The No Surprises Act (Act), which establishes protections for health plan participants from surprise medical billing, was passed in late 2020 as part of the 2021 Consolidated Appropriations Act. On October 7, 2021, the Departments of Labor, the Treasury, and Health and Human Services (collectively, Departments) issued Interim Final Rules implementing certain provisions
U.S. Supreme Court Overturns Roe and Casey: What This Decision Means for Employers
As many expected based on the draft opinion that was leaked months ago, the U.S. Supreme Court has held the U.S. Constitution does not protect the right to obtain an abortion. Dobbs v. Jackson Women’s Health Organization, No. 19-1392 (June 24, 2022).
Dobbs overturns nearly 50 years of precedent from the Court’s decision in
Group Health Plan Considerations in the Face of (Potentially) Changing Abortion Laws
On May 2, 2022, a draft opinion from the U.S. Supreme Court case Dobbs v. Jackson Women’s Health was leaked to the press, and as a result the Court is expected to overturn Roe v. Wade and Planned Parenthood v. Casey, effectively leaving the issue of abortion rights to the states. Thirteen states currently
Transparency in Coverage Enforcement
On April 19, 2022, the Departments of Labor, Health and Human Services, and the Treasury issued additional guidance under the Transparency in Coverage Final Rules issued in 2020. The guidance, FAQs About Affordable Care Act Implementation Part 53, provides a safe harbor for disclosing in-network healthcare costs that cannot be expressed as a dollar
Ohio’s Surprise Billing Law – Impact on Health Plans
Ohio’s Surprise Billing Law, R.C. § 3902.51, became effective January 12, 2022, but its impact on health plans is still evolving. The law strives to prevent patients from receiving and paying surprise medical bills, specifically those stemming from unanticipated out-of-network care. While the Ohio Surprise Billing Law intends to shield insureds from surprise medical
Do Employers Now Have to Offer Affordable Family Coverage?
In furtherance of the Biden Administration’s January 28, 2021, Executive Order 14009 and April 5, 2022, Executive Order 14070 to protect and strengthen the ACA, the Treasury Department and IRS published a proposed rule on April 7, 2022, advancing an alternative interpretation of Internal Revenue Code Section 36B. Employers can breathe a sigh of relief
Happy National Employee Benefits Day – – April 5, 2022!!
Last year about this time, we wrote of how far we had come collectively in the world of employee benefits roughly one year after the onset of the COVID-19 Pandemic. We reveled at how we kept on keeping on, what we were able to accomplish in the face of unprecedented everything, and admirably pivot with
Court Strikes Down a Portion of the No Surprises Act Interim Regulations
While health plans, insurers, and providers are busy understanding and implementing the new requirements under the No Surprises Act, a U.S. District Court recently vacated an essential portion of the interim regulations carrying out the Act. While this decision applies nationwide, the court only vacated a portion of the interim regulations affecting the new dispute
More Clarity Regarding Employer Mandates for At-Home COVID-19 Testing
As employers and insurers continue to establish programs to enable participants in group health plans to receive at-home COVID-19 tests at no cost, even without a prescription, the Department of Labor (DOL) has issued additional guidance and an updated FAQ providing further clarification and flexibility to insurers and plan sponsors in providing coverage to eligible
Updated Rates for California EDD Benefits and San Francisco Paid Family Leave Ordinance
The California Employment Development Department (EDD) has released the Voluntary Plan Employee Contribution and Benefit Rates for 2022.
Employers with employees located in California are generally required to withhold and send state disability contributions to the EDD. The 2022 rates are as follows:
| “Employee Contribution Rate” | 1.10% |
| “Taxable Wage Ceiling” (per employee per year) |