Employee Health & Welfare Plans

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Group health plans that are not grandfathered under the 2010 health care reform law (the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010) must provide women’s contraception without cost-sharing beginning with the first plan year that starts on or after August 1, 2012. The three agencies…

It’s fairly common for employers to continue benefits for employees out on leaves of absence. But what happens after protected leaves such as FMLA and USERRA end, or if the leave is not protected by law, and coverage continues? This post discusses a recent case where the carrier was able to back out of coverage because the plan terms simply did not support coverage during the leave, creating significant exposure for the employer.
Continue Reading Continuing Health Coverage During Leaves of Absence, A Trap for the Unwary

The Internal Revenue Service has given a last-minute holiday gift to sponsors of insured group health plans.  It announced delayed enforcement for the new nondiscrimination provisions applicable to insured group health plans under the Patient Protection and Affordable Care Act of 2010 (as amended by the Health Care and Education Reconciliation Act of 2010; together …

The Patient Protection and Affordable Care Act (Affordable Care Act), requires the Secretary of Health and Human Services (HHS) to impose restrictions on the imposition of annual limits on the dollar value of essential health benefits in a new or existing group health plan for plan years beginning on or after September 23, 2010 and prior to January 1, 2014. Interim final regulations published on June 28, 2010, established these restricted annual limits, along with the possibility for a waiver from these restricted annual limits as granted by HHS if complying with the interim final regulations would result in a significant decrease in access to benefits or a significant increase in premiums.
Continue Reading HHS Updates Guidance on Obtaining Waivers from PPACA Annual Limits

As group health plans brace for open enrollment periods under the new Patient Protection and Affordable Care Act of 2010, one of the key issues they face is the Act’s new coverage requirements for adult children. Previously, a child became ineligible for family coverage under a group health plan for federal tax purposes once…