Posts Categorized: Health Benefits

Eating Disorders and Information Requests under the MHPAEA

in Health Benefits, Welfare Benefits

On June 16, a new FAQ was released and additional steps were taken towards increasing disclosures to participants with respect to mental health/substance abuse benefits.  The FAQ confirms that eating disorders are a mental health condition and, therefore, the treatment of eating disorders is a mental health benefit under MHPAEA.  The Departments also requested comments on whether additional clarification is needed on how MHPAEA applies to this treatment. Perhaps of more consequence to plan administrators, the Departments also released a draft form that can be used by participants and their authorized representatives to request information regarding available mental health/substance abuse… Continue Reading

Ninth Circuit Issues Shocking Opinion Concerning Health Care Provider ERISA Claims

in Court Cases, Health Benefits

The Ninth Circuit Court of Appeals is not known for being employer-friendly.  So, when the Ninth Circuit issued its latest opinion on health care provider ERISA claims, most thought it would be against employer-sponsored health plans.  But, in a shocking opinion, the Ninth Circuit dealt health care providers a serious (and possibly fatal) blow to their recent crusade to use ERISA to pursue claims for reimbursement against employer-sponsored health plans. In DB Healthcare v. Blue Cross Blue Shield of Arizona, Inc. and Advanced Women’s Health Center, Inc. v. Anthem Blue Cross Life and Health Insurance Co., the Ninth Circuit affirmed… Continue Reading

An Employer-Centric Summary of the American Health Care Act

in Affordable Care Act, Health Benefits

Updated on March 13, 2016 Unless you recently were stranded on an uninhabited island, or do not own a mobile phone, computer or television, you likely have not heard that the House released the Affordable Care Act repeal and replace bill. This new bill is referred to as the American Health Care Act (“AHCA”).  While there is much to discuss, at this point, we are only focusing on those provisions that affect employers.  Further, we know that this draft will not be the final legislation, and so overly debating its pros and cons is not practical at this point. In… Continue Reading

If You Have Less than 50 Employees, Read This

in Affordable Care Act, Health Benefits

You may not yet have heard about a new type of health plan arrangement created in December 2016 for small employers – the “QSEHRA”.  Many employers, particularly small employers, were adversely affected by a change in the law prohibiting employers from reimbursing employees for the cost of their individual health policies.  Under this new law, Qualified Small Employers can adopt a Health Reimbursement Arrangement that complies with the rules set out in Internal Revenue Code Section 9831(d).  These new arrangements are available only to employers with less than 50 full-time employees and full-time equivalent employees who offer no health plan… Continue Reading

President Trump Administration Freezes New Regulations

in Fiduciary Issues, Health Benefits, Welfare Benefits

Soon after Donald Trump officially became the forty-fifth president of the United States, Reince Priebus, the President’s Chief of Staff, issued a memorandum freezing all pending regulations.  This memorandum is similar to the memorandums issued at the beginning of prior administrations.  In general, and subject to certain exceptions, the memorandum provides the following – Agencies shall send no new regulations to be published in the Federal Register until an appropriate individual appointed or designated by the President reviews such regulation. With respect to regulations that have been sent to the Federal Register but not yet published, agencies must immediately withdraw… Continue Reading