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Enforcement Back On: Departments Rescind Enforcement Relief for Machine Readable File Requirements under Transparency in Coverage Rules

On September 27th, the Departments released FAQs about Affordable Care Act Implementation Part 61 (“FAQ 61”), announcing that the Departments are rescinding prior-issued enforcement relief for certain machine-readable file requirements under the Transparency in Coverage (the “TiC”) regulations. The final TiC regulations, published in the Federal Register on November 12, 2020, in part required group […]

| 3 min read

Tighter Margins: IRS Makes It More Difficult to Meet ACA Affordability Safe Harbors in 2024

We have reported previously on the importance of understanding the coverage and reporting rules of the Affordable Care Act.  In particular, Code Section 4980H imposes penalties on large employers for failure to offer minimum essential coverage to 95% or more of their full-time employees (and dependents) or to provide affordable, minimum value health insurance. Whether […]

| 2 min read

COVID-19 Comes to an End(emic):  Preparing Group Health Plans for Anticipated End of COVID-19 Emergencies

The Biden Administration recently announced its plan to end both the National Emergency and Public Health Emergency for COVID-19 (together, the “COVID-19 Emergencies”) on May 11, 2023.  The end of the COVID-19 Emergencies will trigger (immediately or within specified timeframes) the end of various COVID-19 requirements and related relief for group health plans.  As further […]

| 3 min read

Proposed Rules Expand Access to Contraceptive Care as a Preventive Service

On January 30, 2023, the Departments of Health and Human Services, Treasury, and Labor (collectively “the Departments”) issued proposed rules entitled “Coverage of Certain Preventive Services under the Affordable Care Act” (the “Proposed Rules”).  The Proposed Rules reflect the Departments’ continuing efforts to ensure that women have access to contraceptive care without cost sharing through […]

| 4 min read

What’s Old Is New Again: HHS Proposes to Reinstate and Expand Transgender Nondiscrimination Rules

Since it was enacted in 2010, Section 1557 of the Affordable Care Act (“Section 1557”) has prohibited discrimination in covered health programs and activities on the basis of race, color, national origin, age, disability, or sex.  As we have previously reported, the application of Section 1557 has proven controversial with several competing regulations and numerous […]

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Federal Agencies Issue Guidance After Dobbs Ruling

In response to the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization, the U.S. Department of Health and Human Services (“HHS”) Secretary Xavier Becerra directed HHS agencies to act within their power to protect the rights of patients seeking reproductive care and their providers.  Some of the significant guidance HHS agencies issued in […]

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An Interesting Intersection: No Surprises Act Claims and the New Fee Disclosure Requirements for Group Health Plans

As reported in our January 7, 2022 SW Benefits Blog “The DOL Asks and Answers Questions About the New Welfare Plan Fee Disclosure Rules,” group health plans must now comply with the ERISA Section 408(b)(2) disclosure requirements.  The CAA amended ERISA Section 408(b)(2) to extend the disclosure requirements, which have long applied to retirement plans, […]

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Departments Provide Some Relief to Health Plan Sponsors Facing Looming Year-End Deadlines

Year-end is always a scramble for health plan sponsors as they go through renewal and open enrollment.  This year was looking to be worse than normal given the impending deadlines for complying with the transparency in coverage regulations (“TiC”) and the numerous changes made by the Consolidated Appropriations Act, 2021 (the “CAA”).  As reflected in […]

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Better Late Than Never: IRS Issues Guidance Clarifying COBRA Premium Subsidy Rules

S&W Insight: The IRS clarified several trailing issues with respect to COBRA premium subsidies under the American Rescue Plan Act, including extended election periods, eligibility for other coverage, and rules about allocating premium credits among employers. In addition, a notice deadline is on the horizon. Many employers have been grappling with the ramifications of the […]

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