Insights

On December 22, 2024, a federal court in the Northern District of Texas issued a preliminary injunction against HHS in a case concerning the 2024 HIPAA Privacy Rule to Support Reproductive Healthcare Privacy, preventing that agency from enforcing that rule against the plaintiffs pending the resolution of litigation. As discussed in our May 7, 2024, article in Compliance Corner, this rule prohibits the use or disclosure of PHI by individuals, covered entities (which includes group health plans),

Thanks to the Internet of Things (IoT), construction sites can run more efficiently and improve worker safety. Utilizing IoT tech can increase productivity, reduce risk and help manage costs, ensuring a more sustainable and profitable industry.

This session provides valuable insights into building a solid financial foundation and preparing for a secure future.

The answer is generally no. Although carriers will sometimes tell employers they can make changes within 30 or 31 days of the plan year beginning, that doesn’t give employees carte blanche to change their minds and choose new elections. Under IRC Section 125, the employee's election must occur prior to the coverage effective date, and the related deduction should come out of a future paycheck. Section 125 also states that employees should not have the ability to change their elections after the

On January 24, 2025, in the high-profile case of Lewandowski v. Johnson & Johnson, et al., a New Jersey district court dismissed two ERISA fiduciary breach claims filed against defendant Johnson & Johnson, in its capacity as group health plan sponsor, and its benefit committee (collectively, J&J). The court found that the plaintiff participant had failed to establish standing as required under Article III of the US Constitution. Generally, the court’s ruling and opinion are good new

On January 20, 2025, on his first day in office, President Trump signed several executive orders that could eventually impact benefits compliance for group health plans. As background, an executive order does not have the same force as a congressionally passed law. Instead, it directs the federal administrative agencies (DOL, IRS, HHS, etc.) to take conforming actions during the coming days, weeks, and months. Executive orders do not instantaneously change compliance requirements or otherwise h

On January 17, 2025, the DOL, IRS, and HHS (the departments) released the 2024 MHPAEA Report to Congress (“the 2024 Report”). The 2024 Report highlights ongoing efforts of the departments to enforce protections of MHPAEA and, more specifically, the CAA 2021 nonquantitative treatment limitation (NQTL) comparative analyses requirements. The 2024 Report, which was issued simultaneously with the 2023 Enforcement Fact Sheet, is intended to fulfill the CAA 2021 requirement that the departments provid

The DOL and CMS recently released the 2023 Mental Health Parity and Addiction Equity Act (MHPAEA) Enforcement Fact Sheet that summarizes MHPAEA enforcement efforts for fiscal year 2023. The MHPAEA Fact Sheet provides general statistics related to group health plans. EBSA estimates there are 2.6 million employment-based group health plans covering 136 million participants and beneficiaries. EBSA is tasked with enforcing the MHPAEA with respect to those plans. This is accomplished through approxi

On January 15, 2025, the DOL, HHS, and IRS (the departments) withdrew proposed rules that would have, among other items, expanded ACA preventive care coverage to include over-the-counter (OTC) contraceptives. Current regulations require non-grandfathered group health plans to cover contraceptives without cost-sharing if prescribed by a healthcare provider. As explained in our November 5, 2024, Compliance Corner article, under the proposed rules, plans would have been required to cover reco