A federal district court in Texas has invalidated and enjoined actions by federal agencies on and after March 23, 2010—when the Affordable Care Act (ACA) was enacted—to implement the ACA requirement that health plans and insurance policies cover the full cost of in-network preventive care that carries an A or B rating by the USPSTF.… Continue Reading
January 1 Compliance Deadline Passes for Colorado’s FAMLI Program
As of January 1, 2023, all Colorado employers are required to post or otherwise provide employees with the state-issued FAMLI Program notice (available in English and Spanish) and also begin deducting employees’ shares of FAMLI Program premiums from employee paychecks, where applicable.
Under the FAMLI Program, eligible employees may receive up to up to $1,100 in weekly FAMLI Program benefits for eligible leave starting in 2024, and up to 90 percent of the state average weekly wage rate for eligible leave taken thereafter.… Continue Reading
Pregnant and Nursing Workers Benefit from Expanded Employment Protections
On December 29, 2022, as part of the Fiscal Year 2023 Omnibus Spending Bill, President Biden signed into law two pieces of legislation that will benefit pregnancy and nursing mothers – the Pregnant Workers Fairness Act (PWFA) and the Providing Urgent Maternal Protections for Nursing Mothers Act (PUMP for Nursing Mothers Act). … Continue Reading
Reviewing the Welfare Plan Rules Under the Consolidated Appropriations Act, 2021
The Consolidated Appropriations Act, 2021, (CAA) and transparency regulations introduced major changes to health benefit plans. These changes continue to evolve with some requirements just now taking effect.
The Upshot
- Health plan sponsors need to comply with new requirements for reporting on prescription drug and other health care expenditures, although they have been given a very short reprieve.
Holiday Relief for Reporting Requirements
In a new set of Frequently Asked Questions, the U.S. Departments of Labor, Health and Human Services, and the Treasury provide significant relief to health plan sponsors and insurers seeking to report on expenditures for prescription drugs and other health care items and services in compliance with the Consolidated Appropriations Act, 2021.… Continue Reading
Webinar Recording: End of Roe – What it Means for Employers and Employee Benefit Plans
Recently, Ballard Spahr attorneys spoke about the overturning of Roe v. Wade and the impact on employee benefit plans and other issues important to employers. The webinar addressed measures that employers can consider and implement in response to these developments and the legal and practical issues they present.
Below you’ll find a link to a recording of the webinar and presentation slides.… Continue Reading
U.S. Issues Final Rules Implementing No Surprises Act and Modifying Dispute Resolution Process
On August 19, 2022, the U.S. Departments of Labor, Treasury, and Health & Human Services issued final rules entitled, “Requirements Related to Surprise Billing: Final Rules,” which modify the independent dispute resolution (IDR) process implemented under the No Surprises Act.
The No Surprises Act (the Act), enacted as part of the Consolidated Appropriations Act, 2021 (CAA), created novel protections against out-of-network balance billing and established an IDR process for resolving payment disputes between certain providers and health plans when they are unable to agree upon an appropriate price for out-of-network services. … Continue Reading
IRS Adjusts Figure Applicable to ACA Employer Mandate
The Employer Shared Responsibility Provisions (commonly known as the “employer mandate”) under the Affordable Care Act (ACA) require covered large employers to pay an assessment under the Internal Revenue Code if they fail to offer health coverage to their full-time employees that meets certain standards. Those standards include a requirement that the coverage be affordable for full-time employees.… Continue Reading
Upcoming Webinar: The End of Roe – What it Means for Employers and Employee Benefit Plans
Tuesday, July 26, 2022, 12:00 – 1:30 PM ET
The recent Supreme Court decision overturning Roe v. Wade and state laws banning abortion in the wake of the decision have raised significant employee benefit and other issues for employers. This webinar will address measures that employers are considering and implementing in response to these developments, and the legal and practical issues they present.… Continue Reading
Philadelphia Employers Will Soon Be Required to Provide Commuter Benefits to Their Employees
On June 9, 2022, the Philadelphia City Council passed an ordinance that would require covered employers to make available to eligible employees a commuter transit benefit program. The bill is currently awaiting the Mayor’s signature, which many expect will occur shortly. To read more about this development, please see our Alert on this development.… Continue Reading