Archives: Employee Health & Welfare Plans

Subscribe to Employee Health & Welfare Plans RSS Feed

ACA Cadillac Tax Proposed Regs: What Treasury and IRS Are Considering

The Affordable Care Act (“ACA”) added section 4980I to the Internal Revenue Code (“Code”). Code section 4980I applies to tax years after December 31, 2017, and provides a tax on high cost employer-sponsored health coverage – if the aggregate cost of employer-sponsored coverage (referred to as “applicable coverage”) provided to an employee exceeds a statutory … Continue Reading

As Employers Await Wellness Program Regulations From The EEOC, Congress Has Acted

We reported in December 2014, that the Equal Employment Opportunity Commission (EEOC) said it was planning to issue proposed regulations (scheduled for February 2015) that would “promot[e] consistency between the ADA and HIPAA, as amended by the ACA,” and “clarify[] that employers who offer wellness programs are free to adopt a certain type of inducement … Continue Reading

EEOC Announces Intent to Propose Regulations That May Harmonize ADA and GINA with ACA Wellness Program Rules

Since filing multiple litigations against employers concerning their wellness programs, including seeking a temporary restraining order against Honeywell International, the Equal Employment Opportunity Commission (EEOC) has faced a significant amount of push back from many U.S. companies, their CEOs and other organizations. The reason … programs designed to be compliant with the wellness program rules … Continue Reading

2014 Transitional Reinsurance Fee Reporting Deadline Extended to December 5, 2014

The Department of Health and Human Services (HHS) has announced that the 2014 deadline for reporting the number of participants covered under a health plan for purposes of paying the 2014 Transitional Reinsurance Fee has been extended from November 15, 2014 to December 5, 2014. Insurers and sponsors of self-insured plans who have not already … Continue Reading

Court Denies EEOC’s TRO Motion Seeking to Halt Employer’s Wellness Program

As reported in our Disability, Leave & Health Management Blog, Judge Ann D. Montgomery of the U.S. District Court for the District of Minnesota denied the EEOC’s TRO request to immediately stop an employer, Honeywell, from implementing its wellness program, ruling that the EEOC did not establish that there would be irreparable harm. Judge Montgomery did … Continue Reading

HPID Requirement Delayed by HHS

The scramble for group health plan administrators to navigate the Centers for Medicare & Medicaid Services (CMS) website and obtain a Health Plan Identifier (HPID) ahead of next week’s deadline is over.  On October 31, 2014, the CMS Office of e-Health Standards and Services (OESS), the division of the Department of Health & Human Services … Continue Reading

Biometric Screening Requirement Under Wellness Program Violates ADA and GINA, According to EEOC Suit

The EEOC has challenged a third employer-sponsored wellness program in three months. Filed in federal court in Minnesota on October 27, the EEOC’s petition seeks to enjoin Honeywell International, Inc. from implementing its wellness program. We expect this case will be watched more closely by employers and wellness vendors alike as the program the EEOC describes … Continue Reading

EEOC Challenges the Design of Another Employer’s Wellness Program under the ADA

Little more than a month ago, we reported to you about the U.S. Equal Employment Opportunity Commission’s (EEOC’s) first lawsuit against a Wisconsin employer concerning its wellness program. On October 1, the EEOC announced a second lawsuit against another Wisconsin employer. EEOC v. Flambeau, Inc. (W.D.WI, filed October 1, 2014). Based on the report, the agency’s … Continue Reading

Have You Obtained a HPID?

The Department of Health and Human Services (“HHS”) recently released guidance on the application process to obtain a Health Plan Identifier (“HPID”). A HPID is an all-numeric 10-digit identification number that many HIPAA-covered health plans are required to adopt by November 5, 2014. Think of a HPID like an EIN for health plans. HPIDs will … Continue Reading

Employers – Review Your Controlled Group to Assure ACA and Retirement Plan Compliance

Beginning in 2015, certain employers that fail to offer affordable health insurance that provides minimum value to their full-time employees and their dependents may incur substantial Employer Shared Responsibility penalties under the Affordable Care Act (“ACA”).  We previously wrote about the importance of properly classifying workers as employees or independent contractors to assure ACA compliance.  … Continue Reading

Look Beyond the ACA Wellness Regulations When Designing Your Program, EEOC Sues Employer Over Its Program

The EEOC could sue my company over the wellness program that is part of our medical plan? Yes, that agency recently sued an employer in Wisconsin claiming the penalty the employer imposed for nonparticpation in its program was too significant, causing the medical inquiries under the program to be involuntary for purposes of the Americans … Continue Reading

Affordable Care Act Employer Penalties – Another Reason to Make Sure Workers are Properly Classified as Employees or Independent Contractors

