Understanding Employee Benefits and key developments in the employee benefits field and items of interest to our clients. MORE

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Employers who sponsor health plans for their employees can purchase insurance contracts to fund those plans. Alternatively, employers can self-fund or self-insure those benefits, agreeing to pay the claims themselves. Many employers who provide self-funded plans also buy stop-loss insurance to cover the risk of exceptionally large claims. However, employers must be careful that their …

Many employers are offering wellness programs to employees in connection with their health plans and are aware of the HIPAA regulations that govern such programs. Although employers design their wellness programs to conform to the HIPAA guidance, they sometimes forget that the Americans with Disabilities Act (ADA) might also affect the wellness program.

Employers covered …

The Department of Labor has published two checklists that plan sponsors can use to test their compliance with group health plan requirements. One checklist addresses the Affordable Care Act (ACA or health care reform) provisions, including a plan’s status as a “grandfathered” plan exempt from some ACA requirements, and such ACA requirements as limitations on …

The Affordable Care Act requires most health plans to cover certain women’s preventive services, including contraception, without charging a co-pay or deductible. On January 30, 2013, the Obama Administration released proposed rules that continue to implement provisions in the health care law providing women contraceptive coverage without cost sharing, while at the same time respond…

My colleague, Jessica Kracl, has written an Alert  for our health care clients about the recently issued privacy and security regulations under the Health Insurance Portability and Accountability Act (HIPAA). Employer group health plans are covered entities under HIPAA and therefore must comply with the new regulations. Jessica’s Alert is a good summary of the…

The Patient Protection and Affordable Care Act requires employers who issue 250 or more W-2s in a year to report the aggregate cost of coverage under an employer-sponsored group health plan in Box 12 of each employee’s Form W-2, using code DD. In general, the amount reported should include both the employer and employee-paid portions …

The Affordable Care Act establishes a Patient-Centered Outcomes Research Institute as a private nonprofit corporation to assist patients, clinicians, purchasers and policy makers in making informed health decisions using evidence based medicine. The Institute is to be funded through a trust fund called the Patient-Centered Outcomes Research Trust Fund. Under the Affordable Care Act, both …

Employers are generally aware that medical plans are subject to continuation coverage under the federal law known as COBRA.  They may forget that COBRA extends to all group health plans, including dental, vision and medical flexible spending account plans. A recent federal district court decision highlighted the risk to employers who forget those facts.

The …

Small employers (those who normally employ fewer than 20 full-time equivalent employees during the preceding year) are not subject to health care continuation requirements under the law known as “COBRA.” (Some states have their own “mini-COBRA” laws; this post is speaking only about the federal requirements.) A recent district court decision from Ohio considered the …