Insights

Possibly. First, if an employer discovers a failure to offer COBRA in a timely manner, they should consult with their own legal counsel. This is important because qualified beneficiaries interested in maintaining health coverage are typically more likely to file complaints with the DOL to enforce their COBRA rights. A failure to meet COBRA requirements can potentially result in an employer facing significant penalties, participant lawsuits, and even the self-funding of participant claims. For t

In April, Gov. Huckabee Sanders signed numerous healthcare bills into law. Act 424 (previously SB 83) mandates coverage for breast reconstruction surgery and requires prior authorization for breast reconstruction surgeries. The act requires health benefit plans to cover all services provided for breast reconstruction surgeries and to cover any surgery determined to be the best course of treatment by a healthcare professional consistent with prevailing medical standards. Additionally, if a cover

In May and June 2025, Gov. Polis signed the following healthcare bills into law: HB25-1309 Protect Access to Gender-Affirming Health Care: Under current law, health benefit insurance plans (health benefit plans) include coverage for "gender-affirming health care" as part of individual and group health benefit plans. The bill codifies gender-affirming healthcare treatments in the statute and prohibits a health benefit plan from denying or limiting medically necessary gender-affirming healthcare

On May 6, 2025, Gov. Moore signed SB 785 into law, resulting in a number of changes to the Maryland Parental Leave Act (PLA). Beginning October 1, 2025, Maryland employers who are covered by the federal Family and Medical Leave Act (FMLA) are no longer required to comply with the state’s unpaid parental leave law. The definition of “employer” under Maryland’s PLA will also be modified to exclude those already covered by the FMLA, even if they have between 15 and 49 employees. The Maryland PLA&n

On May 23, 2025, the Congressional Research Service (CRS) published an overview of the ACA’s preventive services coverage requirement. According to this report, between 150 million and 180 million individuals are enrolled in a plan subject to the preventive services coverage requirement. The ACA requires group health plans (including most private health insurance plans, but not grandfathered plans) and insurers to cover certain preventive care without cost-sharing. The required covered care inc

On June 2, 2025, the DOL introduced its enhanced opinion letter program. The program is designed to help employers and other stakeholders understand and comply with federal laws, including employee benefit laws that are enforced by the DOL. The recently announced program spans five key DOL enforcement agencies, including the Employee Benefits Security Administration (EBSA), which oversees private retirement and health and welfare benefit plans. The EBSA will issue advisory opinions and informat

On April 8, 2025, Gov. Lujan Grisham signed SB 120 into law. The new law aims to make permanent prohibitions on cost-sharing for behavioral health services and to provide exemptions for certain types of plans. The law prohibits group health insurance policies, healthcare plans, or certificates of insurance issued, delivered, issued for delivery, or renewed in the state that offer coverage for behavioral health services from imposing cost-sharing on those services in-network. Behavioral health s

On March 20, 2025, in Owens v. Blue Shield of California et al., a U.S. District Court in California granted and denied in part a motion to dismiss a claim involving the applicability of ERISA to state continuation coverage. The plaintiff was employed with one of the defendants, Fredrickson and Company, through March 2020 and received employer-sponsored health coverage through Blue Shield of California. The plaintiff’s health benefits ceased on March 31, 2020, at which time she elected continue

On May 1, 2025, Gov. Scott announced the third phase of the Vermont Family and Medical Leave Insurance (Vermont FMLI) program, making it available to self-employed workers and individuals who do not have access to coverage through their employer.