NEWS & INSIGHTS
Evolving technology, increasing threat vectors, and growing attacker sophistication have continued to drive up both the frequency and severity of cyber incidents, resulting in an ongoing rise in cyber insurance claims and subsequent underwriting losses. Amid these market conditions, most policyholders experienced higher cyber insurance rates throughout 2022. In addition to increased premiums, insureds…
Environmental, social, and governance (ESG) factors are often considered by socially conscious investors when evaluating companies on sustainability and social conscientiousness. While ESG metrics can be hard to measure, the risks surrounding them are increasing. As consumer, investor, and shareholder action increasingly focus on ESG, companies and their directors and officers (D&Os) must proactively address…
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The Employee Benefits Market Outlook examines critical employee benefits topics and trends, delivering insights into the market and forecasting where the industry may be headed in 2023 and beyond. Before addressing future trends, it’s critical to understand the central themes from 2022 that laid the groundwork for this year. To that end, the Market Outlook…
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A Shifting Market Since 2019, the commercial insurance sector has been grappling with a hard marketplace that is notably less friendly to insurance buyers. Such challenging conditions were brought on by a confluence of factors that led insurance companies to reevaluate their positions in the industry. After all, the increased frequency and severity of claims,…
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COVID-19 News
In today’s dynamic market, HR professionals are tasked with adapting to the changing expectations of organizations and employees, particularly in challenging economic conditions. In 2024, proactive HR leaders and professionals will implement strategies that incorporate AI into everyday operations, meet evolving compliance standards, and prioritize their workforce’s needs and aspirations. Organizations can foster a more…
Throughout 2023, the commercial insurance space became an increasingly complex environment. Mirroring other areas of the economy, the sector encountered continued volatility within the past year. Shifting market dynamics, new capacity, and optimal underwriting results in some lines of coverage set the stage for improved conditions and premium deceleration. On the other hand, headwinds facing…
2023 presented employers with many new and difficult compliance challenges, including federal and state laws and regulations expanding worker protections, widespread adoption of artificial intelligence (AI) in the workplace, and increased enforcement actions by federal agencies. Employers have had to respond as courts and federal agencies addressed several hot-button issues. In addition to these novel…
In 2023, employers were forced to confront new and enduring challenges, including rising healthcare costs, regulatory changes, ongoing high inflation, a competitive labor market, and growing employee demands. For many organizations, these challenges resulted in a difficult and demanding year. While many of these difficulties will likely continue through 2024 and beyond, understanding these challenges…
Increasing cyber insurance claim frequency and severity have generated a volatile risk environment in recent years, with most policyholders facing continued premium hikes. Fortunately, the segment experienced underwriting profitability in 2022, allowing for conditions to soften during 2023. Yet, many insureds are still experiencing coverage restrictions, scrutiny from underwriters regarding cybersecurity practices and exclusions for…
On April 13, 2023, the Departments of Labor, Health and Human Services, and the Treasury (Departments) issued frequently asked questions (FAQs) regarding the Affordable Care Act’s (ACA) preventive care coverage requirement. The Departments issued these FAQs in response to a recent court decision from Texas (Braidwood Management Inc. v. Becerra) that invalidated a portion of…
The coronavirus pandemic has sparked one of the largest social experiments in history. Virtually overnight, businesses across the world have been forced to rethink how they operate. Decisions made during this uncertain period will resonate for years and may serve as the base for a new, remote lifestyle post-coronavirus. Employee work-life balance is especially important…
May is Mental Health Awareness Month, a national campaign designed to raise awareness about mental health issues and reduce the stigma surrounding mental illness. Mental health issues and mental illness are common. According to the National Institute of Mental Health, nearly 60 million U.S. adults lived with mental illness in 2021. Your mental health is…
