READ TIME: 6 MINUTES Pharmacy benefit managers (PBMs) play a pivotal role in the U.S. healthcare system, managing prescription drug benefits on behalf of insurers and employer-sponsored health plans. However, rising concerns over PBM transparency, pricing practices, and reimbursement rates have led to an expanding patchwork of state-level legislation. For employers – especially those offering […]
Read moreCategory: ERISA
When is a Plan an ERISA Plan?
READ TIME: 5 MINUTES Key Takeaways from Hansen v. Laboratory Corporation of America A short-term disability (STD) plan is not automatically covered under ERISA just because it’s included in an employer’s benefits package. Even if an employer treats the plan like an ERISA plan – such as including it in a wrap plan or on […]
Read moreInflation Adjusted Penalties for Health and Welfare Plans
READ TIME: 5 MINUTES The Department of Labor (DOL) recently released a final rule providing the adjusted civil penalty amounts for certain health and welfare plan violations assessed after January 15, 2024. The Employee Retirement Income Security Act (ERISA) provides for the imposition of penalties for a number of plan-related failures or administrative errors and […]
Read moreWebinar: ERISA Plan Documents – What Employers Need to Know
Tuesday, August 9, 2022 2:00PM EST Register Now The ERISA plan document requirements can be confusing for many employers. In this webinar, we will dig into the ERISA written plan document requirements and discuss the documents employers need to adopt and maintain to satisfy these seemingly complex regulations. We will also discuss how to distribute […]
Read moreCompliance Recap – May 2019
May was a busy month in the employee benefits world. The Internal Revenue Service (IRS) released health savings account annual contribution limits and high deductible health plan minimum annual deductibles and annual out-of-pocket maximums for 2020. The Department of Labor (DOL) released questions and answers (Q&As) to clarify its enforcement of the association health plan […]
Read moreUpdate on DOL’s Association Health Plans Final Rule
On April 26, 2019, the Department of Justice (DOJ) filed an appeal in the court case that recently invalidated portions of the U.S. Department of Labor’s June 2018 association health plan (AHP) final rule. The DOL’s final rule broadened the definition of “employer” under the Employee Retirement Income Security Act (ERISA) to allow an additional […]
Read moreIRS Releases Draft Forms and Instructions for 2017 ACA Reporting
Background Under the Patient Protection and Affordable Care Act (ACA), individuals are required to have health insurance while applicable large employers (ALEs) are required to offer health benefits to their full-time employees. Reporting is required by employers with 50 or more full-time (or full-time equivalent) employees, insurers, or sponsors of self-funded health plans, on health […]
Read moreCompliance Recap // July 2017
Compliance Recap July 2017 July was a relatively quiet month in the employee benefits world, despite the U.S. Senate’s release of two bills in its attempt to repeal the Patient Protection and Affordable Care Act (ACA). First, the U.S. Senate revised its Better Care Reconciliation Act and declined to vote on its revision. Then the […]
Read moreCompliance Recap // June 2017
June was an active month in the employee benefits world. The U.S. Senate released a draft of the Better Care Reconciliation Act of 2017 which would substitute the U.S. House Resolution 1628 that aimed to repeal and replace the Patient Protection and Affordable Care Act (ACA). The U.S. Supreme Court decided an ERISA church plan […]
Read moreQualified Small Employer Health Reimbursement Arrangements and ERISA
Starting on January 1, 2017, certain small employers have the option to reimburse individual health coverage premiums up to a dollar limit through Qualified Small Employer Health Reimbursement Arrangements (QSE HRAs) under the 21st Century Cures Act (Cures Act). The Cures Act amends the Employee Retirement Income Security Act of 1974 (ERISA) to exclude QSE […]
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