Employee Benefits & Executive Compensation Blog

The View from Proskauer on Developments in the World of Employee Benefits, Executive Compensation & ERISA Litigation

Stacy Barrow

Stacy Barrow

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EEOC’s Proposed Wellness Regulations Add Burdensome Notice Requirement; Still Prohibit Mandatory HRAs

On April 16, 2015, the Equal Employment Opportunity Commission (EEOC) released proposed regulations covering wellness programs that involve disability-related inquiries or medical examinations.  The release of the proposed regulations follows months of EEOC enforcement actions against employers alleging that wellness programs sponsored by the employers violated the Americans with Disabilities Act (ADA) despite compliance with … Continue Reading

New HHS Regulations “Clarify” that Health Plans Covering Families Must Have “Embedded” Individual Cost-Sharing Limits

On February 27, 2015, the Department of Health and Human Services (HHS) released its final HHS Notice of Benefit and Payment Parameters for 2016.  The lengthy regulation covers a wide range of topics affecting group health plans, including minimum value, determination of the transitional reinsurance fee, and qualified health plan rates and other market reforms … Continue Reading

U.S. Supreme Court to Decide Fate of Same-Sex Marriage Laws

It was announced today that the U.S. Supreme Court will consider two important questions relating to same-sex marriage–whether states are required to allow same-sex marriages within their jurisdictions, and whether states are required to recognize same-sex marriages performed in other states.  The decisions are expected to be issued in June of this year.… Continue Reading

Deja-Vu All Over Again: Congress Once Again Retroactively Increases Mass Transit Benefit Limits

Prior to the enactment of the Tax Increase Prevention Act of 2014 (“TIPA”) in December 2014, effective for 2014, mass transit commuters were only able to contribute a maximum of $130 per month on a pre-tax basis toward their transit expenses (a reduction from $245 per month permitted in 2013).  TIPA retroactively increased the maximum … Continue Reading

SCOTUS to Review Subsidy Issue

On November 7, the U.S. Supreme Court announced it was going to review King v. Burwell.  At issue in the case is whether Fourth Circuit correctly determined that the IRS did not exceed its authority when it released a rule in 2012 providing that federal subsidies under the Affordable Care Act are available in both … Continue Reading

IRS to Close “Loophole” on “Sub-Standard” Plans without Hospitalization or Physician Services Coverage

On November 4, 2014, the Internal Revenue Service (“IRS”) announced that it intends to close a perceived “loophole” in health care reform.  This so-called loophole allows employers to offer low cost health plans that don’t cover inpatient hospitalization services or physician services (or both).  If that coverage were treated as “minimum value” coverage, then employers … Continue Reading

IRS to Amend Cafeteria Plan Regulations to Facilitate Enrollment in Marketplace Coverage

On Thursday, September 18, 2014, the Internal Revenue Service (“IRS”) released Notice 2014-55, which expands the cafeteria plan “change in status” rules to allow plans to offer employees an option to revoke their elections for employer-sponsored health coverage to purchase a qualified health plan through a Health Insurance Marketplace (“Marketplace”).   The notice is effective immediately … Continue Reading

California Repeals 60-Day Limit on Waiting Periods

On August 15, 2014, California passed Senate Bill 1034, which repealed an insurance law (Assembly Bill 1083) that prohibited insurance companies from including waiting periods in excess of 60 days in their group health insurance contracts.  The new law, effective January 1, 2015, prohibits California insurance companies from applying any “waiting or affiliation period” under … Continue Reading

IRS Increases 9.5% Affordability Threshold—Or Did It?