Your mental health includes how you think, feel, and act and your emotional and social well-being. Mental health can change over time, depending on factors like workload, stress, and work-life balance. Mental Health Awareness Month is a national movement in May to increase awareness about mental health, fight the stigma, celebrate recovery, and support Americans…
The Biden administration had previously announced a May 11, 2023, end date for the national and public health emergencies (PHE). Still, the signing of the bipartisan legislation terminates the national emergency as of April 10, 2023. The PHE is still scheduled to end on May 11, 2023. On Jan. 30, 2023, the Biden Administration announced…
Environmental, social, and governance (ESG) factors are often considered by socially conscious investors when evaluating companies on sustainability and social conscientiousness. While ESG metrics can be hard to measure, the risks surrounding them are increasing. As consumer, investor, and shareholder action increasingly focus on ESG, companies and their directors and officers (D&Os) must proactively address…
The Employee Benefits Market Outlook examines critical employee benefits topics and trends, delivering insights into the market and forecasting where the industry may be headed in 2023 and beyond. Before addressing future trends, it’s critical to understand the central themes from 2022 that laid the groundwork for this year. To that end, the Market Outlook…
A Shifting Market Since 2019, the commercial insurance sector has been grappling with a hard marketplace that is notably less friendly to insurance buyers. Such challenging conditions were brought on by a confluence of factors that led insurance companies to reevaluate their positions in the industry. After all, the increased frequency and severity of claims,…
Over the last few years, almost every aspect of the workplace has changed, leading to many unforeseen challenges. Unfortunately, many challenges plaguing workplaces in 2022 will likely continue in 2023 and beyond. In particular, current labor challenges are forcing employers to find ways to balance rising costs and inflation while providing employees with benefits they…
JANUARY 10, 2023 [UPDATED on Jan. 11] Controlled substances became a little less controlled during the pandemic. That benefited patients (for their health) and telehealth startups (to make money). Some potentially addictive medications — like buprenorphine and Adderall — are now far more available online to patients because of regulatory changes. Given the scarcity…
JANUARY 4, 2023 OKLAHOMA CITY — By the summer of 2021, Phil Maytubby, deputy CEO of the health department here, was concerned to see the numbers of people vaccinated against covid-19 slipping after an initially robust response. With doubt, fear, and misinformation running rampant nationwide — both online and offline — he knew the agency…
Between the COVID-19 pandemic, inflation, and evolving job duties, more employees are experiencing mental health challenges. A 2022 Lyra survey revealed that 84% of employees experienced at least one mental health challenge over the past year. They’re feeling anxious, burnt out, stressed and depressed. As such, organizations are expected to take more responsibility for workers’…
On January 11, 2023, the Secretary of Health and Human Services (“HHSâ€) renewed the COVID-19 pandemic Public Health Emergency. This will again extend the Public Health Emergency Period (the “Emergency Periodâ€) for an additional 90 days, and as a result, numerous temporary benefit plan changes will remain in effect. Important Definitions Emergency Period HHS…
Just as HR professionals quickly adapted to changes at the height of the pandemic, they must now adapt and respond to today’s evolving expectations of organizations and employees. As such, savvy HR leaders and professionals will approach 2023 with human-centric strategies that holistically support and benefit workers. Organizations will benefit from putting people first and…
DECEMBER 6, 2022 Anna Sutton was shocked when she received a letter from her husband’s job-based health plan stating that Humira, an expensive drug used to treat her daughter’s juvenile arthritis, was now on a long list of medications considered “nonessential benefits.†The July 2021 letter said the family could either participate in a new…
DECEMBER 7, 2022 Nearly 6 million Americans have taken Paxlovid for free, courtesy of the federal government. The Pfizer pill has helped prevent many people infected with covid-19 from being hospitalized or dying, and it may even reduce the risk of developing long covid. But the government plans to stop footing the bill within months,…
