By Brian M. Pinheiro and Edward I. Leeds on Posted in COBRAThe IRS (with the concurrence of the DOL and HHS) has issued new guidance explaining how the extension of the deadline for paying COBRA premiums will be applied. The extension of deadlines for individuals to elect COBRA and pay for COBRA premiums on account of the COVID-19 pandemic remains in effect. These rules operate by [&hellip… Continue Reading »
By Edward I. Leeds and Brian M. Pinheiro on Posted in COBRAThe United States Department of Labor has issued much anticipated guidance and model forms under the COBRA subsidy rules introduced by the American Rescue Plan (ARP). The FAQ guidance and forms clarify some issues that employers have raised about the COBRA subsidy provisions of the ARP, but leave a number of the most significant questions unanswered. Clarifications and confirmations [&hellip… Continue Reading »
By Edward I. Leeds, Brian M. Pinheiro, Brian D. Pedrow and John Devine on Posted in Healthcare,LegislationPresident Trump signed additional COVID-19 relief legislation (H.R. 133) into law on December 27, 2020. The deal includes a $900 billion economic stimulus package that will provide relief benefits to businesses and individuals impacted by the COVID-19 pandemic. The following is a summary of some of the provisions that will have a major impact: Financial [&hellip… Continue Reading »
By Edward I. Leeds and Brian M. Pinheiro on Posted in Health Plans,Healthcare Providers / Suppliers,LegislationSummary The U.S. Supreme Court unanimously upheld an Arkansas statute that regulates the price that pharmacy benefit managers (PBMs) pay retail pharmacies for prescription drugs. The Upshot Act 900 in Arkansas regulates the price paid by PBMs for the cost of drugs purchased at retail pharmacies through mechanisms designed to ensure that the pharmacy would [&hellip… Continue Reading »
By Brian M. Pinheiro, Edward I. Leeds and Paige A. Haughton on Posted in Healthcare,Legislation,Non-discrimination RulesThe U.S. District Court for the Eastern District of New York issued an order on Monday (August 17, 2020) that prevented federal rules removing nondiscrimination protections from taking effect. The rules would have removed protections against discrimination based on gender identity and sex stereotyping from the nondiscrimination provision within the Patient Protection and Affordable Care Act (ACA). [&hellip… Continue Reading »
By Edward I. Leeds and Brian M. Pinheiro on Posted in Health Plans,Healthcare Providers / Suppliers,NondiscriminationThe Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) has finalized rules that narrow and eliminate various nondiscrimination requirements under Section 1557 of the Affordable Care Act (Act). Section 1557 prohibits certain health care providers, health benefit plans, and health insurers from discriminating against individuals on account [&hellip… Continue Reading »
By Brian M. Pinheiro on Posted in Individual Coverage Mandate,LegislationThe Tax Cuts and Jobs Act, signed into law by President Donald J. Trump shortly before Christmas, is the most significant tax reform legislation in more than 30 years. While early versions of the legislation would have made sweeping changes to employee benefit plans and executive compensation arrangements, the final Act has a narrower, though [&hellip… Continue Reading »
By Jean C. Hemphill, Brian M. Pinheiro, Brenda M. Ching and Edward I. Leeds on Posted in Health Plans,Healthcare Providers / Suppliers,LegislationThe House Ways and Means and Energy and Commerce Committees have released, in two parts, budget reconciliation legislation, the first steps of Congress’ proposal to “repeal and replace” the Affordable Care Act. Reconciliation legislation is limited to budget-related provisions and restricts legislators’ ability to address fully all of the repeal and replacement provisions that we [&hellip… Continue Reading »
By Kurt R. Anderson, Edward I. Leeds and Brian M. Pinheiro on Posted in Cadillac Tax,Taxes and FeesThe Internal Revenue Service has issued a new notice addressing issues relating to future rules governing the calculation and payment of the so-called “Cadillac tax” under the Affordable Care Act. Beginning in 2018, the ACA will impose a 40 percent nondeductible excise tax on the value of group health coverage that exceeds a baseline amount [&hellip… Continue Reading »
By Edward I. Leeds, Brian M. Pinheiro, Jean C. Hemphill and Diane A. Thompson on Posted in Employer Responsibilities,ReportingThe Internal Revenue Service has issued two lengthy sets of questions and answers on the requirement under the Affordable Care Act that employers report on their compliance with the employer mandate and employees’ qualification for exchange subsidies. The new guidance is divided into general information about the reporting rules and information about completing the actual [&hellip… Continue Reading »
By Brian M. Pinheiro, Edward I. Leeds, Brian D. Pedrow and Daniel V. Johns on Posted in Cadillac Tax,Taxes and FeesYesterday, the Internal Revenue Service issued preliminary but much-anticipated guidance on the so-called Cadillac tax imposed by the Affordable Care Act (ACA). The new notice offers very few concrete answers to employer questions about how the tax is to be calculated. Mostly, the IRS identifies issues that may be the subject of future proposed regulations, [&hellip… Continue Reading »
By Jean C. Hemphill, Diane A. Thompson, Brian M. Pinheiro, Edward I. Leeds and Alisa M. Huth on Posted in LitigationDoes the Affordable Care Act (ACA) authorize the payment of premium and copayment subsidies, or “premium assistance subsidies,” to individuals enrolled in a federally established Exchange? On July 22, 2014, two federal courts issued conflicting opinions on this subject. The U.S. Court of Appeals for the District of Columbia Circuit, in Halbig v. Burwell, concluded [&hellip… Continue Reading »
By Brian M. Pinheiro, Jean C. Hemphill and Edward I. Leeds on Posted in LitigationThe U.S. Supreme Court has ruled in favor of three for-profit corporations that claimed that the Affordable Care Act (ACA) mandate to provide preventive care coverage for certain types of contraception violated the protections afforded to them under the federal Religious Freedom Restoration Act of 1993 (RFRA). This ruling is expected to apply primarily to [&hellip… Continue Reading »
By Brian M. Pinheiro, Jean C. Hemphill and Edward I. Leeds on Posted in Litigation,Plan Design Requirements,Preventive ServicesThe U.S. Supreme Court has ruled in favor of three for-profit corporations that claimed that the Affordable Care Act (ACA) mandate to provide preventive care coverage for certain types of contraception violated the protections afforded to them under the federal Religious Freedom Restoration Act of 1993 (RFRA). This ruling is expected to apply primarily to [&hellip… Continue Reading »