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
At-Home COVID-19 Testing Options and Alternatives
In fulfillment of President Biden’s promise to make at-home COVID tests more available for all of us, two significant action steps have now occurred:
- Every U.S. household has access to free at-home COVID-19 tests. As of January 18, 2022, any individual with a residence in the United States may request up to four (4) at-home
It’s Almost the End of 2021. Do You Know Where Your Healthcare Dollars Go?
The CAA Transparency Rules Will Let Plans and Participants Know. The Department of Labor, Health and Human Services, and the IRS (collectively the Departments) recently released the Interim Final Rules with a request for Comment (IFC), Prescription Drug and Health Care Spending. These rules implement Section 204, Title II, another phase of the transparency provisions
Fifth Circuit ERISA Decision Denies Widow Paid-For Life Insurance Benefits
On October 19, 2021, the Fifth Circuit Court of Appeals denied a widow supplemental group life insurance benefits of $300,000 upon her husband’s death even though he had paid the premiums for the coverage for four years through payroll deductions by his employer, National Oilwell Varco. The case, Talasek v. National Oilwell Varco, L.P., appealed
2021 Plan Amendment Deadlines and Other Looming Fourth Quarter Considerations
As the year draws to a close, it is helpful for employers to pause to evaluate employee benefit plan amendment deadlines and other crucial fourth-quarter considerations, including: More…
Money Money Money: How Much can the Health Plan Surcharge on Unvaccinated Employees Be?
In light of the lingering COVID-19 pandemic and its impact on employee productivity and health care expenses, employers are considering imposing a premium surcharge on employees participating in the company’s health plan who are not vaccinated against COVID-19.
As we have discussed here, several federal laws must be taken into consideration when designing such
Health Plan Premium Surcharges For Those Not Vaccinated for COVID-19?
According to Forbes.com, more employers are considering imposing a premium surcharge on employees participating in the company’s health plan who are not vaccinated for COVID-19. Whether positioned as rewards or penalties, wellness program incentives have become vehicles of choice for encouraging behaviors believed to be healthy and reducing health plan costs. For years, tobacco
Incentives: From Water Bottles to “Not so Substantial”
For years (and we do mean years), the EEOC has waffled about whether incentives were permissible in connection with a medical inquiry under a voluntary wellness program. Friday, the EEOC issued its most recent pronouncement on the topic, this time related to incentives for COVID-19 vaccinations.
The ADA prohibits employers from requiring medical examinations or
IRS Provides Clarity on ARPA COBRA Subsidy Impact on State “Mini-COBRA” Plans
In our most recent summary of IRS Notice 2021-31, we noted the Internal Revenue Service provided much-needed clarity to looming compliance challenges as employers, insurers, and others race to implement the applicable COBRA premium subsidy provisions of the American Rescue Plan Act of 2021 (ARPA). While there are many other important clarifications made by
Washington Steps Up Insurance Protections for Gender Affirming Treatments
As some states make headlines for so-called “anti-trans” laws, the Washington state legislature rejected a bill designed to limit youth participation in sports based on their gender as assigned on a birth certificate and passed the new Gender Affirming Treatment Act. This Act prohibits health insurers from denying or limiting coverage for gender affirming treatment