NOVEMBER 18, 2022 ELKO, Nev. — When Elko County commissioners rejected a $500,000 grant from the Centers for Disease Control and Prevention that could have helped the county create a health department or health district, Kayla Hopkins pleaded with them to reconsider. Hopkins, who has lived for nearly nine years in the sprawling rural…
NOVEMBER 9, 2022 When Josephine Cabrera Taveras was infected with covid-19 in the spring of 2020, she didn’t anticipate that the virus would knock her out of work for two years and put her family at risk for eviction. Taveras, a mother of two in Brooklyn, New York, said her bout with long covid…
How the Inflation Reduction Act Will Help Small Businesses September 12, 2022 By signing the Inflation Reduction Act, President Biden is delivering on his promise to build an economy that works for working families and small businesses. The Inflation Reduction Act makes urgent investments to lower prescription drug, health care, and energy costs to create…
The American Rescue Plan Act (ARPA), signed into law March 11, 2021, provides a 100% subsidy of premiums for employer-sponsored group health insurance continued under the Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA) and similar state continuation of coverage (mini-COBRA) programs. ARPA subsidies cover the total cost of COBRA or mini-COBRA premiums from April…
PPP Frequently Asked Questions (FAQs) The Small Business Administration (SBA), in consultation with the Department of the Treasury, intends to provide timely additional guidance to address borrower and lender questions concerning the implementation of the Paycheck Protection Program (PPP), including both First Draw PPP Loans and Second Draw PPP Loans. Appropriate agencies will update information…
Overview of the ARPA Provisions On President Joe Biden signed the American Rescue Plan Act of 2021 (ARPA) into law on March 11, 2021. Along with providing financial relief for individuals, state and local governments, schools, businesses, and for other purposes, the law contains the following measures of particular interest to employers and their employees:…
Understanding the $1.9 Trillion American Rescue Plan The $1.9 trillion relief bill, known as the American Rescue Plan, has been signed into law by President Joe Biden. Highlights of the bill include extended unemployment benefits, direct checks to individuals, and more. While Congress changed some of the ARP bill, it’s mainly similar to the House’s…
On Jan. 28, 2021, the Centers for Medicare & Medicaid Services (CMS) announced a new special enrollment period (SEP) due to the coronavirus (COVID-19) pandemic through Exchanges using the federal www.HealthCare.gov platform. States operating their Exchange platforms are strongly encouraged to make a similar SEP available in their states. Overview of the COVID-19 SEP Starting…
The U.S. Dept. of Labor (DOL) has issued two additional Q&As regarding employee leave under the Families First Coronavirus Response Act (FFCRA).  Q&As 104 and 105 were issued on December 31, 2020. They address employees’ entitlement to FFCRA leave after December 31, 2020, and their right to payment for FFCRA leave taken before December…
The U.S. Department of Treasury and the U.S. Small Business Administration (SBA) recently announced that beginning Monday, January 11, applications would be accepted for the second round of loans in the SBA’s Payment Protection Program (PPP). This second round includes $284 billion in funding allocated for the PPP in the stimulus bill passed on December 27, 2020.…
The Centers for Disease Control and Prevention (CDC) has prepared a list of FAQs to educate the public on various aspects of COVID-19 vaccination. This article features some of these FAQs.  Vaccine Development  How many COVID-19 vaccines are under development?  Currently, two vaccines are authorized and recommended to prevent COVID-19:  Pfizer-BioNTech COVID-19 vaccine…
On July 23, 2020, the Secretary of Health and Human Services (“HHS”), Alex Azar, declared the Public Health Emergency, scheduled to end on July 25, 2020, will once again be extended for an additional 90 days. As a result, numerous temporary benefit plan changes remain in effect. Important Definitions Emergency Period. HHS Secretary Azar issued…
The U.S. Department of Labor (DOL) seeks information from the public about the effectiveness of paid employee family and medical leave. In a Request for Information (RFI) issued July 15, 2020, the DOL said it intends to gather information about the effectiveness of current state- and employer-provided paid leave programs, and how access (or lack…
