Insights

There are specific rules related to eligibility and changes of status related to the employer mandate. A change in status means that the employee has had a bona fide change in employment status from part-time (PT) or variable hour to full-time (FT) or vice versa. It does not include an employee who has not experienced a bona fide change in employment and whose hours are simply trending lower or higher. As a reminder, an applicable large employer subject to the employer mandate has two methods

On September 6, 2022, the DOL published an updated Interpretive Bulletin (the updated IB) setting forth guidelines for determining when a qualified public accountant is independent for purposes of auditing and providing an opinion on the financial statements required to be included in the Form 5500 filing for an ERISA employee benefit plan. According to the DOL, a primary purpose of the updated IB was to remove outdated and unnecessarily restrictive provisions from prior guidance, Interpretive

On August 26, 2022, in Georgia v. Biden, the US Court of Appeals for the Eleventh Circuit ruled the December 7, 2021, nationwide preliminary injunction issued by the US District Court for the Southern District of Georgia against President Biden's federal contractor vaccine mandate was overly broad in its jurisdictional reach. A preliminary injunction is a court order stopping a party from continuing the challenged action before the case can be fully briefed and decided. To succeed at the prelim

On August 26, 2022, in Franciscan Alliance, Inc., et al v. Becerra, et al, the US Court of Appeals for the Fifth Circuit upheld a federal district court injunction against HHS that stopped the agency from interpreting and enforcing Section 1557 of the ACA in a way that would require a Catholic hospital system and other religious institutions to provide coverage for (or to perform) gender-reassignment surgeries or abortions in violation of its sincerely held religious beliefs. Section 1557 prohi

On August 31, 2022, the Department of Financial Services (DFS) issued Circular Letter No. 12 to advise health insurers of the coverage requirements for monkeypox virus testing, diagnosis and immunization. The memo follows Gov. Hochul's declaration of a state disaster emergency to combat the spread of the monkeypox virus on July 29, 2022, and the issuance of Executive Order No. 20.1 (EO 20.1) on August 28, 2022. EO 20.1 was issued to ensure that health insurance coverage requirements and cost-sh

On September 8, 2022, HHS released an updated user manual that explains how to use the Prescription Drug Data Collection (RxDC) module within the Health Insurance Oversight System. The RxDC module is designed for use by group health plans and health insurers to satisfy the CAA prescription drug and healthcare spending reporting requirements. To promote greater transparency in prescription drug pricing, the CAA requires group health plans and health insurers to report detailed data about prescri

On August 26, 2022, the Department of Labor and Employment's Division of Family and Medical Leave Insurance (the division) adopted rules on benefits and employer participation in the state's Family and Medical Leave Insurance program (FMLI). We covered FMLI and earlier rules issued by the division in the May 24, 2022, edition of Compliance Corner. Although the program does not start until January 1, 2024, the new rules require employers (even those who choose to use a private plan rather than t

Delaware recently amended its laws to allow for the exculpation of corporate officers, in addition to corporate directors, in some cases. While these new provisions are not an absolute shield, they could change the total risk picture for corporations in certain scenarios. Get more information on this evolving issue and our experts' take on what this could mean for premiums and retentions in the future, and find out what you need to do next.

On August 19, 2022, the Departments of Health and Human Services (HHS), Labor, and the Treasury (the departments) provided a status update on the federal Independent Dispute Resolution (IDR) portal. The departments launched the portal on April 15, 2022, to resolve payment disputes between insurers/plans and providers for certain out-of-network (OON) charges. The portal was discussed in the April 26, 2022, edition of Compliance Corner. The No Surprises Act requires that the departments publish c