Archives: Health and Welfare Plans

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Amy Gordon and Susan Nash Named Top Authors in JD Supra’s 2017 Readers’ Choice Awards

Amy Gordon and Susan Nash were recognized as top authors by JD Supra’s 2017 Readers’ Choice Awards for their thought leadership pieces in the Defense & Space Industry and Affordable Care Act (ACA) categories. In addition, Amy’s article, along with Sarah Raaii and Jamie Weyeneth, “Recent Government-Issued FAQs Clarify ACA Employer Mandate, Market Reforms” was … Continue Reading

More Federal Legislation Aimed at Expanding Medicare Coverage of Telehealth Services

Shelby Buettner, Marshall Jackson, Jr., Lisa Schmitz Mazur and Dale Van Demark wrote this bylined article on a proposed US Senate bill to expand Medicare’s coverage of telehealth services. The bill would require the Center for Medicare and Medicaid Innovation to test the effectiveness of telehealth models, and cover through the Medicare program those models … Continue Reading

The Future of Discretionary Clauses in California Life and Disability Insurance Agreements

On May 11, 2017, the United States Court of Appeals for the Ninth Circuit reversed a district court ruling, and upheld a California law that invalidates a plan provision that assigns the final determination on benefit payout determinations to an insurer. How will this impact the future of discretionary clauses in California life and disability … Continue Reading

CMS Aims to Stabilize Exchanges but Does Not Address Issuers’ Biggest Questions

CMS recently released a final rule with the goal of stabilizing Exchange markets for 2018. The agency also issued several significant guidance documents where CMS extended the deadlines for 2018 rate and Exchange qualified health plan application submissions, adopted a good faith compliance standard for 2018 and delegated additional plan certification responsibilities to states. While … Continue Reading

Executive Order Regarding Contraceptive Mandate Directed toward Religious Employers

Late last week, President Donald Trump signed an executive order directing federal agencies to look into exempting religious employers from the Affordable Care Act’s (ACA) contraceptive mandate. Qualifying religious employers (e.g. houses of worship) are already exempt from providing contraceptive coverage under their benefit plans, and an accommodation process is provided for certain non-profit employers … Continue Reading

Upcoming Employee Benefits Innovators Roundtable Series!

McDermott will be holding its annual Employee Benefits Innovators Roundtable Series this month. The roundtables offer experienced benefits professionals an opportunity to discuss cutting-edge, topical employer-driven benefit programs with their peers and members of McDermott’s employee benefits team. We are meeting in four locations this year. Join us in one of the following cities: May … Continue Reading

IRS Implementation of ACA’s Employer Shared Responsibility Provision Falls Short Based on the Results of a Recent Audit

Based on a recent audit conducted by the Treasury Inspector General for Tax Administration (TIGTA), the IRS’ processes and procedures to ensure compliance with the employer information reporting requirements mandated by the employer shared responsibility provision (the play or pay rules) of the Affordable Care Act (ACA), have fallen short of their intended goals. (see … Continue Reading

DOL Health & Welfare Plan Audit Response and Protection: Reducing Risk Exposure to Avoid Costly Penalties

In a recent presentation, McDermott attorneys discussed how to prepare responses for a Department of Labor (DOL) investigative audit of a company’s health and welfare plan, including required documentation and procedures, DOL audit triggers, and key legal provisions that employers and employee benefits advisers should monitor regularly and review prior to responding to a DOL … Continue Reading

View From McDermott: Employee Benefit Plan Considerations for Health Systems in 2017

Amy Gordon, Jeffrey Holdvogt, Susan Nash and Mary Samsa wrote this bylined article on health system employee benefit opportunities and challenges in 2017. The authors urged health systems to review internal controls for 403(b) plan compliance and new design opportunities for 457(f) plans, to review their short- and long-term health plan operation in light of … Continue Reading

American Health Care Act: Considerations for Employers

On Monday March 6, 2017, the House Republican leadership in the Energy and Commerce and Ways and Means Committees unveiled their signature bill to “repeal and replace” the Affordable Care Act (ACA). The “American Health Care Act” (AHCA) is an effort to make good on President Trump’s promise to dismantle the ACA. Democrats are united … Continue Reading

Trump Administration Takes First Steps to Support Exchanges, but Key Questions Remain

In an effort to stabilize the Exchanges and encourage issuer participation, the Centers for Medicare & Medicaid Services (CMS) recently extended the federal Exchange application and rate filing deadlines and published a proposed rule affecting the individual health insurance market and the Exchanges. While issuers will likely see these actions as encouraging signs of the … Continue Reading

The Challenges of the Trump Administration’s Vow to “Repeal and Replace” the Affordable Care Act

In the presentation “ACA Repeal/Replace Under the Trump Administration,” Susan Nash discusses the implications of President Trump and the GOP’s immediate vow to “repeal and replace” the Affordable Care Act (ACA), which was enacted in 2010 by the Obama Administration to reform the health care system in the US. A complete repeal is unlikely since … Continue Reading

Three Key Employee Benefit Plan Issues for Health Systems in 2017

Health system employers should make sure they are familiar with three key employee benefit issues: (1) the new Department of Labor (DOL) fiduciary rule that currently becomes effective April 10, 2017 (but may be delayed in the near future under the new administration); (2) recent excessive fee litigation filed against universities (and now health care … Continue Reading

DOL Finalizes New Disability Claim Rules for Welfare and Retirement Benefit Plans

The US Department of Labor’s Employee Benefit Security Administration recently released final rules on the adjudication of disability claims under welfare and retirement plans (the Final Rule). The purpose of the Final Rule is to add procedural protections and safeguards that are aimed at providing a full and fair claims review process for disability benefit … Continue Reading

Northern District of Texas Blocks Enforcement of the Non-Discrimination Regulations of the ACA

On December 31, 2016, the US District Court for the Northern District of Texas issued an opinion and order in Franciscan Alliance, Inc. et al v. Burwell, which preliminarily enjoins the US Department of Health and Human Services from enforcing, on a nationwide basis, certain portions of the regulations under Section 1557 of the Affordable … Continue Reading

Supreme Court Declines to Hear Appeal to a Michigan Tax on Health Insurance Plans

The Supreme Court of the United States has declined to hear the Self-Insurance Institute of America Inc.’s ERISA preemption challenge to a Michigan tax on health insurance plans. As we previously reported last year, the Sixth Circuit, had decided, on remand from the Supreme Court, that the Michigan Health Insurance Claims Assessment Act (Act) was … Continue Reading

Accelerating Deductions for Compensation and Benefits if Corporate Tax Rates Are Reduced

President-elect Trump proposes to reduce the maximum corporate income tax rate from 35 percent to 15 percent. While the effective date of any rate reduction is uncertain, it likely will not occur before 2018. Deductions claimed when tax rates are 35 percent are worth 20 percent more to the taxpayer than if the same deduction … Continue Reading

Guidance on Ransomware Attacks under HIPAA and State Data Breach Notification Laws

The US Department of Health and Human Services has recently issued guidance under the Health Insurance Portability and Accountability Act on what covered entities and business associates can do to prevent and recover from ransomware attacks; however, other state data breach notification laws can also be triggered by a ransomware attack. The authors of this … Continue Reading
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