Health Care Reform Dashboard

Health Care Reform Dashboard

Charting developments on the
Affordable Care Act

Plan Design Requirements

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11/07/2016

Final Regulations on Short-Term Health Plans Under the Affordable Care Act

The U.S. Departments of Labor, Health and Human Services, and the Treasury have finalized regulations under the Affordable Care Act (ACA) that address certain exceptions under the ACA. Among other things, the regulations: Define “essential health benefits” for purposes of identifying plans that are (and are not) subject to the ACA prohibition against annual and [&hellip… Continue Reading »
11/05/2016

Guidance Addresses Mental Health Parity

The U.S. Departments of Labor, Health and Human Services, and the Treasury have issued a set of Frequently Asked Questions and Answers that, among other things, implement certain of the recommendations included in a report issued by the White House Mental Health and Substance Use Disorder Parity Task Force. This guidance manifests the administration’s continuing [&hellip… Continue Reading »
10/24/2016

Temporary Relief for Certain Student Health Plans Extended Indefinitely

In recently issued guidance, the U.S. Departments of Treasury, Labor, and Health and Human Services indicated that they will indefinitely extend relief to colleges and universities that subsidize the cost of individual insurance premiums for student employees. Under previously issued guidance, a health reimbursement arrangement or other program that pays some or all of the premium [&hellip… Continue Reading »
09/27/2016

Hot Topics in Employer Health Benefits

As we start looking forward to 2017, and as many employers head into annual enrollment periods this fall, it is necessary to account for changes in the law that have a significant impact on health benefit plans. This short list of significant developments may help you prepare for what is coming: Affordable Care Act (ACA) Reporting. The [&hellip… Continue Reading »
05/25/2016

EEOC Finalizes Wellness Program Regulations

The Equal Employment Opportunity Commission has published final regulations and a set of questions and answers on how the Americans with Disabilities Act (ADA) applies to employer-sponsored wellness programs that offer employees incentives to respond to disability-related inquiries or undergo medical examinations. At the same time, the EEOC published final regulations and a set of [&hellip… Continue Reading »
02/11/2016

Temporary Relief for Certain Student Health Plans

In recent guidance, the U.S. Departments of Treasury, Labor , and Health and Human Services have extended transitional relief to colleges and universities that subsidize the cost of individual insurance premiums for student employees. Under previously issued guidance, a health reimbursement arrangement or other program that pays some or all of the premium for individual [&hellip… Continue Reading »
01/27/2016

Wellness Program Exempted from ADA

A federal district court in Wisconsin has upheld an employer-sponsored wellness program against a challenge by the Equal Employment Opportunity Commission (EEOC) that the program violated the Americans with Disabilities Act (ADA). In EEOC v Flambeau, the court ruled that the wellness program qualified for a safe harbor under the ADA that permits an employer [&hellip… Continue Reading »
12/28/2015

Further Guidance on ACA Market Reforms for Group Health Plans

Following up on the issuance of final regulations on various market reform provisions under the Affordable Care Act (ACA), the IRS has issued a notice with Questions and Answers that take a more detailed look at specific ACA issues. In particular, this notice addresses: Health reimbursement arrangements (HRAs). The guidance confirms that retiree-only HRAs may [&hellip… Continue Reading »
11/09/2015

EEOC Proposes Guidance on GINA, Wellness Program

The Equal Employment Opportunity Commission (EEOC) has followed up on proposed regulations that it issued this spring on wellness programs under the Americans with Disabilities Act (ADA) with a new set of proposed regulations on wellness programs under the Genetic Information Nondisclosure Act (GINA). Most significantly, the regulations provide relief with regard to an issue [&hellip… Continue Reading »
07/30/2015

Final Rules for Preventive Services

The U.S. Departments of Treasury, Labor (DOL) and Health and Human Services (HHS) have issued interim final regulations and Frequently Asked Questions and Answers on the cost-free coverage of preventive services under the Affordable Care Act (ACA). Although the regulations address many preventive care subjects, all of the attention has focused on the changes to [&hellip… Continue Reading »
05/26/2015

New Guidance on Cost-Sharing Limits and Provider Nondiscrimination Rules

The U.S. Departments of Labor, Health and Human Services, and the Treasury have jointly issued a new set of FAQs that clarifies the application of the rules establishing cost-sharing limits. For 2016, non-grandfathered group health plans must cap the amount that plan participants pay in deductibles, copayments, coinsurance and the like at $6,850 for self-only [&hellip… Continue Reading »
05/13/2015

