Health & Welfare

Stimulus Package Makes Major Changes with Respect to Employer Sponsored Benefit Plans

By Dannae Delano, Barry Salkin and Roberta Casper Watson

Arkansas Pharmacy Law Not Preempted by ERISA

In Pharmaceutical Care Management Association v. Rutledge, the U.S. Supreme Court has held that ERISA does not preempt an Arkansas statute that imposes rules on pharmacy benefits managers (“PBMs”).

Agencies Issue Final Grandfathered Group Health Plan Regulations

The Department of Labor, Department of Health and Human Services, and the IRS (collectively, the “Agencies”) have issued final regulations providing greater flexibility to plan sponsors that wish to retain their group health plans’ “grandfathered” status under the Affordable Care Act (“ACA”).  The final regulations are substantially unchanged from the earlier proposed regulations.

Agencies Issue Further Guidance on COVID-19

The Department of Labor, Department of Health and Human Services, and the IRS (the “Agencies”) have issued Frequently Asked Questions #43 (“FAQs”) regarding implementation of the Families First Coronavirus Response Act (the “FFCRA”), the Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”), and other health coverage issues related to COVID-19.

Massachusetts Announces Individual Mandate Figures for 2021

Although the penalties under the Affordable Care Act’s individual mandate were eliminated in 2017, Massachusetts has continued its own individual health insurance mandate as well as associated penalties for failure to comply. 

1557 Rule Changes and Bostock

The Department of Health and Human Services (“HHS”) announced on June 12, 2020, as part of a new final regulation (the “Final Rule”), that it had eliminated Obama-era nondiscrimination rules under Section 1557 of the Affordable Care Act (“ACA”) that defined the term “on the basis of sex” to include gender identity, sex stereotyping, and pregnancy, reasoning that this interpretation was an ...

IRS Issues Guidance on COVID-19 Leave Donation Programs

The IRS has issued Notice 2020-46 to explain the tax consequences of employer-based COVID-19 leave donation programs.

ACA Out-of-Pocket Limit and PCORI Fee Announced

HHS and IRS have announced inflation-adjusted out-of-pocket (“OOP”) limits that will apply to non-grandfathered health plans for plan years beginning in 2021, and the indexed PCORI fee. The OOP limit includes the plan’s deductible and cost-sharing amounts for benefits that are considered essential health benefits (“EHBs”) under the Affordable Care Act (“ACA”). 

DOL and IRS Extend Certain Deadlines for Welfare Plans and Participants

The DOL and IRS have issued COVID-19 related guidance that temporarily extends certain deadlines applicable to welfare plans and their participants and beneficiaries.    

IRS Announces 2021 HSA Limits

The IRS has announced the 2021 calendar year dollar limits for health savings account (“HSA”) contributions, and the minimum deductible amounts and maximum out-of-pocket expenses for high deductible health plans (“HDHPs”). By law, these limits are indexed annually to adjust for inflation.