Health and Welfare Plans

Revisiting the HIPAA Proposed Rule: What Group Health Plan Sponsors Need to Know

SARAH BOWEN, May 26, 2022  In late 2020, the Office for Civil Rights (OCR) at the Department of Health and Human Services (HHS) proposed significant changes to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule, aimed primarily at improving care coordination and data sharing. As the final rule on these changes […]

Texas District Court Vacates Part of New IDR Rule for Surprise Medical Billing

 JENNIFER WONG, March 31, 2022  On February 23, 2022, the U.S. District Court for the Eastern District of Texas vacated certain provisions of the interim final regulations (IFR) which the tri-agency Departments of Labor, Health and Human Services, and Treasury (the “Departments”) issued pursuant to the surprise medical billing rules under the No Surprises Act […]

Tri-Agencies Provide Additional At-Home COVID-19 Testing Coverage Guidance

RYAN KADEVARI and JENNIFER TRUONG, February 22, 2022  On February 4, 2022, the Departments of Labor, Health and Human Services (HHS), and the Treasury (collectively, the Departments) released additional guidance concerning group health plan and health insurance coverage of over-the-counter COVID-19 diagnostic tests (“OTC Tests”). The guidance complements an initial set of FAQs previously issued […]

Health Plans and Insurers Required to Cover At-Home COVID Tests

MARY E. POWELL, January 11, 2022  On January 10, 2022, the Departments of Labor, Health and Human Services, and Treasury (the “Departments”) issued FAQs Part 51 (FAQs) regarding the requirement for health plans to cover over-the-counter (OTC) COVID-19 diagnostic testing (“OTC COVID Tests”). This will be required effective with OTC COVID Tests purchased on and after […]

Delay of Some Key Provisions of the Consolidated Appropriations Act and the Affordable Care Act’s Transparency Requirements

MARY E. POWELL, August 31, 2021  On August 20, 2021, the Departments of Labor (DOL), Health and Human Services (HHS) and Treasury (collectively, the Departments), issued Frequently Asked Questions (FAQs) regarding the implementation of certain provisions of the Consolidated Appropriations Act, 2021 (CAA) and the Affordable Care Act (ACA). Fortunately, several of the most complicated […]

IRS Guidance on COBRA Premium Assistance — What We Know Now

SARAH KANTER, July, 2021  After the passage of the American Rescue Plan Act of 2021 (ARP) and release of DOL model notices and FAQs on April 7, 2021, employers and other plan sponsors were still left with many open questions regarding the implementation of COBRA premium assistance. The IRS provided clarity to many of these […]

American Rescue Plan Act: COBRA Subsidy Relief and Dependent Care FSA Limit Increase

ELIZABETH LOH, March 18, 2021   On March 11, 2021, President Biden signed into law the American Rescue Plan Act (the “Act”). This $1.9 trillion legislative package provides significant pandemic relief. This article focuses on the COBRA continuation coverage subsidy relief, as well as increased Dependent Care Flexible Spending Account (“Dependent Care FSA”) relief provided under […]

New FAQs Clarify Coverage Requirements for COVID-19 Testing and Vaccines

MARY E. POWELL and SARAH KANTER, March 1, 2021   On February 26, 2021, the Departments of Labor, Health and Human Services (HHS) and Treasury (collectively the “Departments”) released FAQs About Families First Coronavirus Response Act (the “FFCRA”) and Coronavirus Aid, Relief and Economic Security Act (the “CARES Act”) Implementation Part 44 (the “FAQs”).1 These FAQs […]

Outbreak Extension Period — When Does It End?

MARY E. POWELL and SARAH KANTER, March 1, 2021   On February 26, 2021, the Department of Labor (DOL) issued Employee Benefits Security Administration (EBSA) Disaster Relief Notice 2021-01 (“2021 Relief Notice”)1, which explains how employee benefit plans must administer the end date of the tolling period for certain plan deadlines due to the COVID-19 national […]

An Overview of the Group Health Plan Provisions of the Consolidated Appropriations Act and the Final Transparency in Coverage Regulations

MARY E. POWELL and SARAH KANTER, January 29, 2021   The Consolidated Appropriations Act, 2021 (the CAA) contains numerous provisions that impact group health plans. At a high level, these CAA provisions can be broken into three main categories: (1) reducing Out-of-Network (OON) costs for enrollees, (2) providing transparency regarding costs, and (3) permissive changes that […]

Flexible Spending Account Relief in Consolidated Appropriations Act, 2021

MARY E. POWELL and ELIZABETH LOH, January 6, 2021  In December, the President signed the Consolidated Appropriations Act, 2021 (CAA), which combines COVID-19 stimulus relief with a number of year-end appropriations bills. The CAA contains numerous provisions that will impact health and welfare plans. The provisions of the CAA that need immediate attention are the […]

Keeping COBRA Notices Compliant in an Ever-Changing Landscape

JAHIZ NOEL AGARD, November 24, 2020  2020 has presented several issues requiring urgent attention for employers who sponsor group health plans, including a need to update the notices required under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), in particular the general (or initial) notice and the continuation coverage election (or enrollment) notice. This […]

New Proposed Rule Regarding Grandfathered Plans

SARAH KANTER, October 8, 2020  A new proposed rule (the “Proposed Rule”), released by the Departments of Treasury, Labor, and Health and Human Services (HHS) (the “Departments”) on July 10, 2020, would permit grandfathered group health plans and grandfathered group health insurance coverage (“grandfathered plans”) to make greater increases to certain types of cost-sharing requirements […]

IRS Allows for Temporary Flexibility with Long-Awaited Guidance that Expands Mid-Year Election Change Opportunities for Cafeteria Plans

GISUE MEHDI and BRIANA B. DESCH, July 9, 2020   In response to the COVID-19 pandemic, the U.S. Department of Treasury and the Internal Revenue Service (IRS) issued Notice 2020-29 and Notice 2020-33 (the “Notices”) on May 12, 2020. Notice 2020-29 provides increased flexibility for participants to make mid-year health plan, health flexible spending account (“Health […]

COBRA, HIPAA Special Enrollment, Claims and Appeals, and ERISA Notice Related Deadlines Extended

ELIZABETH LOH, May 7, 2020 On April 28, 2020, the Department of Labor (DOL), the Department of the Treasury (“Treasury Department”), and the Internal Revenue Service (IRS), issued several pieces of guidance providing relief to plan participants, COBRA-qualified beneficiaries, claimants, and plan sponsors who are impacted by the COVID-19 pandemic. This guidance includes the following: […]

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