Beginning next year, an applicable large employer that does not offer affordable minimum value group health coverage to its fulltime employees (and their children up to age 26) will be vulnerable to employer shared responsibility penalties under Internal Revenue Code §4980H.  Whether an employer is an “applicable large employer” depends on its number of fulltime … Continue Reading

IRS GUIDANCE: EMPLOYEE INCOME TAX CORRECTION FOR SAME-SEX SPOUSAL HEALTH COVERAGE AFTER UNITED STATES V. WINDSOR

  On June 27, 2014, the IRS released Information Letter 2014-0012, which contains guidance for employees who have had the value of same-sex spousal coverage under employer health plans — which until recently was required to be included in gross income — reported on their Forms W-2. BACKGROUND Historically, the employer cost of opposite-sex spousal … Continue Reading

Dueling Decisions in the 4th and D.C. Circuit Courts of Appeals Spell More ACA Uncertainty for Employers

Just as employers are gearing up to prepare for compliance with the Shared Responsibility rules under the ACA, a pair of decisions from two federal appeals courts has thrown a curve ball into what was already a complicated assessment of risk for employers and raised new questions. The U.S. Court of Appeals for the District … Continue Reading

Getting Ready for 2015: How Government Contractors, Health Care Reform, and the Family Medical Leave Act Intersect

It’s summer now, mid-year 2014. Open enrollment for the 2015 health plan year is just around the corner. . . We want to make sure that all employers are ready. We want to ensure, as well, that government contractors specifically understand the intersection of the Service Contract Act (SCA) with other federal laws. To be … Continue Reading

EEOC Pregnancy Discrimination Enforcement Guidance Implicates Contraception Coverage Concerns

On July 14, 2014, the EEOC issued new Enforcement Guidance on Pregnancy Discrimination and Related Issues.  The immediately-effective Guidance sets forth the EEOC’s policies with regard to its enforcement of pregnancy-based employment discrimination prohibitions under Title VII — as clarified by the Pregnancy Discrimination Act of 1978 — and other federal laws. With regard to … Continue Reading

SUPREME COURT RULES THAT ACA’S CONTRACEPTIVE MANDATE VIOLATES RELIGIOUS FREEDOM

Last week the Supreme Court ruled, 5-4, in Burwell v. Hobby Lobby Stores, Inc., et al., that closely held corporations cannot be required to provide contraceptive coverage as mandated by the Affordable Care Act (ACA) because the requirement violates the Religious Freedom Restoration Act of 1993 (RFRA).  At issue in the case were regulations promulgated … Continue Reading

Wellness Program Update: EEOC is Planning to Issue Proposed Regulations to Address ADA, GINA Issues

In May, the Equal Employment Opportunity Commission (EEOC) announced that it intends to issue proposed regulations addressing health plan-based wellness programs. According to the EEOC’s announcement, the guidance is expected to address the following items: Does title I of the Americans with Disabilities Act (ADA) allow employers to offer financial inducements and/or impose financial penalties as part of … Continue Reading

Remember ERISA Basics: SPD and Eligibility

During the past 14+ years practicing employee benefits law, I’ve seen many changes, not the least of which has been the Affordable Care Act (ACA). However, with all of the recent changes flowing from the ACA, it is important not to forget some very basic and long-standing aspects of plan compliance, design, drafting and administration, … Continue Reading

DOL Proposes Changes to Model Notices and Procedures

The Department of Labor (DOL) has published proposed regulations containing amendments to the COBRA notice provisions.  The amendments are intended to align the model general and election notices with the Affordable Care Act provisions already in effect and to ensure that the DOL will have flexibility to modify the model notices going forward. The proposed … Continue Reading

U.S. Surgeon General’s Report May Spur More Wellness Program Activity

A U.S. Surgeon General’s Report issued this month marks fifty years since the Surgeon General’s landmark report in 1964 that set in motion a nationwide campaign to reduce and hopefully eliminate tobacco smoking in the United States. Also during this month, rules under the Affordable Care Act (ACA) go into effect, enhancing employers’ ability to … Continue Reading

Employers Don’t Have to Give More Than One Shot Per Year at Avoiding a Tobacco Surcharge, According to DOL FAQs

The Departments of Labor, Treasury and Health and Human Services issued final regulations on June 3, 2013, that implement PHS Act section 2705, added by the Affordable Care Act (ACA), and existing provisions under ERISA and the Code. The preamble to those regulations stated that the Departments anticipated issuing future subregulatory guidance as necessary. Frequently … Continue Reading

Health Care Reform Resource Center

We are pleased to announce the launch of Jackson Lewis’ Health Care Reform Resource Center. Our Resource Center provides one convenient place for you to obtain key health care reform-related law, agency guidance, Jackson Lewis articles and related information. We hope you find this resource helpful.… Continue Reading
LexBlog