Mary E. Powell

Two Interesting New Rules Regarding Prescription Drugs — What is Really Going On?

MARY E. POWELL, September, 2019    In the last few months, the Internal Revenue Service (IRS) and the U.S. Department of Health and Human Services (HHS) have issued rules that impact the cost that group health plans (GHPs) can charge participants for certain prescription drugs. This article explains those rules and also takes a critical […]

Improper Delegation of Authority Could Cost a Plan its Deferential Standard of Review

 GISUE MEHDI and MARY E. POWELL, December, 2018   The Employee Retirement Income Security Act (ERISA) gives participants and beneficiaries the right to have plan benefit denials reviewed in federal court. The court reviews a plan claims administrator’s benefit denial decision as “de novo” (looking at the facts anew and reaching its own decision, with no […]

Proposed Regulations for Health Reimbursement Arrangements — Impact of the Trump Administration on the Affordable Care Act

MARY E. POWELL, November, 2018    On October 29, 2018, the U.S. Departments of Labor (DOL), Treasury (“Treasury”) and Health and Human Services (HHS) (together, the “Departments”) issued proposed regulations that would allow a health reimbursement arrangement (HRA) to be used for the purchase of individual health insurance coverage and include an “excepted benefit” HRA that […]

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”), […]

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 […]

Qualified Small Employer Health Reimbursement Arrangements Available for Small Employers

ELIZABETH LOH and MARY POWELL, December 2016     On December 13, 2016, the 21st Century Cures Act (“Act”) was enacted. The Act contains a special holiday gift for small employers. The Act allows a small employer to offer “Qualified Small Employer Health Reimbursement Arrangements” (“QSEHRA”) that may be used by eligible employees for the […]

EEOC Issues Final Wellness Rules Under the ADA and GINA

MARY E. POWELL and JENNIFER TRUONG, May 2016 — The Equal Employment Opportunity Commission (“EEOC”) issued final wellness plan rules under Title I of the Americans with Disabilities Act (“ADA”) and Title II of the Genetic Information Nondiscrimination Act (“GINA”) on May 16, 2016. The ADA rule focuses on wellness plan incentives for an employee […]

Understanding How Medicare Coverage Affects HSA Eligibility to Avoid Surprise Tax Penalties

MARY E. POWELL and JENNIFER TRUONG, May 2016 — Health Savings Accounts (“HSA”) are an increasingly popular savings arrangement that allows enrollees to pay for certain out-of-pocket medical expenses on a tax-favored basis. Although there are many rules that govern HSA eligibility and contribution limits, one way an individual loses eligibility to contribute is if […]

IRS Issues New Draft Forms and Instructions for ACA-Required Reporting in 2016

MARY POWELL and ERIC SCHILLINGER, August 2015 — On August 7, 2015, the IRS issued new draft forms and instructions to be used by certain health-coverage providers and employers who are required by the Patient Protection and Affordable Care Act (the “ACA”) to report health coverage offered and provided in the prior calendar year on […]

Opt-Out Payments and Health Coverage Affordability Issues

MARY POWELL and ERIC SCHILLINGER, August 2015 — Beginning this year in 2015, the Patient Protection and Affordable Care Act’s Employer Shared Responsibility Provisions under Internal Revenue Code (“Code”) Section 4980H (often referred to as the “Employer Mandate” or the “Pay-or-Play Rules”) took effect, requiring an “applicable large employer” to either offer certain health coverage […]