On July 20, 2020, the U.S. Department of Labor (DOL) announced the agency’s publication of additional guidance on applying federal employment laws in the context of the COVID-19 pandemic. The guidance adds information to sets of Q&As the agency issued earlier in the year about the operation of the federal Family and Medical Leave Act…
The Wage and Hour Division (WHD) of the U.S. Department of Labor (DOL) has revised the forms employers and employees may use to meet their notification and certification obligations under the federal Family and Medical Leave Act (FMLA). In a July 16, 2020, statement announcing the changes, the DOL said the forms were revised…
July 17, 2020 | FFCRA Update The IRS issued Notice 2020-54 to help employers properly report 2020 emergency paid sick leave and expanded family medical leave wages paid to employees under the Families First Coronavirus Response Act (“FFCRAâ€). Employers with less than 500 employees who provided benefits under either leave program will need to…
July 13, 2020 | FFCRA Update With the summer season officially upon us, the Department of Labor’s Wage and Hour Division (“the Departmentâ€) has issued Field Assistance Bulletin (“FABâ€) 2020-4 to clarify when benefits under the Families First Coronavirus Response Act (“FFCRAâ€) may be available due to a summer camp or enrichment program being closed…
July 8, 2020 | Legal Update In a highly anticipated decision issued on June 15, 2020, the U.S. Supreme Court has ruled that Title VII of the federal Civil Rights Act (Title VII) protects individuals against employment discrimination based on their sexual orientation or gender identity. Title VII prohibits employers with 15 or more…
On June 23, 2020, the Departments of Labor, the Treasury, and Health and Human Services (“HHSâ€) (collectively, “the Departmentsâ€) issued FAQ Part 43, which includes certain guidance on the Families First Coronavirus Response Act (“FFCRAâ€) and the Coronavirus Aid, Relief, and Economic Security Act (“CARES Actâ€), as well as other COVID-19 health plan issues. …
Criminals prey on unfortunate circumstances, seeking to capitalize on victims during times of panic and hardship. Unfortunately, the coronavirus disease 2019 (COVID-19) pandemic is no exception. The Cybersecurity and Infrastructure Security Agency (CISA), part of the U.S. Department of Homeland Security, told individuals to be vigilant about scams related to COVID-19. Cybercriminals have been known…
The coronavirus disease 2019 (COVID-19) pandemic has caused employers to make significant changes to their business practices, including onboarding. Managers and new hires across the country are navigating the unchartered waters of remote onboarding. The onboarding process—which is designed to cultivate a long-term relationship between the employer and the employee while fostering a feeling of…
The coronavirus (COVID-19) pandemic has interrupted many businesses across the country. While it’s unclear how long COVID-19 will continue to affect organizations, many employers are looking to the future of employees returning to work. Echoing public health officials’ sentiments, a return to normalcy won’t be like flipping a switch, but rather a continuous effort. In…
On April 4, 2020, the Centers for Disease Control and Prevention (CDC) issued guidance for discontinuing home isolation following a COVID-19 diagnosis. The CDC also issued guidance for what essential workers should do following exposure to COVID-19. CDC Guidance for Discontinuing Isolation Following a COVID-19 Diagnosis The decision to discontinue isolation should be made…
The coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented changes for many industries. As social distancing is encouraged, gatherings with over ten people are banned, and stay-at-home or shelter-in-place orders for all nonessential employees are issued. Many employers ask their employees to work from home. For some employees, working from home is business as usual.…
On June 11, 2020, the Equal Employment Opportunity Commission (EEOC) issued more guidance concerning COVID-19 and return to work. This article compiles some of the frequently asked questions (FAQs) from the new guidance. As a best practice, and in advance of having some or all employees return to the workplace, are there ways for…
On April 28, 2020, the Departments of Labor (DOL) and the Treasury (Departments) issued deadline relief to help employee benefit plans, plan participants, and plan service providers impacted by the COVID-19 outbreak. This Compliance Overview summarizes the participant deadline extensions affecting COBRA continuation coverage, special enrollment periods, claims for benefits, appeals of denied claims, and…
