1. In 2016, the IRS, DOL and HHS (the "Agencies") issued additional guidance on the federal mental health parity law. They confirmed plans cannot impose different "non-quantitative treatment limitations" (such as preauthorization requirements) on mental health and substance abuse [...]
1. Under PPACA, non-grandfathered plans must provide in-network preventive care benefitswithout cost-sharing. In 2016, the IRS, DOL and HHS (the "Agencies") published FAQs clarifying preventive care requirements for colonoscopies and contraceptives. Also, the U.S. Preventive Services Task Force [...]
1. In July 2016, the IRS issued guidance formalizing major changes to its determinationletter program. Notably, the guidance confirmed the IRS will stop issuing most types of determination letters, advised that expiration dates in prior determination [...]
1. At the request of President Obama, the DOL issued proposed regulations on the definition of an ERISA fiduciary and corresponding changes to the DOL's prohibited transaction exemptions. The proposals, if adopted, would make it more likely that [...]
1. In November 2015, the IRS, HHS, and DOL (the "Agencies") published final regulations on many PPACA benefit mandates , including the rules regarding grandfathered health plans, preexisting condition exclusions, lifetime and annual dollar limits, rescissions, coverage of [...]
1. Federal law does not expressly require that ERISA health plans cover same-sex spouses . However, in 2015 the Equal Employment Opportunity Commission ("EEOC") took the position that sexual orientation is protected under federal anti-discrimination law (Title VII). [...]
1. In June 2014, the U.S. Supreme Court in Fifth Third Bancorp v. Dudenhoeffer eliminated the "Moench" presumption that employer stock is a prudent investment under ERISA.Fifth Third Bancorp v. Dudenhoeffer, 134 S. Ct. 2459 (2014). And so ESOP [...]
1. Non-grandfathered plans must provide certain preventive care benefits without cost-sharing.All of the USPSTF's recommendation statements are available at http://www.uspreventiveservicestaskforce.org/Page/Name/uspstf-a-and-b-recommendations/. Plans must comply with new and revised recommendations starting with the first plan year that begins one or [...]
1. In June 2013 the Supreme Court issued its decision in U.S. v. Windsor, invalidating a section of DOMA, the law which limited federal recognition of marriages to opposite-sex couples.U.S. v. Windsor, 133 S. Ct. 2675 (2013). [...]
New Guidance Related To Health Plans & Health Care Reform (PPACA) Further Guidance on PPACA's Summary of Benefits and Coverage (SBC) Requirement In March and May of this year, the IRS, DOL, and HHS issued two new [...]