Employee Benefits & Executive Compensation Blog

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

Category Archives: Health Plan Compliance

Subscribe to Health Plan Compliance RSS Feed

District Court Holds Third-Party Administrator Violated ACA’s Anti-Discrimination Rules by Administering Self-Insured Plan’s Exclusion for Gender-Affirming Care

On the heels of several recent court decisions concerning gender-affirming care, a federal district court in Washington concluded that the denial of benefits for gender-affirming care by a third-party administrator (“TPA”) administering a self-insured plan violated Section 1557 of the Patient Protection and Affordable Care Act (the “ACA”).  By way of background, Section 1557 sets … Continue Reading

IRS Permanently Extends Deadlines for ACA Reports to Individuals

On December 15, 2022, the Internal Revenue Service (“IRS”) published final regulations that make permanent certain relief and changes relating to the Affordable Care Act (“ACA”) reporting requirements. Specifically, the final regulations (1) include an automatic 30-day extension for providing Forms 1095-B and 1095-C to covered individuals and employees, which would otherwise be due on … Continue Reading

The Greatest Gift of All…Tri-Agencies Issue Welcome Relief on Prescription Drug Reporting

Just three short days before the December 27th deadline for health plans and issuers to report prescription drug and health care spending information to the government, on December 23, 2022, the Departments of Labor, Treasury, and Health and Human Services (the “Departments”) issued undoubtedly welcome reporting relief for health plans and issuers facing difficulty meeting … Continue Reading

IRS Announces 2023 Increases to Health FSA and Transportation Fringe Benefit Limits

On October 18th, the IRS announced a slew of inflation adjustments for 2023, including to the annual contribution and carryover limits for healthcare flexible spending accounts and the monthly limit for qualified transportation fringe benefits.  The IRS did not increase the annual contribution limit for dependent care flexible spending accounts because that limit is not … Continue Reading

After Dobbs v. Jackson Women’s Health Organization: Impact on Employee Benefits

Employers and other group health plan sponsors are left with much to consider following the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which  overruled the Supreme Court’s prior landmark decisions in Roe v. Wade and Planned Parenthood v. Casey.  Those cases solidified a federal constitutional right to obtain an abortion and … Continue Reading

There’s More! Tri-Agencies Provide Clarifying Guidance on Group Health Plan Coverage of Over-the-Counter At-Home COVID-19 Tests

A few short weeks ago we told you in a blog post that, with only four days’ notice, the Departments of Labor, Treasury, and HHS (the Departments) required that, starting January 15, 2022, group health plans cover FDA-approved over-the-counter (OTC) at-home COVID-19 tests without participant cost-sharing, preauthorization, or medical management, regardless of whether a health … Continue Reading

You Can Go Home Again: Tri-Agencies Release New Group Health Plan Coverage Requirements for Over-the-Counter At-Home COVID-19 Tests

Looking forward to the weekend?  Many employers and plan administrators may also have been . . . up until yesterday, when the government issued new requirements that take effect on Saturday.  Specifically, starting this Saturday, January 15, 2022—yes, that’s four short days from now—and through the end of the public health emergency, group health plans … Continue Reading

IRS Proposal Extending Deadlines for ACA Reports to Individuals

The Internal Revenue Service (“IRS”) recently issued proposed regulations affecting certain reporting deadlines under the Patient Protection and Affordable Care Act (“ACA”).  Specifically, proposed regulations would make permanent an automatic 30-day extension for issuing Forms 1095-B and 1095-C to covered individuals and employees, which would otherwise be due by January 31. The proposed regulations also … Continue Reading

What Employers Should Know about ACA Shared Responsibility Payments

A recently released redacted report from the Treasury Inspector General for Tax Administration (TIGTA) offers some helpful insights for employers who may be assessed shared responsibility payments because the IRS thinks they failed to offer adequate health coverage, as required by the Affordable Care Act (ACA). The TIGTA report shows a wide gap between the … Continue Reading

New IRS Guidance for Tax-Exempt Entities Funding Employee Benefits

The IRS recently released a final regulation clarifying how voluntary employees’ beneficiary associations (VEBAs) and supplemental unemployment benefit trusts (SUBs) should calculate unrelated business taxable income. VEBAs and SUBs are tax-exempt entities that are used to fund employee benefit programs. Read below for background, details of the final regulation, and the applicability date. Background Although … Continue Reading

[Podcast]: ACA Employer Assessment Letters

In this episode of the Proskauer Benefits Brief, senior counsel Damian Myers and associate Liz Down examine the IRS’s enforcement of the Affordable Care Act’s (ACA) employer shared responsibility mandate. We discuss how the IRS is assessing penalties and offer tips on what employers can do when they receive assessment notices. Be sure to tune in for the … Continue Reading

More To Do’s to Add to Your 2013 Health Plan Compliance Calendar – Don’t Forget About HIPAA/HITECH

For much of 2013, group health plan sponsors have been gearing up for the compliance challenges associated with the Affordable Care Act. There is no doubt that much of the planning, focus and energy trained on the next round of effective dates under the Affordable Care Act is warranted. Nevertheless, plan sponsors must be certain … Continue Reading
LexBlog

This website uses third party cookies, over which we have no control. To deactivate the use of third party advertising cookies, you should alter the settings in your browser.

OK