Guidance Clarifies Certain Preventive Care Requirements

Recent guidance issued jointly by the U.S. Departments of Labor, Health and Human Services, and the Treasury clarifies how the Affordable Care Act’s requirement to provide cost-free coverage for preventive care applies to several types of products and services. In particular, the guidance clarifies that:  Coverage for all types of contraception (currently 18 different types are [&hellip… Continue Reading »
04/21/2015

EECO Tackles Wellness Programs

After much silence, some litigation, and recent congressional hearings, the Equal Employment Opportunity Commission (EEOC) has at long last proposed regulations (together with a fact sheet and set of frequently asked questions and answers) that interpret how the Americans with Disabilities Act (ADA) applies to wellness program incentives. Employers that sponsor wellness programs are likely [&hellip… Continue Reading »
02/25/2015

Partial Relief for Employer Payment of Individual Insurance Premiums

In a recent notice, the Internal Revenue Service has tempered prior guidance that closed the door on employer arrangements for paying the cost of individual health insurance for employees. The IRS still views these premium reimbursement arrangements as group health plans that fail to meet the Affordable Care Act (ACA) prohibition against annual dollar limits [&hellip… Continue Reading »
01/09/2015

Expatriate Plans Exempted from Many Affordable Care Act Provisions

In the Consolidated and Further Continuing Appropriations Act (the recently enacted federal budget bill often known as the “CRomnibus” legislation), Congress has exempted health plans designed to cover expatriates from most of the requirements of the Affordable Care Act. The exemption will generally apply where a group health plan provides significant health coverage and substantially [&hellip… Continue Reading »
11/05/2014

IRS Seeks to Curb Popularity of ‘Skinny’ Health Plans

The Internal Revenue Service, in Notice 2014-69, has concluded that certain unconventional group health plan designs that offer limited or no coverage for in-patient hospitalization services and/or physician services will not provide “minimum value.” Consequently, this may expose large employers to financial penalties under the Affordable Care Act’s (ACA’s) “pay-or-play” employer mandate. These plans, sometimes [&hellip… Continue Reading »
08/25/2014

Government Agencies Release Further Accommodations to Organizations Opposing Mandated Contraceptive Coverage

In response to the recent U.S. Supreme Court decision in Burwell v. Hobby Lobby, Inc., the U.S. Departments of Health and Human Services (HHS) and Labor (DOL) published proposed rules on August 22, 2014, expanding the availability of the religious accommodation to the contraceptive mandate provided in their July 2013 final regulations to closely held [&hellip… Continue Reading »
07/14/2014

Midyear Check on Health Plan Compliance

If you sponsor or administer a group health plan, you are almost certainly taking steps to prepare for legal requirements that will become effective on or before January 1, 2015. New rules under HIPAA, the Affordable Care Act (ACA), and other laws will affect your plans. As we pass the midpoint of 2014, it is [&hellip… Continue Reading »
05/07/2014

New FAQs Address Effect of Affordable Care Act on COBRA and Other Matters

In a wide-ranging set of frequently asked questions (FAQs) and other guidance, the U.S. Departments of Labor, Treasury, and Health and Human Services have addressed a number of issues pertaining to the Affordable Care Act (ACA). They include issues pertaining to COBRA and the Children’s Health Insurance Program Reauthorization Act (CHIPRA), annual cost-sharing limits, preventive care, [&hellip… Continue Reading »
04/03/2014

IRS Issues Guidance on Health FSAs

The IRS has issued guidance on two issues affecting health flexible spending arrangements (health FSAs). The first provides guidance on how a health FSA that consists solely of amounts carried forward from the prior year (through rules issued last fall that allow up to $500 to be carried forward) may be coordinated with coverage under [&hellip… Continue Reading »
11/12/2013

Final Mental Health Parity Act Regulations Released

The Internal Revenue Service, U.S. Department of Labor, and U.S. Department of Health and Human Services have jointly released final regulations and new FAQs implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). MHPAEA provisions generally became effective for plan years beginning on or after October 3, 2009, with [&hellip… Continue Reading »
07/02/2013

Final Regulations Issued on Contraceptive Coverage, Religious Organizations

The U.S. Departments of Health and Human Services, Labor, and Treasury recently released final regulations on the exemption from providing coverage for contraceptive and certain other preventive services that is available to certain religious organizations. The final regulations apply to plan years beginning on or after January 1, 2014. The final rules adopt most of the [&hellip… Continue Reading »
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