By Roberta Casper Watson, Dannae Delano and Barry Salkin New guidance from the Department of Health and Human Services (“HHS”) affirms that Section 1557 of the Affordable Care Act (the “ACA”), by referencing statutes that prohibit discrimination on the basis of race,...
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PCORI Fee Announced
IRS has released Notice 2022-4, which provides the “applicable dollar amount” for the Patient-Centered Outcomes Research Institute (“ PCORI” ) fee for plan years ending before October 1, 2022. Background. PCORI was established under the Affordable Care Act to conduct...
Insurer Need Not Defer to Participant’s Physician or Government Agency Decisions
The Seventh Circuit Court of Appeals has ruled, in Feeney v. Unum Life Insurance, that an insurance company need not defer to either a participant’s treating physician or governmental agencies when determining if the participant is entitled to long term disability...
Prepare for Shot-or-Test Mandate Inspections
Earlier this week a Federal Court panel revived the Covid-19 emergency temporary standard (ETS). Now, litigation challenging the emergency shot-or-test mandate is making its way to the United States Supreme Court. However, that will not stop the quickly approaching...
Agencies Issue Interim Final Regulations on Prescription Drug and Health Care Spending Data Submission by Group Health Plans and Health Insurance Issuers
Section 204 of Title II of Division BB (“Section 204”) the Consolidated Appropriations Act, 2021 (the “Act”) requires group health plans and health insurance issuers offering group health insurance coverage to annually submit to the Departments of Treasury, Labor, and...
2021 ERISA/EMPLOYEE BENEFITS LEGAL COMPLIANCE CHECKLIST
Tax Qualified Plans Plan document: Required amendments 401(k) and 403(b) plans – Amendments to comply with the IRS final hardship distribution regulations must be adopted by December 31, 2021 (regardless of plan year end) Defined benefit pension plans - Those...
Is PBGC Adding “Early Warning” and “Follow-On” to its Toolbox for Multiemployer Plans?
By Israel Goldowitz Corporate sponsors of defined benefit pension plans may be familiar with the Pension Benefit Guaranty Corporation’s (PBGC) Early Warning program and its Follow-on policy. Under Early Warning, PBGC intervenes when a corporate spinoff or other...
Retirement Plan Post-2021 Opportunities
By Jon Schultze Employers and plan sponsors of retirement plans need to be aware of some responsibilities and opportunities that are available as we head into 2022. Adopting a New Plan – Employers can take advantage of extended deadlines under the SECURE Act to adopt...
CMS Announces Medicare Part A Deductibles and Part B Premiums for 2022
The Centers for Medicare & Medicaid Services (“CMS”) has announced the 2022 premiums, deductibles and coinsurance amounts for the Medicare Part A and Part B programs. Medicare Part A covers inpatient hospital, skilled nursing facility, hospice, inpatient...
Agencies Issue Two Rounds of No Surprise Billing Guidance
By Roberta Casper Watson, Dannae Delano and Barry Salkin The No Surprises Act (“Act”), part of the Consolidated Appropriations Act, 2021, enhances the ACA’s consumer protections by prohibiting balance billing in many situations and limiting out-of-network cost sharing...