Archives: Health Care Reform

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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

Premium Reimbursement Arrangements – Employers Beware

The Department of Labor (DOL) has just published a series of FAQs regarding premium reimbursement arrangements.  Specifically, the FAQs address the following arrangements: An arrangement in which an employer offers an employee cash to reimburse the purchase of an individual market policy. Where an employer provides cash reimbursement for the purchase of an individual market … 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

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

Employer Action Item – Health Care Reform

Under the Patient Protection and Affordable Care Act, beginning in 2015, certain large employers who do not offer affordable health insurance that provides minimum value to their full-time employees may be subject to significant penalties. Please refer to our article titled “Health Care Reform: Employers Should Prepare Now for 2015 to Avoid Penalties” for information … 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

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

“Final” Obamacare Employer Penalty Rules Released

The US Treasury released the final regulations implementing the employer shared responsibility penalty provisions of the 2010 health care reform law on February 10, 2014.  In many ways, the final regulations resemble the proposed regulations issued over a year ago but there are several – mostly welcome – changes and transition provisions for employers.  (See … 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

REMINDER! VIRTUALLY ALL EMPLOYERS MUST FURNISH “MARKETPLACE” NOTICE TO EMPLOYEES BY OCTOBER 1, 2013

The Patient Protection and Affordable Care Act requires employers to furnish employees a notice of the availability of coverage through public health insurance exchanges, i.e., the “Marketplace”. The Department of Labor requires that employers give employees the notice by October 1, 2013. As highlighted in our earlier blog post, Department of Labor Technical Release 2013-02  … Continue Reading

Employers Must Provide Notices Regarding Availability of Exchange Coverage

A provision of the 2010 health care reform law requires employers to provide notices, by March 1, 2013, to all employees regarding the availability of health coverage options through the state-based exchanges created pursuant to that law. In January, the Department of Labor had announced delayed enforcement of the exchange coverage notice provision (which added Section … Continue Reading

More Guidance on the Summary of Benefits and Coverage (But No Surprises)

The Department of Labor, Health and Human Services and the Treasury collectively published new FAQs regarding the requirement to provide a summary of benefits and coverage (SBC) under the Affordable Care Act (ACA) (http://www.dol.gov/ebsa/faqs/faq-aca14.html#footnotes). The FAQs include an updated SBC template and an updated sample completed SBC (available at cciio.cms.gov and www.dol.gov/ebsa/healthreform).  It is noteworthy … Continue Reading
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