does not preempt a Michigan law that imposes a 1% tax on paid health care claims to fund its Medicaid program in light of its recent ERISA preemption (6 – 2) decision.
Mar 15, 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.
Mar 1, 2016
Comments to DOL on Claims Procedure Regulation Amendment for Plans Providing Disability Benefits
The Business Group, in response to the DOL's notice of proposed rulemaking regarding disability claims procedures, submitted comments encouraging the DOL to retain the current regulations.
Jan 19, 2016
ACA Key Plan Effective Dates for 2013-2018
This chart summarizes Affordable Care Act compliance deadlines applicable to group health plans for 2013-2018.
Aug 21, 2015
Supreme Court to Hear Case on Whether State Can Force Employer to Turn Over Claims Data
Recently, the U.S. Supreme Court decided to take up a case between Vermont and a self-funded employer plan over claims data.
Jun 30, 2015
Letter to the Mayor of San Francisco Requesting that the City Repeal the Employer Mandate Provisions of the Health Care Security Ordinance
The National Business Group on Health sent a letter to San Francisco Mayor Edwin M. Lee requesting that the city repeal the employer mandate provisions of the Health Care Security Ordinance. While the Business Group supports efforts to increase the number of people insured, we believe that the city can do so without taxing employer plans.
Aug 5, 2014
Final Mental Health Parity Rules: What's Changed and What's the Same
During this webinar, we provide an overview of the new regulations under the Mental Health Parity and Addiction Equity Act and how they apply to group health plans.
Nov 22, 2013
Group Health Plan Federal Legal Compliance: A Resource for Members of the National Business Group on Health
This slide deck provides an overview of basic legal compliance requirements under federal law for self-insured group health plans.
Feb 28, 2013
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.
Feb 10, 2012
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.
Dec 19, 2011
External Review Checklist: Contract and Administration Issues Related to Independent Review Organizations (IROs)
This document provides a checklist of issues for plans to consider when contracting and working with IROs.
Nov 10, 2011
Summary Plan Description (SPD) Checklist: Internal Claims and Appeals and External Review
This document provides a checklist of provisions to include and issues to consider when amending SPDs to include internal claims and appeals and external review requirements under the Affordable Care Act.
Nov 10, 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.
Jun 24, 2011
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).
Jun 28, 2010
Joint Letter to the Solicitor General in Support of U.S. Supreme Court Review of the Ninth Circuit's Decision in Golden Gate Restaurant Association v. City of San Francisco
The National Business Group on Health and The ERISA Industry Committee sent a joint letter to the Solicitor General to ask that the U.S. Supreme Court grant the petition in order to address the issue of ERISA preemption raised by the Ninth Circuit's decision in Golden Gate Restaurant Association v. City of San Francisco.
Nov 10, 2009
Joint Friend of the Court (Amicus) Brief to the U.S. Supreme Court Supporting Its Review of ERISA Preemption of San Francisco Health Reform Ordinance
The National Business Group on Health and the ERISA Industry Committee submitted a Friend of the Court legal brief to the U.S. Supreme Court supporting the petition for judicial review of ERISA Preemption of San Francisco Health Reform Ordinance.
Jul 13, 2009
Joint Friend of the Court (Amicus) Brief in Support of ERISA Preemption of San Francisco Health Reform Ordinance
Friend of the Court legal brief submitted to the Ninth U.S. Circuit Court of Appeals supporting ERISA Preemption of San Francisco Health Reform Ordinance
Oct 31, 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.
Sep 30, 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.
Jun 20, 2008
Joint Friend of the Court (Amicus) Brief Opposing Employer Mandates in San Francisco's Health Care Ordinance
Friend of the Court legal brief submitted to the Ninth U.S. Circuit Court of Appeals in support of the lower federal district court ruling that found that the employer "pay or play" mandate in San Francisco's universal health care plan violated the Employee Retirement Income Security Act of 1974 (ERISA).
Mar 28, 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.
Jan 10, 2008
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.
Jun 21, 2004
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.
Jun 30, 2003
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.
Jun 20, 2002

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