On March 28, 2019, a federal court stated that the final rule on association health plans was an "end-run" around the ACA and that the DOL exceeded its authority under ERISA.
Health Reform Bulletin 143 | Status of ACA Litigation; Murky Future of AHPs; ...CBIZ, Inc.
Litigation challenging and rescinding various aspects of the Affordable Care Act (ACA) continues to reign. Last December, Judge Reed O’Connor of the Fifth Circuit Court of Appeals opined that the individual mandate, in the absence of the tax repealed by the Tax Cuts and Jobs Act, is unconstitutional; and since it is a cornerstone of the ACA, then the entire ACA must fall (see our prior CBIZ Health Reform Bulletin 142).
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DOL Releases Final Rule Expanding Association Health PlansMichael L. Benner
DOL Releases Final Rule Expanding Association Health Plans
The U.S. Department of Labor (DOL) has issued a final rule expanding the opportunity of unrelated employers of all sizes (but particularly small employers) to offer employment-based health insurance through Association Health Plans (AHPs). Significantly, the final rule applies “large group” coverage rules under the Affordable Care Act (ACA) to qualifying AHPs. Please see attached Client Alert.
Health Reform Bulletin 143 | Status of ACA Litigation; Murky Future of AHPs; ...CBIZ, Inc.
Litigation challenging and rescinding various aspects of the Affordable Care Act (ACA) continues to reign. Last December, Judge Reed O’Connor of the Fifth Circuit Court of Appeals opined that the individual mandate, in the absence of the tax repealed by the Tax Cuts and Jobs Act, is unconstitutional; and since it is a cornerstone of the ACA, then the entire ACA must fall (see our prior CBIZ Health Reform Bulletin 142).
Crystal Connection (1/2019): Trending News in Employee Benefits, January 2019Susan Glenn
The Crystal Connection monthly magazine provides the most up-to-date developments in federal and state regulations that affect employer-sponsored benefits programs, as well as trends in benefits. This is a must read for employers who want to stay compliant and in the know!
DOL Releases Final Rule Expanding Association Health PlansMichael L. Benner
DOL Releases Final Rule Expanding Association Health Plans
The U.S. Department of Labor (DOL) has issued a final rule expanding the opportunity of unrelated employers of all sizes (but particularly small employers) to offer employment-based health insurance through Association Health Plans (AHPs). Significantly, the final rule applies “large group” coverage rules under the Affordable Care Act (ACA) to qualifying AHPs. Please see attached Client Alert.
Health Care Reform - list of items for employers as we approach 2013 and 2014. Join us 9/12/12 for our event on the Affordable Care Act/Health Care Reform.
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See full session at: http://video.hint.com/dr-phil-eskew-mewa-like-your-hra
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http://www.whitehouse.gov/21stcenturygov/actions/21st-century-regulatory-system
Health Reform Bulletin 128 | House Passes the American Health Care ActCBIZ, Inc.
On May 4, 2017, the House passed the American Health Care Act of 2017 (“AHCA”, H. R. 1628). Since the initial bill was officially introduced on March 20, 2017 (see The GOP Proposal to Repeal and Replace the Affordable Care Act, HRB 127, 3/10/17), there have been several amendments made to the law’s text. The bill will now progress to the Senate for consideration; its fate in the Senate is unclear at this point. Every indication is that the bill with undergo significant scrutiny and probably substantial change. Following is a brief overview of certain provisions of the bill passed by the House.
It's an understandable response to the Affordable Care Act to simply throw in the towel and give your employees some cash to buy health coverage on their own. Unfortunately, it's not as simple as that. The U.S. Department of Labor has just tackled that topic in its most recent round of "frequently asked questions," surrounding the implementation of the health care law. Here are some highlights of the latest guidance.
Shifting away from employer-provided healthcare means individuals will be responsible for cost containment.
With the onset of the ACA, will the Government become the last -or- best resort for the private sector's healthcare cost containment?
Compliance Bulletin - Washington Enacts Employee-paid Long-term Care ProgramKelley M. Bendele
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Health Care Reform - list of items for employers as we approach 2013 and 2014. Join us 9/12/12 for our event on the Affordable Care Act/Health Care Reform.
MEWA like your HRA...Just don’t give me a bad STLDIHint
Dr. Phil Eskew, DO, JD, MBA of Proactive MD takes on the large and constantly growing list of healthcare acronyms. This talk is packed with information about where we are today, and offers predictions about where we are likely headed from a regulatory standpoint.
See full session at: http://video.hint.com/dr-phil-eskew-mewa-like-your-hra
On Nov. 8, 2013, the DOL, HHS and the Treasury released Frequently Asked Questions (FAQs) regarding implementation of the Mental Health Parity and Addiction Equity Act. These FAQs were released in conjunction with final rules on the MHPAEA, which contain some clarification regarding the law's protections.
News Flash January 27 2015 - Settled Law Changing _ Retiree Medical Benefits...Annette Wright, GBA, GBDS
The following article describes a new employee benefits development (Supreme Court decision could make it easier for employers to reduce union retiree health benefits).
