Initial No Surprises Act Regulations Provide Some Clarity for Employer Plans

Plan participants can be hit with surprise medical bills when they receive care from out-of-network providers. Sometimes, this happens when participants do not know that the care they are receiving is from an out-of-network provider, like when they have surgery at an in-network facility only to find that the facility-appointed anesthesiologist, for example, is out-of-network.  Now, employers have a bit more clarity about how those surprise medical bills are supposed to be paid, beginning January 1, 2022, under new “No Surprises Act” regulations.

The New IRS COBRA Subsidy Guidance: Key Takeaways for Employers

The American Rescue Plan Act of 2021 (ARPA) implemented a 100 percent COBRA subsidy for certain qualified beneficiaries beginning on April 1, 2021, and ending September 30, 2021. On May 18, 2021, more than a month into the subsidy period, the Internal Revenue Service (IRS) released Notice 2021-31. This guidance, provided in the form of questions and answers (Q&As)—86 Q&As!—addresses issues of interest to employers, including issues related to reporting the Medicare tax credit and receiving advance payment of payroll tax credits that exceed Medicare taxes owed and withheld. Here are the key takeaways for employers.

COBRA Subsidy: What We Know Now After Initial DOL Guidance

Less than a month after the American Rescue Plan Act of 2021 (ARPA) was signed into law, new U.S. Department of Labor (DOL) guidance and model forms are clearing up a number of employer concerns about the 100 percent COBRA coverage subsidy for continuing health benefits that runs from April 1, 2021, to September 30, 2021.

New COVID-19 Relief Law Includes Full COBRA Premium Subsidy

The American Rescue Plan Act of 2021 (ARPA), which became law on March 11, 2021, provides a 100 percent subsidy of premiums under the Consolidated Omnibus Budget Reconciliation Act (COBRA) beginning on April 1, 2021, through September 30, 2021, with employers to recoup the missing premiums through Medicare tax credits.

Consolidated Appropriations Act Underscores Mental Health Parity Compliance

The Consolidated Appropriations Act (CAA), 2021, enacted late in 2020, imposes a new requirement on group health plans to ensure compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA). Unlike many of the other provisions of the CAA that affect group health plans, the MHPAEA requirement under CAA section 203 goes into effect very soon—on February 10, 2021.

EEOC Issues Long-Awaited Proposed Wellness Program Rules

The U.S. Equal Employment Opportunity Commission (EEOC) recently issued its revamped proposed rules governing employer-sponsored wellness programs. These proposed rules have been a long time coming, with the EEOC’s prior rules on the topic having been invalidated by a court and then partially revoked. In this current proposal, the EEOC has issued two separate sets of regulations: one under the Americans with Disabilities Act (ADA) and one under the Genetic Information Nondiscrimination Act of 2008 (GINA).

Use It, but Don’t Lose It: New Stimulus Law Extends Time to Spend Down 2020 Health FSA and Dependent Care Balances

Employers will now have additional options to address participants’ unspent contributions to dependent care or health flexible spending accounts (FSAs) resulting from the COVID-19 pandemic. The Consolidated Appropriations Act, 2021 (H.R. 133, P.L. 116-260), signed into law on December 27, 2020, provides temporary relief for employees that were unable to spend down their dependent care and health FSAs by the end of the plan year and may otherwise forfeit these contributions.

What’s Changed, What Hasn’t: A Review of HIPAA Rules in a COVID-19 Context

With employers planning for employees to return to work following COVID-19–related closures, there are sure to be questions about sharing employee medical information as it relates to COVID-19 (symptoms, test results, status) within the workplace and with public authorities. Now may be a good time to review what has changed about federal privacy rules in light of the COVID-19 pandemic—and what hasn’t.

Federal Judges Halt Expanded Exemption From ACA Contraceptive Mandate

In back-to-back decisions, two federal district court judges have blocked implementation of a Trump administration rule that would exempt more employers from the Patient Protection and Affordable Care Act (ACA) requirement that employer-sponsored group health plans cover birth control supplies and services as preventive care without cost-sharing.

Proposed Rule Aims to Resurrect Health Reimbursement Arrangements

Under a proposed rule that the Department of Labor (DOL), Department of the Treasury, and the Department of Health and Human Services (HHS) jointly issued on October 29, 2018, employers may soon have more flexibility to fund health insurance coverage for employees through health reimbursement arrangements (HRAs), other account-based group health plans, and individual health insurance policies.

New Mental Health Parity Guidance and Enforcement Efforts May Warrant a Deep Dive Into Plan Administration

The Department of Labor (DOL), the Department of the Treasury, and the Department of Health and Human Services (HHS) are making good on their promise to issue more guidance and to aggressively enforce the federal Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) by recently issuing a slew of new guidance, enforcement statistics, and promises of continued aggressive enforcement.

DOL Proposes More Permissive Association Health Plan Rule

Small businesses and self-employed individuals may soon have more options for obtaining affordable group health coverage. As directed by Executive Order 13813, on January 5, 2018, the U.S. Department of Labor (DOL) released proposed regulations (83 Fed. Reg. 614) intended to increase the availability of association health plans (AHPs).