Health and Welfare Plans

Coming Soon: Determination Letter Program for Individually Designed Section 403(b) Plans

JAHIZ NOEL AGARD and KATURI KAYE, April 27, 2023 Starting in June 2023, the Internal Revenue Service (the “IRS”) will start accepting determination letter applications for individually designed Internal Revenue Code Section 403(b) plans (“section 403(b) plans”) (also known as tax-sheltered annuity plans). As announced in Revenue Procedure 2022-40 (issued in November 2022), plan sponsors […]

Group Health Plans Must Submit Gag Clause Attestations by December 31, 2023

ALAINA HARWOOD and ELIZABETH LOH, April 27, 2023 On February 23, 2023, the U.S. Departments of Labor, Health and Human Services, and Treasury (the “Departments”) issued joint guidance (“Tri-Agency FAQs”) for group health plans and insurers regarding annual attestations on gag clause prohibition compliance as required under the Consolidated Appropriations Act, 2021 (CAA). Attestations will […]

The End of the COVID-19 Emergency Periods Is Fast Approaching

ELIZABETH LOH, April 6, 2023 During the COVID-19 National Emergency (NE) and Public Health Emergency (PHE) periods, the government issued guidance providing various forms of temporary relief to plan sponsors and plan participants, and also requiring plan sponsors to make certain plan design changes during these emergency periods (e.g., covering COVID-19 testing, the extension of […]

Final Rule Provides Permanent Automatic Extension of Time to Furnish Certain Affordable Care Act Tax Forms

SARAH KANTER, December 21, 2022 On December 12, 2022, the Treasury Department (“Treasury”) and the Internal Revenue Service (IRS) released a “Final Rule” that automatically extends the timeframe for employers and other reporting entities to furnish IRS Forms 1095-B and 1095-C to individuals, regarding their health coverage each year, to March 2 of the following […]

DOL Proposes Stricter Prohibited Transaction Exemption Application Procedures

MIA BUTZBAUGH, July 28, 2022  The Employee Retirement Income Security Act of 1974, as amended (ERISA) includes rules that limit plan fiduciaries’ conduct. The limits set forth in ERISA Sections 406 and 407(a) are known as the “prohibited transaction rules” and are so broad that, absent exemptions, employee benefit plans would be unable to function. […]

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 […]

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