On July 24, 2014, the Internal Revenue Service (IRS) released three Revenue Procedures (2014-46, 2014-37, and 2014-41), which provide guidance to individuals on their obligation to maintain minimum essential coverage (MEC) under the Affordable Care Act’s (ACA) so-called “individual mandate.” Most notably for employers is that, in Revenue Procedure 2014-37, the IRS increased the threshold … Continue Reading

Hobby Lobby: The Supreme Court’s View and Its Impact

For the second time in two years the United States Supreme Court (the “Court”) has ruled against the Obama Administration with respect to elements of the Affordable Care Act (the “ACA”).  In a 5-4 decision announced today in Burwell v. Hobby Lobby Stores, Inc.  (“Hobby Lobby”) (f/k/a Sebelius v. Hobby Lobby Stores, Inc.), the Court … Continue Reading

Final Regulations on Orientation Periods Released

On June 20, the Federal regulatory agencies in charge of health care reform guidance (the Departments of Labor, Treasury, and Health and Human Services) released final regulations (“Final Regulations”) clarifying the relationship between a group health plan’s eligibility criteria and the Affordable Care Act’s (ACA) 90-day limit on waiting periods. Specifically, the Final Regulations (published … Continue Reading

Reminder: ACA’s Out-of-Pocket Limits Differ from HSA-Qualified HDHPs Starting in 2015

In April, the IRS released the 2015 inflation adjustments for Health Savings Accounts (HSA) and HSA-qualified high deductible health plans (HDHPs). A month earlier, HHS released details on the “premium adjustment percentage,” which is used to calculate annual increases in cost sharing under the Affordable Care Act’s (ACA) maximum out-of-pocket rules. These ACA rules limit … Continue Reading

ACA’s Deductible Limits for Small Groups Repealed

On April 1, 2014, President Obama signed into law the Protecting Access to Medicare Act of 2014. The primary purpose of the law is to provide a one-year delay of a 24% reduction in payment rates for physicians who participate in the Medicare program. Of interest to small employers, Section 213 of the law repeals … Continue Reading

Coverage of Dependents: Final “Pay-or-Play” Regulations Exclude Stepchildren and Others; Extend Prior Transitional Relief

As previously reported, the IRS recently released final regulations on the Affordable Care Act’s (ACA) employer “shared responsibility” provisions, also known as the “pay-or-play” mandate. Under the mandate, in order to avoid potential penalties, an applicable large employer (generally, 50 or more full-time equivalent employees (100 or more in 2015)) must offer affordable, minimum value … Continue Reading

They’re Back! Final Regulations On Employer “Pay-or-Play” Mandate Released – IRS Provides Transition Relief To Employers with 50-100 Employees

On Monday, February 10, 2014, the IRS released final regulations on the Affordable Care Act’s (ACA) employer “shared responsibility” provisions, also known as the “pay-or-play” mandate. The final regulations weigh in at 227 pages. We will review them over the coming days and will release additional communication pieces once we fully digest these new regulations. … Continue Reading

Recent Guidance on Wellness Programs Clarifies Premium Surcharges for Tobacco Use

As previously reported, the federal agencies responsible for drafting the rules implementing the Affordable Care Act (ACA) (the U.S. Labor Department, the U.S. Department of Health and Human Services and the U.S. Treasury Department (together, the “Departments”)) on January 9, 2014 issued FAQ Part XVIII, regarding implementation of the market reform provisions of the ACA. … Continue Reading

Departments Release New FAQ Guidance on ACA and MHPAEA Implementation Issues

On January 9, 2014, the Departments of Treasury, Labor, and Health and Human Services (collectively, the “Departments”) published the eighteenth installment of a series of answers to Frequently Asked Questions regarding implementation of the Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The FAQ provides guidance on … Continue Reading

Agencies Release Guidance on HRAs, FSAs, and Employer Payment Plans

On Friday, September 13, 2013, the IRS released Notice 2013-54 and the DOL issued Technical Release 2013-03 in substantially identical form.  This guidance, which is generally effective January 1, 2014, provides much needed clarification on the application of certain provisions of the Patient Protection and Affordable Care Act (“ACA”) (annual limits and preventive care) to … Continue Reading
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