On June 17, 2020, the Equal Employment Opportunity Commission (EEOC) issued an additional answer to frequently asked questions (FAQs) about how employers should comply with the Americans with Disabilities Act (ADA) while also observing all applicable emergency workplace safety guidelines during the coronavirus pandemic. The new FAQ, which addresses antibody tests (see A.7), was added…
Under most state workers’ compensation (WC) laws, COVID-19 may be a compensable, work-related condition only if an employee can show that: He or she contracted coronavirus while performing services growing out of and incidental to their employment; and The disease arose out of that employment (work-relatedness). As of June 30, 2020, however, several states…
On June 18, 2020, the Occupational Safety and Health Administration (OSHA) released guidance to help employers plan how to reopen nonessential businesses. The guidance also addresses issues employers should consider as they ask their employees to return to work during the COVID-19 pandemic. OSHA’s publication of guidelines for reopening nonessential businesses includes charts, examples,…
The uncertainty wrought by COVID-19 has left employers at an increased risk of exposure to employment-related claims alleging wrongful termination, discrimination, retaliation, and harassment, among others. As COVID-19 continues to spread throughout the United States, there has been a massive upheaval of the American workplace. Employers have found themselves drafting and implementing policies and…
The novel coronavirus (officially called COVID-19) is believed to spread from person-to-person, primarily through respiratory droplets produced when an infected person coughs or sneezes. The virus is also believed to spread by people touching a surface or object and then touching one’s mouth, nose, or possibly the eyes. Employers and workers should follow these general…
The U.S. Department of Labor (DOL) has issued temporary regulations to implement the paid leave mandates of the Families First Coronavirus Response Act (FFCRA). The regulations provide direction for administration of the Emergency Paid Sick Leave Act (EPSLA) and the Emergency Family and Medical Leave Expansion Act (EFMLEA). This action is intended to…
The U.S. Department of Labor (DOL) has issued frequently asked questions (FAQs) that address which employers are covered by the paid leave requirements of the Families First Coronavirus Response Act (FFCRA). The FFCRA requires covered employers to provide their employees with paid sick leave and expanded family and medical leave for specified reasons related to…
Small and midsize employers may begin using two new refundable payroll tax credits to obtain reimbursement for the costs of providing coronavirus-related leave to their employees, the U.S. Department of Labor (DOL) and Internal Revenue Service (IRS) announced on March 20, 2020. According to IRS Notice 2020-12, these credits are available for qualified leave wages…
The regulations, published April 6, 2020, clarify and explain the employee leave provisions under the FFRCA’s Emergency Family and Medical Leave Expansion Act (EFMLEA) and Emergency Paid Sick Leave Act (EPSLA). While the corrections mainly address minor drafting errors in the regulations, some of the changes may impact employers’ implementation of the law. Substitution of…
The Coronavirus Aid, Relief, and Economic Security (CARES) Act, enacted on March 27, 2020, provides federal funding to expand the availability of unemployment insurance (UI) benefits during the coronavirus (COVID-19) public health emergency. Under this law, virtually all types of workers, even those who otherwise would not qualify for UI benefits, may receive payments for…
The U.S. Department of Labor (DOL) has issued temporary regulations under the Families First Coronavirus Response Act (FFCRA). The FFCRA created new employer requirements to provide paid sick leave and partially compensated, expanded FMLA leave for reasons related to the COVID-19 pandemic. The regulations include important clarifications to the law and earlier DOL guidance on…
Under the Coronavirus Aid Relief and Economic Security Act (CARES Act), eligible employers that keep employees on their payroll for specified reasons related to COVID-19 are eligible for employee retention tax credits. This Compliance Bulletin provides the Internal Revenue Service’s (IRS) answers to frequently asked questions (FAQs) on how the CARES Act retention tax credits…
As part of sweeping legislation—the Families First Coronavirus Response Act (FFCRA)—signed into law by President Trump on March 18, 2020, two laws were enacted that provide workers with paid leave for reasons related to the coronavirus (COVID-19) pandemic. The “Emergency Family and Medical Leave Expansion Act†allows 12 weeks of partially compensated FMLA leave to…
