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HDHP Telehealth Relief Extended for Remainder of 2022, but Mind the 3-Month Gap in Relief

On March 15, 2022, the Consolidated Appropriations Act, 2022 (the “2022 CAA”) was signed into law.  Section 307 of the 2022 CAA extends the relief permitting high deductible health plans (“HDHPs”) to provide telehealth and other remote care services free of charge before a participant meets their required deductible, but there’s a catch. The CARES […]

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Group Health Plans Must Provide Free Over-the-Counter COVID-19 Tests Effective January 15, 2022

On January 10, 2022 the Departments of Labor, Health and Human Services, and Treasury issued Affordable Care Act FAQs Part 51 which addresses, in relevant part, payment for over-the-counter (“OTC”) COVID-19 testing.   For more information about the OTC COVID-19 testing and its impact on employer-sponsored group health plans, see our SW Benefits Update, “Group Health Plans Must […]

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Free COVID-19 Vaccine and Testing Update

On November 30, Moderna announced that it is seeking FDA authorization for its COVID-19 vaccine.  In addition, on November 17 the FDA issued an emergency use authorization for the first COVID-19 diagnostic test for self-testing at home.  With these recent developments, a COVID-19 update for health and welfare plans might be helpful. Free COVID-19 Vaccines […]

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IRS to Begin Enforcing 4980H Penalties on Large Employers Before End of 2017

On November 2, 2017, the IRS issued guidance regarding the enforcement of Employer Shared Responsibility payments, otherwise known as the Section 4980H penalty. Questions 55-58 of the IRS Questions and Answers on Employer Shared Responsibility Provisions Under the Affordable Care Act indicate that the IRS is moving forward with assessing penalties on Applicable Large Employers […]

Former Associate

“A Trap for the Unwary” – Does Your Self-Funded Health Plan Provide Transgender Benefits? It Might Need to Soon.

Assistant Secretary of Labor Phyllis Borzi recently offered informal guidance on the broad scope of nondiscrimination regulations proposed under Section 1557 of the Affordable Care Act. During her remarks at the ABA Labor Section Employee Benefits Committee Meeting in February, Ms. Borzi indicated that the proposed regulations would apply to any health plan that receives […]

IRS Issues More Guidance On Employers That Pay For Individual Health Insurance Policies for Employees – Gives Limited Relief to Small Employers

I have blogged more on the topic of how the Health Care Reform Act applies to employers that reimburse employers for individual health insurance policies than any other topic in the last year.  At one point in time, as indicated in my post of June 11, 2014, The IRS Meant What It Said in Notice […]


Health Care Reform 2015 – An Update

2015 is a significant year for health care reform because the large employer shared responsibility penalties under Internal Revenue Code Section 4980H take effect for most large employers.  See our SW Benefits Update, “Health Care Reform’s Employer Shared Responsibility Penalties:  A Checklist for Employers,” for a detailed explanation of the large employer penalties. Many people are under […]


HHS Extends November 17 Deadline to Submit Covered Lives Data under Reinsurance Program

The Health Care Reform Act created the transitional reinsurance program, which requires most self-insured health plans to make contributions to HHS for the 2014, 2015, and 2016 calendar years, in an attempt to stabilize premiums in the individual market.  The contribution amount is determined by the number of covered lives under each plan.  For 2014, […]

Former Associate

November 5 Deadline to Obtain HPID Delayed by HHS

On October 31, 2014, HHS announced a delay, “until further notice,” in the enforcement of the regulations pertaining to Health Plan Identifiers (HPIDs) and their use in HIPAA standard electronic transactions.  For more information on the HPID requirements, please see our October 1, 2014 SW Benefits Update, “HIPAA Requires Many Health Plans to Obtain a […]

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Former Partner
Former Associate

Accurate Documentation of Welfare Plans May Save Employers Certain Costs and Headaches Down the Road

ERISA requires all pension and welfare benefit plans to be maintained in a written plan document.  The DOL and several courts have taken a broad view of what constitutes a “written plan document,” and while pension plans are usually very well documented, many welfare plans consist of a loose, and often out-of-date, collection of insurance […]

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Former Associate