The Trump Labor Board Goes Back to the FuturePolsinelli PC
The last weeks of 2017 brought significant changes to the National Labor Relations Board and federal labor law. Polsinelli’s Traditional Labor Practice Group will cover all of these changes, including the short-lived Republican majority, the new Board members and General Counsel, a recap of the major decisions reversing several of President Obama’s pro-employee initiatives over the last eight years, and discuss what is in store for employers in 2018.
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In January 2011, President Obama outlined his plan to create a 21st-century regulatory system – one that protects public health and welfare while promoting economic growth, innovation, competitiveness, and job creation. Among other things, his Executive Order on Regulation said the following: Always consider costs and reduce burdens for American businesses and consumers when developing rules; expand opportunities for public participation and public comment; simplify rules; promote freedom of choice; and ensure that regulations are driven by real science. this is the January 2012 update from the Department of Health and Human Services, go here for more information:
http://www.whitehouse.gov/21stcenturygov/actions/21st-century-regulatory-system
Health Reform Bulletin 128 | House Passes the American Health Care ActCBIZ, Inc.
On May 4, 2017, the House passed the American Health Care Act of 2017 (“AHCA”, H. R. 1628). Since the initial bill was officially introduced on March 20, 2017 (see The GOP Proposal to Repeal and Replace the Affordable Care Act, HRB 127, 3/10/17), there have been several amendments made to the law’s text. The bill will now progress to the Senate for consideration; its fate in the Senate is unclear at this point. Every indication is that the bill with undergo significant scrutiny and probably substantial change. Following is a brief overview of certain provisions of the bill passed by the House.
It's an understandable response to the Affordable Care Act to simply throw in the towel and give your employees some cash to buy health coverage on their own. Unfortunately, it's not as simple as that. The U.S. Department of Labor has just tackled that topic in its most recent round of "frequently asked questions," surrounding the implementation of the health care law. Here are some highlights of the latest guidance.
Shifting away from employer-provided healthcare means individuals will be responsible for cost containment.
With the onset of the ACA, will the Government become the last -or- best resort for the private sector's healthcare cost containment?
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2.
2
This Compliance Bulletin is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice.
Readers should contact legal counsel for legal advice.
Association Health Plans
An AHP is a type of ERISA‐covered group health plan that is
sponsored by a group or association of employers (instead of
a single employer) to provide health coverage to employees
of the AHP’s members. Under ERISA, an AHP is both a group
health plan and a multiple employer welfare arrangement
(MEWA).
On June 21, 2018, the DOL published a final rule that allows
more employer groups and associations to join together as a
single group to purchase health coverage. The final rule
allows AHPs to offer coverage to some or all employers in a
state, city, county or multistate metro area, or to businesses
in a common trade, industry, line of business or profession in any area, including nationwide.
The final rule did not affect existing AHPs that were allowed under prior DOL guidance. Under the final rule,
these plans could continue to operate under the prior guidance or could elect to follow the provisions of the
final rule. The final rule also gave new plans the option to follow either the new final rule or the old rules.
However, the option to follow the new rules may be affected by the court’s ruling.
The Court’s Ruling
After the final rule was issued, 11 states and the District of Columbia sued the DOL, claiming that the final
rule’s interpretation of the definition of “employer” in ERISA was unlawful. The court agreed, and vacated the
relevant portions of the final rule.
The court noted that, because the ACA defines terms key to its implementation—including “employer” and
“employee”—according to the definition of these terms in ERISA, the final rule was intended to expand AHPs
in a way that allows small businesses and some individuals to avoid the health care market requirements
imposed by the ACA.
As stated by the court, the final rule’s definition allows virtually any association of disparate employers
connected by geographic proximity to qualify as single ERISA plans. These associations no longer have to be
viable apart from offering an AHP, and may form solely for the purpose of creating an AHP. In addition, the
final rule brings sole proprietors without any employees within ERISA’s scope by counting them as both
“employers” and “employees.”
The court ruled that the bona fide association and working owner provisions of the final rule were
unreasonable interpretations of ERISA and must be vacated. Under the final rule’s severability provision, the
remainder of the rule is still valid. However, the court has directed the DOL to reconsider how the rest of the
rule is affected by its ruling.
The court decided that the final
rule’s interpretation of “employer”
to include working owners and
employer groups without a common
interest was an unreasonable
interpretation of ERISA and a clear
“end‐run” around the ACA’s
requirements.
3.
3
This Compliance Bulletin is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice.
Readers should contact legal counsel for legal advice.
DOL’s Response
Following the court’s ruling, the DOL released a set of questions and answers (Q&As) to address issues related
to the court decision. According to these Q&As, the DOL disagrees with the court’s ruling and is considering all
available legal options, including the possibility of appealing the ruling and requesting that the court stay its
decision pending an appeal.
The DOL’s Q&As also address how the court’s ruling may impact individuals who are currently enrolled in an
AHP. According to the DOL, participants in AHPs affected by the court’s decision have a right to benefits as
provided by the plan or policy. Plans and health insurance issuers must keep their promises in accordance with
the policies and pay valid claims. However, the DOL recognizes that AHPs may change their structure or
operations going forward. An AHP’s plan administrator is the best resource for information about changes that
the AHP may make in the future.