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Trump Signs Act Mandating Group Health Plans Cover COVID-19 Testing For Free

On March 18, 2020, President Trump signed the Families First Coronavirus Response Act (“FFCRA”) requiring group health plans to cover COVID-19 testing for free and without preauthorization.  This means no deductibles, no copays, and no coinsurance.  More details regarding the changes employers are required to make are explained in our Employee Benefits Update of March […]

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NC

The Family Medical Leave Act and Benefit Plans: What comes first – the Law or the Employer’s Established Policy?

An employer that employs 50 or more employees for each working day during each of 20 or more calendar workweeks in the current or preceding calendar year is subject to the Family Medical Leave Act (“FMLA”). Therefore, often when I am reviewing an employee benefits plan or policy I flag language that states something like: […]

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Air Ambulance Services – What Does Your Plan Cover?

Due to the increased litigation of air ambulance claims, employers may want to review their plan language to see whether their group health plan covers air ambulance services, and if so, to better understand the terms of the coverage. Below are three issues employers may want to consider: Expensive and Often Out-of-Network.  Air ambulance claims […]

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Curing What Ails You – Relief for Small Employer HRAs

The impact of the Affordable Care Act (“ACA”) on health reimbursement arrangements (“HRAs”) has not been favorable.  Many employers got rid of their HRAs or integrated them with a major medical plan in order to avoid significant penalties under ACA.  These rules imposed a significant burden on small employers, because many small employers used HRAs […]

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NC

What is Telemedicine? A Cool Benefit or a Hot Mess?

We’ve had numerous inquiries lately about telemedicine benefits.  My clients most typically ask either “is this a group health plan?” or “is it just access to another provider?”  Clearly, there is much confusion surrounding telemedicine benefits.  Part of the problem is that the regulators have yet to issue guidance on how telemedicine should be treated.  […]

NC

Proposed Regulations for Summary of Benefits and Coverage Seek to Simplify Compliance

As part of Health Care Reform, employers and insurers are required to provide group health plan participants with a Summary of Benefits and Coverage (“SBC”) describing the important features of the group health plan option(s) offered by the employer/insurer.  The SBC is also intended to provide participants a way to easily compare different group health […]

KH
Former Associate