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The American Rescue Plan Act signed in March 2021 provides for a 100% COBRA premium subsidy for certain individuals who are eligible for and enroll in COBRA coverage between April 1, 2021 and September 30, 2021. Employers sponsoring health plans should take action quickly to ensure that the subsidy is properly administered and consider its effects on any planned layoffs or other severance events.
Continue Reading COBRA Subsidies Under ARPA: Employer Action Needed

On May 14, 2020, the Department of Health and Human Services issued a final rule stating that group health plans, including employer-sponsored health plans, are not required to count the value of drug manufacturer coupons toward participant deductibles and out-of-pocket maximums.  The Final Rule, published in HHS’s Notice of Benefit and Payment Parameters for 2021, allows group health plans to exclude the value of drug manufacturer coupons from participant annual cost-sharing amounts even where no medically appropriate generic drug is available. …
Continue Reading HHS Rule is Good News for Prescription Drug Accumulator Programs

For at least one more year, health plans, including employer-sponsored plans, will be able to exclude the value of drug manufacturer discounts from participant deductibles and out-of-pocket maximums, even where no medically appropriate generic drug is available.  …
Continue Reading Government Hits Pause on HHS Prescription Drug Rule Set to Take Effect January 1, 2020

On October 29, 2018, the Internal Revenue Service, Department of Labor and Department of Health and Human Services jointly released proposed regulations in response to President Trump’s executive order calling for an expansion of the ability of employers to offer health reimbursement arrangements to their employees and to allow HRAs to be used in conjunction with nongroup coverage.
Continue Reading Proposed Regulations Expand Availability of Heath Reimbursement Arrangements

The IRS recently updated the FAQs on its website regarding the employer mandate to provide some details on the process it will use to impose penalties for failure to provide coverage to “ACA full-time” employees (those working 30 or more hours per week) in accordance with Section 4980H of the Code (often referred to as the “employer mandate”).
Continue Reading IRS Indicates That Employer Mandate Penalty Letters Are Coming Soon

On May 4, the House of Representatives passed the American Health Care Act, which is aimed at repealing and replacing portions of the Affordable Care Act. While many of the changes do not affect employer-sponsored coverage, there are several changes in the bill that are likely to be of interest to employers.
Continue Reading The American Health Care Act: What It May Mean for Employers

The IRS has issued final versions of Forms 1095-C and 1094-C as well as updated final instructions on completing these forms. While the instructions and forms remain similar to those used last year, there are a few key changes worth noting.
Continue Reading ACA Update: IRS Issues Final Versions of 2016 Forms 1094-C and 1095-C and Instructions

Earlier this year, the Department of Health and Human Services Office of Civil Rights published final rules implementing Section 1557 of the Affordable Care Act (ACA). Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age or disability by healthcare providers and group health plans that receive federal financial assistance. The rules include restrictions on discrimination relating to gender identity, as well as requirements regarding accessibility for individuals with limited English and with disabilities.
Continue Reading ACA Update: New HHS Nondiscrimination Rules Applicable to Certain Employee Health Plans