As the COVID-19 outbreak continues to spread, employers may get questions from employees about their health plan’s coverage for COVID-19 testing, including whether they will need to pay a deductible or copayment. This is a rapidly evolving issue, with many health insurance issuers announcing that they will voluntarily waive any cost sharing for COVID-19…
In light of the spread of COVID-19 in the United States, the Department of Labor (DOL) has published answers to frequently asked questions on how employers can stay in compliance with the federal Fair Labor Standards Act (FLSA), which regulates wage and hour conditions for employees. When responding to pandemics or other public health emergencies,…
The U.S. Department of Labor has issued Q&As on the federal Family and Medical Leave Act (FMLA) and COVID-19 (the disease caused by the new coronavirus) and other health emergencies. The Q&As explain that under the FMLA, covered employers must provide eligible employees with job-protected, unpaid leave for specified family and medical reasons, which may include…
As the number of reported cases of the novel coronavirus (COVID-19) continues to rise, employers are increasingly confronted with the possibility of an outbreak in the workplace. Employers are obligated to maintain a safe and healthy work environment for their employees, but are also subject to a number of legal requirements protecting workers. For example,…
On Jan. 31, 2020, the Department of Health and Human Services (HHS) published its proposed Notice of Benefit and Payment Parameters for 2021. This proposed rule describes benefit and payment parameters under the Affordable Care Act (ACA) that would be applicable for the 2021 benefit year. Proposed standards included in the rule relate to: Annual…
Background Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007 created reporting requirements for group health plans to CMS. These requirements were effective January 1, 2009. In most cases, the insurance carrier and TPA are the RREs. An employer may be the RRE when it both sponsors and administers the group…
On Jan. 17, 2020, the Department of Health and Human Services (HHS) published a final rule increasing the civil monetary penalties for violations of laws enforced by HHS, including the HIPAA privacy and security rules. HHS is required to adjust these penalties for inflation each year to improve their effectiveness and maintain its deterrent…
On December 16, 2019, the Wage and Hour Division of the U.S. Department of Labor (DOL) published final regulations on “regular rate of pay†for overtime pay purposes under the Fair Labor Standards Act (“FLSAâ€). The final regulations address common employer-provided benefits as well as other workplace practices, which were not specifically addressed in previous…
In a bipartisan effort, the U.S. Congress agreed on a spending package to fund the federal government which included important changes to federal laws affecting employer-sponsored group health and welfare benefit plans. The legislation was signed into law by the President on December 20, 2019. The law repeals the following taxes under the Affordable Care…
On September 30, 2019, the IRS published proposed regulations to clarify the application of the employer mandate under the Affordable Care Act (“ACA”) and certain nondiscrimination rules under the Internal Revenue Code (“Code”) Section 105(h) to health reimbursement arrangements (“HRAs”) integrated with individual health insurance coverage (individual coverage HRAs, or “ICHRAs”). Notably, the proposed regulations…
Background The Centers for Medicare and Medicaid Services (CMS) is a federal agency that collects data and administers various federal programs. The agency utilizes the CMS online tool to collect information from employers about whether their group health plan’s prescription drug coverage is creditable or non-creditable. Creditable coverage means the group health plan’s prescription drug…
In 2017, Equifax, one of the largest credit reporting agencies in the United States, was the victim of a massive cyber attack—an attack that compromised the personal information of approximately 147 million people. On July 22, 2019, the company agreed to pay at least $575 million—and up to $700 million—as part of a global settlement…
Don’t miss an important meeting or family gathering, and don’t be that person who makes everyone else wait in line. Real IDs are set to become a new requirement in the security process for flying in the United States, and if you don’t take the necessary steps to prepare for the changes, you won’t be…
