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A Momentary Victory for the ACA: Federal Judge Issues a Nationwide Injunction against Trump Administration’s Contraceptive Coverage Carve Outs

On January 14, 2019, US District Judge Wendy Beetlestone in the US District Court for the Eastern District of Pennsylvania issued a nationwide preliminary injunction blocking the Trump administration’s carveouts to the Affordable Care Act’s (ACA) contraceptive coverage mandate. One day prior, US District Judge Haywood Gilliam in the US District Court for the Northern District of California issued a more limited injunction blocking the same carve outs from taking effect in 13 states plus the District of Columbia. On October 6, 2017, the Trump administration issued rules that are the subject of these two decisions. The rules would have allowed employers to raise religious and moral objections to avoid the ACA’s requirement that contraceptive coverage be provided without cost sharing under their group health plans. Under the ACA, certain contraceptive products and services are included in the list of preventive services that must be covered by most group health...

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Fridays with Benefits Webinar | Mental Health Parity and Compliance Complexities

New proposed guidance on mental health parity issued last month spotlights the complexities of these rules. Join us for out next Fridays with Benefits webinar on June 1 as Jacob M. Mattinson and Judith Wethall discuss the impact these rules will have on group health plans and how to determine if your plan complies. Find out about recent litigation and agency enforcement actions. Friday, June 1st, 2018 10:00 – 10:45 am PDT 11:00 – 11:45 am MDT 12:00 – 12:45 pm CDT 1:00 – 1:45 pm EDT Register now.  

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Government Shutdown Pushes Back Cadillac Tax

On January 22, 2018, Congress passed an interim funding bill to end the three-day government shutdown that also pushed back the effective date of the Affordable Care Act’s controversial “Cadillac Tax.”  The Cadillac Tax imposes an excise tax on group health plans that provide benefits in excess of certain thresholds.  The new legislation pushes the effective date back an additional two years to January 1, 2022.

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21st Century Cures Act: Small Employer Changes under the Affordable Care Act

President Obama has signed the 21st Century Cures Act, Pub. L. No. 114-225 (Dec. 13, 2016). As we previously mentioned, the new legislation permits small employers (those that are not considered applicable large employers under the Affordable Care Act (ACA)) to maintain general-purpose stand-alone Health Reimbursement Arrangements (HRAs) if they do not offer a group health plan to any of their employees. Stand-alone HRAs were not permitted based on ACA guidance. Annual benefits under these new HRAs cannot exceed an indexed maximum of $4,950 per year ($10,000 if family members are covered), must be funded solely by employer contributions (employee contributions are not permitted), and can only be used for the reimbursement of Internal Revenue Code §213(d) medical care expenses.

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Implementation Date for New Summary of Benefits and Coverage Template

The U.S. Departments of Treasury, Labor, and Health and Human Services (the Departments) recently issued new guidance regarding the intended timeframe for the use of the new summary of benefits and coverage (SBC) template and instructions, an updated uniform glossary and other associated materials. Background The Affordable Care Act (ACA) generally requires group health plans and health insurance issuers offering group or individual health insurance coverage to provide an SBC to participants and beneficiaries. The Departments issued revised final regulations governing the SBC requirement on June 16, 2015, and published a proposed new SBC template on February 26, 2016. Comments on the proposed template and associated documents are due by March 28, 2016. Read the full article.

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Finalized ACA Regulations on Transitional Reinsurance Program Premiums and Potential Effects for Employer-Sponsored Group Health Plans

by Amy M. Gordon, Susan M. Nash and Jacob Mattinson As part of the Patient Protection and Affordable Care Act, the U.S. Department of Health and Human Services (HHS) recently released final regulations regarding the transitional reinsurance program fee effective in CY 2014.  Effective May 10, 2013, the regulations address the estimated amount of annual contributions that will be paid to HHS from employer-sponsored group health plans, the types of welfare plans that are subject to the fee, the applicability of the fee to COBRA coverage and the treatment of certain retiree benefits. To read the full article, click here.

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