Health and Welfare Plans

Due Date for Providing ACA Coverage Forms to Employees/Participants Extended from January 31, 2018 to March 2, 2018

TIFFANY N. SANTOS, December, 2017 Just before the start of the new year, the IRS issued Notice 2018-06, automatically extending to March 2, 2018 the due date for applicable large employers (generally those with 50 or more full-time employees) to furnish the Form 1095-C to full-time employees (pursuant to Section 6056 of the Internal Revenue […]

Compliance Alert: Disaster Relief Guidance for Health Plans

GISUE MEHDI, November 2017 Since August, Hurricane Harvey hit Texas and Louisiana, followed by Irma in Florida and the Caribbean, and Hurricane Maria in Puerto Rico. In addition to the human tragedy, these hurricanes have caused significant disruptions to employer-sponsored health and welfare plans in the impacted regions. Employers will face challenges reaching and tracking […]

The Revolution of Employer-Sponsored Health Insurance

ERIC SCHILLINGER, October 2017   As published by Law360.com on October 19, 2017. On Oct. 12 President Donald Trump issued an executive order regarding the federal laws governing health care and insurance. The executive order itself does not change the existing rules. Rather, it instructs the applicable federal agencies — the U.S. Departments of Treasury, Labor, […]

2018 Annual Open Enrollment Is Here – Are Your Health and Welfare Plans Ready?

TIFFANY N. SANTOS, August 2017   It’s that time of year again for employers and plan sponsors with calendar-year plans — time for annual open enrollment. Here are some items plan sponsors and plan administrators may wish to consider as they prepare amendments and enrollment materials to comply with applicable legal or regulatory requirements for the […]

Does the Trump Administration Control the Fate of the ACA?

MARY POWELL, August 2017   On August 16th, the U.S. Department of Health and Human Services (“HHS”) announced that it would make September cost-sharing reduction payments (“CSR Payments”) to health insurance carriers that offer eligible plans on the public insurance exchanges. CSR Payments are a key component of the Patient Protection and Affordable Care Act (“ACA”), […]

Breaking Down The Graham-Cassidy ACA-Replacement Proposal

ERIC SCHILLINGER, August 2017    Originally published by Law360.com on August 4, 2017.    In the early hours of Friday, July 28, Republican-led efforts to repeal and replace the Patient Protection and Affordable Care Act were rebuffed on the Senate floor. By roughly 1:40 a.m., three Republican Senators — Susan Collins, R-Maine, Lisa Murkowski, R-Alaska, […]

Potential Impact of Senate Health Care Bill: A Closer Look

ERIC SCHILLINGER, June 2017    Originally published by Law360.com on June 28, 2017.    On June 22, 2017, Senate Republicans unveiled a “discussion draft” of the Better Care Reconciliation Act of 2017 (BCRA), a bill that seeks to repeal, replace, revise or delay many of the federal health care laws enacted in 2010 by the […]

The Senate Takes a Crack at a Healthcare Reform Replacement Bill

MARY POWELL, June 2017    On June 22, 2017, Senator Mitch McConnell released a draft of the Better Care Reconciliation Act (“BCRA”), which is the Senate’s version of a replacement bill of the Patient Protection and Affordable Care Act (“ACA”). An amended version of the BCRA was released on June 26, 2017. Process A Senate […]

ACA Replacement Clears Its First Hurdle: An Analysis of What’s Next (Trucker Huss Webinar on May 24)

ERIC SCHILLINGER, May 2017    On Thursday, May 4, the House of Representatives narrowly passed the American Health Care Act (AHCA), a budget reconciliation bill that would repeal and replace many provisions in the Patient Protection and Affordable Care Act (ACA) that relate to the individual insurance market, Medicaid and employer-sponsored group health plans (GHPs). […]

When Close Is Not Good Enough: A Shift Towards Strict Compliance for ERISA Claim Procedures

JENNIFER TRUONG, March 2017    A string of cases in the Second Circuit Court of Appeals is putting ERISA claims administrators on notice that falling short of strict compliance with the Department of Labor’s (DOL’s) claims and appeal regulations may cost administrators a deferential standard of review. And, this shift towards “strict compliance” is not […]

ACA Update: Major Changes for Employers Still Possible This Year — An In-Depth Look at What’s at Stake

ERIC SCHILLINGER, March 2017    On Friday, March 24th, Speaker Paul Ryan cancelled a House of Representatives vote scheduled for that day on the American Health Care Act (AHCA), a bill that proposed to repeal, replace and revise various tax- and spending-related aspects of the Patient Protection and Affordable Care Act (ACA). As explained in […]

Examining the House ACA-Repeal Bill’s Potential Impact on Employers and Other Sponsors of Group Health Plans

ERIC SCHILLINGER, March 2017    On Monday, March 6, the House Ways and Means Committee and Energy and Commerce Committee each released formal proposals partially repealing and replacing the Patient Protection and Affordable Care Act (the “ACA”). Signed into law in 2010 by then-President Barack Obama, the ACA significantly changed the federal laws governing health […]

The State of Wellness Programs

JENNIFER A. MATTHEWS, February 2017    When the Equal Employment Opportunity Commission (“EEOC”) issued its recent final wellness plan rules under the Americans with Disabilities Act (“ADA”) and the Genetic Information Nondiscrimination Act (“GINA”), it was attempting to clarify previous rules and interpretive guidance. And clarification was needed. Even the best-intentioned employers were sometimes unsure […]

DOL Finalizes Disability Benefit Plan Claims Regulations

TIFFANY N. SANTOS, December 2016   On December 19, 2016, the Department of Labor finalized the regulations governing disability benefit claims (see https://www.gpo.gov/fdsys/pkg/FR-2016-12-19/pdf/2016-30070.pdf). Intended “to promote fairness and accuracy in the claims review process and protect participants and beneficiaries in ERISA-covered disability plans,” the regulations for the most part adopt the rules proposed in November […]

Repeal and Replace — What Health Reform Law Changes Might Be in Store for Employer-Sponsored Group Health Plans Under the Trump Administration

ERIC J. SCHILLINGER, November 2016   President-elect Donald Trump and the Republican Party, which retained its House and Senate majorities during the November 8th election, have made no secret of their desire to “repeal and replace” the Patient Protection and Affordable Care Act (the “ACA”). The ACA, passed in 2010 by a then-Democratic controlled Congress […]

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