On Thursday, May 23, 2019, the Senate Health Committee proposed a bipartisan bill called the Lower Health Care Costs Act. This bill sets out to address surprise medical billing, reduce the cost of prescription drugs and the overall cost of delivering health care, and improve transparency. The proposed bill is the latest move federal officials…
Beginning in May of last year, the Trump administration began searching for ways to curb out- of-control prescription drug costs—referring to the initiative as American Patients First. This effort is finally seeing some traction, with the administration publishing its first final rule on the matter. Drug companies will now be “… required to disclose to…
On Monday, July 29, 2019, the Centers for Medicare and Medicaid (CMS) proposed rules that would require all Medicare-participating hospitals to post their negotiated prices for standard health care services. The Outpatient Prospective Payment System (OPPS) & Ambulatory Surgical Center (ASC) proposed rule is intended to increase pricing transparency and help consumers understand the charges…
On Friday, Nov. 15, 2019, the Trump administration released its final rule regarding hospital price transparency. This final rule will take effect Jan. 1, 2021, a year later than originally proposed. The Centers for Medicare and Medicaid Services (CMS) had been listening to feedback on a proposed version of the rule for the past four…
On June 24, 2019, President Trump issued an Executive Order (“EOâ€) directing the relevant federal agencies to issue regulations or other guidance to make available more meaningful information related to the price and quality of healthcare. This summary highlights aspects of the EO that may be relevant to employer-sponsored group health plans and their covered…
A bill has been introduced in New Jersey in both the Senate and Assembly that, if passed, would prohibit insurance carriers or other insurers subject to the insurance laws of New Jersey or any other state from offering, issuing or renewing any stop loss insurance policy of any kind to small employers. Stop loss insurance…
On March 28th, 2019, a Federal District Court in the District of Columbia struck down significant portions of the Department of Labor’s (DOL’s) Association Health Plan (AHP) Final Rule. Specifically, the Court found the DOL “failed to reasonably interpret†ERISA when issuing these rules by: expanding the definition of “employers†to include disparate groups of…
While ERISA fiduciaries have often been challenged for allowing an ERISA retirement plan to pay excessive fees and expenses (such as in the context of a 401(k) plan), such claims have rarely been raised against ERISA fiduciaries of a group health plan. However, the Department of Labor (“DOLâ€) recently sued a group health plan raising…
Apr 2019 – This article is intended to provide you with an update on current legal challenges to invalidate the ACA. There is no immediate impact to employer-sponsored health plans or other requirements under the ACA. In 2018, a Texas Court ruled in favor of 20 Republican state attorneys general (“AGsâ€) to invalidate the…
On March 28th, 2019, a Federal District Court in the District of Columbia struck down significant portions of the Department of Labor’s (DOL’s) Association Health Plan (AHP) Final Rule. Specifically, the Court found the DOL “failed to reasonably interpret†ERISA when issuing these rules by: expanding the definition of “employers†to include disparate groups of…
Researchers warn the attack would allow potential hackers to steal sensitive information stored on your RAM. Security researchers have discovered a flaw with nearly all modern computers that allow potential hackers to steal sensitive information from your locked devices. The attack only takes about five minutes to pull off, if the hacker has physical access…
As the debate over amending health insurance market rules continues, proponents of changing the law have proposed reducing the health benefits provided by non-group plans as a potential way to lower premiums in the market. The Affordable Care Act (ACA) prescribes 10 categories of essential health benefits that non-group and small-group policies must cover, and…
A new Kaiser Family Foundation analysis of short-term, limited duration (STLD) health plans for sale through two major national online brokers finds big gaps in the benefits they offer. Through an executive order and proposed new regulations, the Trump Administration is seeking to encourage broader use of short-term, limited duration health plans as a cheaper…
