The Mental Health Parity and Addiction Equity Act of 2008 (“MHPAEA”) generally requires that the financial requirements and treatment limitations that apply to mental health and substance use disorder (“MH/SUD”) benefits cannot be more restrictive than the financial requirements and treatment limitations that apply to medical and surgical (“M/S”) benefits. Financial requirements include, for example, […]
In my opinion, one of the best changes made by the Affordable Care Act is the mandate that requires health plans to provide certain specified preventive services without imposing any cost sharing. This is sometimes referred to as “free” preventive care. As a result of this mandate, deductibles, copays, coinsurance, and other cost sharing may […]
As efforts to reform the Affordable Care Act (the “ACA”) stall in Congress, a recent government report suggests that the Internal Revenue Service is preparing to identify and collect employer shared responsibility penalties. The Treasury Inspector General for Tax Administration issued the report, Affordable Care Act: Assessment of Efforts to Implement the Employer Shared Responsibility […]
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 […]
On January 20, 2017, President Trump signed an Executive Order (“Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal,” hereinafter referred to as the “Order”) relating to the future of the Affordable Care Act (“ACA”). The stated goal is to direct the agencies (IRS, HHS, and DOL) to waive or […]
After surviving two Supreme Court cases and numerous repeal efforts, the Affordable Care Act (“ACA”) is in jeopardy again. Despite the law’s uncertainty, employers may want to continue their compliance efforts because: (1) the ACA is currently the law and there are significant penalties for noncompliance; and (2) for the reasons stated below complete repeal […]
It’s that time of year when boys and girls start making their lists for the holidays, but we in the employee benefits world make a very different kind of list. In the rapidly changing world of employee benefits and executive compensation law, a checklist can be particularly helpful to make sure important issues do not […]
The IRS delivered welcome news to employers gearing up to meet the Affordable Care Act’s (“ACA”) information reporting deadlines for the 2016 calendar year. In Notice 2016-70, the IRS extended the deadline to furnish Forms 1095-B and 1095-C to employees. The new deadlines are provided below. Old Distribution Deadline New Distribution Deadline Form 1095-B […]
In recent months, we have written a fair amount about providing transgender benefits in light of the nondiscrimination provisions of the Affordable Care Act. Our blogs of March 30, 2016 and June 22, 2016 highlight the key contours of the nondiscrimination rule. In our June 22 post, we mention in passing that the final nondiscrimination […]
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. […]