Several states have lodged a legal challenge to the entire Affordable Care Act (“ACAâ€) on the basis that the lack of an Individual Mandate tax makes the remaining provisions unconstitutional. While the Administration is not intervening, several other states are, defending the ACA’s sustainability without the Individual Mandate tax. No resolution to the legal questions…
For 2018 and 2019 only, there is a tax credit available to certain employers as to FMLA-qualifying circumstances (whether under FMLA or not) for employees earning $72,000 or less for whom paid family and medical leave is provided. Nothing in the rules requires the employer to be subject to FMLA to receive the tax credit.…
In 2015, Congress passed the Federal Civil Penalties Inflation Adjustment Act of 2015 (the “Inflation Adjustment Actâ€) to direct federal agencies to adjust the civil monetary penalties for inflation every year. Civil penalties ensure compliance with federal regulation by incentivizing employers not to violate federal regulation and providing federal agencies the power to ensure compliance.…
The House of Representatives passed two pieces of legislation that, among other things, purport to improve and “modernize†health savings accounts (“HSAsâ€). While the bills call for significant changes to the current rules affecting HSAs, the specific details are very different. Summary of Proposed Changes H.R. 6199 would: Exclude a direct…
On June 1, 2018, New Jersey Gov. Murphy passed the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act (the “OON Actâ€). In general, the OON Act applies to emergency services and other care provided by out- of-network physicians in in-network settings (i.e. hospital-based physicians). It takes effect on September 1, 2018. The Act…
On April 9, 2018, the IRS released its first round of guidance in the form of FAQs concerning the new employer credit for paid family and medical leave (FML) under Code Section 45S. Background Added by the Tax Cuts and Jobs Act, Code Section 45S provides that for tax years 2018 and 2019, eligible…
On June 21, 2018, the U.S. Supreme Court ruled that state governments can collect sales taxes from online retailers, even if a retailer doesn’t have a physical presence in the state. Until this decision, states could only collect taxes from online retailers that had in-state headquarters or another significant connection to that state. This decision…
Recently, researchers at Talos—a cyber intelligence unit of Cisco—warned consumers of malware (malicious software) that specifically targets networking devices. The malware, which is known as VPNFilter, impacts an estimated 500,000 routers worldwide, particularly targeting devices from the following manufacturers: Linksys MikroTik Netgear QNAP TP-Link Once on your equipment, the malware could…
AmeriHealth New Jersey Laboratory Network Update As a reminder, effective May 1, 2018, LabCorp Corporation of America® Holdings (LabCorp) will become the exclusive outpatient lab for all AmeriHealth HMO, Inc. and AmeriHealth Insurance Company of New Jersey (collectively AmeriHealth New Jersey) commercial HMO, HMO Plus, POS, POS Plus, PPO, EPO, and self-funded business. As…
The WannaCry ransomware that has spread across 150 countries since Friday has appeared to slow down, but employees starting the workweek should be careful, as the effects in the United States are yet to be determined. WannaCry locks users out of their computers by exploiting a vulnerability in outdated versions of Microsoft Windows. It…
On August 16, 2017, the Department of Labor (“DOLâ€) led a lawsuit against Macy’s Inc. Health and Welfare plan (and its third party administrators) under ERISA Title I. Specifically, the complaint alleges: The health plan and its fiduciaries failed to follow the written terms of the health plan’s Summary Plan Description (SPD) when reimbursing…
On April 13, 2017, the Department of Health and Human Services (HHS) issued final regulations to help stabilize the individual and small group markets. These final regulations, effective June 19, 2017, do not significantly differ from the proposed regulations issued February 16, 2017. They do not directly impact large group or expatriate health plans, but…
Independence Blue Cross (Independence) and University of Pennsylvania Health System (UPHS) have signed an innovative, five-year contract that strengthens both organizations’ emphasis on coordinated patient care, exchange of critical data, and shared accountability for both quality and cost of care. Independence Blue Cross
Aetna has decided to leave the individual market in New Jersey. Due to New Jersey law, this decision also impacts their New Jersey small employer ACA insured medical products. Health insurance coverage for each of your New Jersey small employer clients with commercial (fully insured) medical plans, will end at midnight on the day before…