Legal Alerts

Tenth Circuit Court of Appeals Hands Down a Big Win for ERISA Preemption

By Stacy Barrow - August 31, 2023

After several failed attempts by pharmacy benefit managers (“PBM”) to challenge state laws regulating PBMs, the 10th Circuit Court of Appeals (in Pharmaceutical Care Management Association v. Mulready) handed down a big win for PBMs and, by extension, self-funded ERISA plans, when it held that provisions under an Oklahoma insurance law that established strict network [Read More]

IRS Issues Affordability Percentage Adjustment for 2024

By Stacy Barrow - August 25, 2023

The Internal Revenue Service (IRS) has released Rev. Proc. 2023-29, which contains the inflation-adjusted amounts for 2024 used to determine whether employer-sponsored coverage is “affordable” for purposes of the Affordable Care Act’s (ACA) employer-shared responsibility provisions and premium tax credit program. As shown in the table below, for plan years beginning in 2024, the affordability [Read More]

Agencies Release Proposed Regulations on Fixed Indemnity Insurance, Seek Comments on Level Funded Plans

By Stacy Barrow - July 27, 2023

On July 12, 2023, the IRS, DOL and HHS (collectively, “the Agencies”) released proposed regulations that modify the conditions for hospital indemnity and other fixed indemnity insurance to be considered an “excepted benefit.” Maintaining “excepted benefit” status is important for fixed indemnity plans, as it exempts them from having to comply with the ACA’s insurance [Read More]

FICA Reduction Redux – IRS Issues Guidance on Wellness Indemnity Payments

By Stacy Barrow - June 28, 2023

On June 9, 2023, the IRS released OCC Memo 202323006, which advises that wellness indemnity payments under a fixed indemnity insurance policy are wages for purposes of Federal Insurance Contributions Act (FICA) taxes, Federal Unemployment Tax Act (FUTA) taxes, and federal income tax withholding (FITW) (collectively, “employment taxes”) if the employee has no unreimbursed medical [Read More]

IRS Releases 2024 HSA Contribution Limits and HDHP Deductible and Out-of-Pocket Limits

By Stacy Barrow - May 26, 2023

In Rev. Proc. 2023-23, the IRS released the inflation-adjusted amounts for 2024 relevant to Health Savings Accounts (HSAs) and high deductible health plans (HDHPs). The table below summarizes those adjustments and other applicable limits.   2024 2023 Change Annual HSA Contribution Limit (employer and employee) Self-only: $4,150 Family: $8,300 Self-only: $3,850 Family: $7,750 Self-only: +$300 [Read More]

Agencies Informally Indicate that the Outbreak Period Tied to the COVID-19 National Emergency Ends July 10, 2023

By Stacy Barrow - April 17, 2023

On April 10, 2023, the President signed H.J.Res. 7, which ended the COVID-19 national emergency on April 10, 2023, approximately one month earlier than anticipated.  However, prior to the passage of H.J. Res. 7, the DOL and other federal agencies issued guidance in the form of FAQs that indicate an end date of May 11, [Read More]

Agencies Issue Guidance on the End of the COVID-19 Emergencies (Revised based on the President’s Signature of H.J.Res. 7 on April 10, 2023)

By Stacy Barrow - April 10, 2023

On January 30, 2023, President Biden issued a Statement of Administration Policy announcing his intent to end the COVID-19 national and public health emergencies on May 11, 2023.  However, on April 10, 2023, the President signed H.J.Res. 7, which ends the COVID-19 national emergency approximately one month earlier than anticipated, on April 10, 2023.  On [Read More]

Agencies Release Revised Instructions for 2022 Reference Year RxDC Reporting

By Stacy Barrow - April 6, 2023

On March 3, 2023, federal agencies released revised Prescription Drug Data Collection (RxDC) Reporting Instructions applicable to the 2022 reference year.  RxDC reporting for the 2022 reference year is due on or before June 1, 2023.    Background The Consolidated Appropriations Act, 2021 (“CAA, 2021”) includes a provision that requires group health plans and health [Read More]

Agencies Release FAQs in Advance of the Upcoming Gag Clause Attestation Filing Deadline

By Stacy Barrow - March 30, 2023

When the Consolidated Appropriations Act, 2021 (the “CAA”) was enacted on December 27, 2020, it included a provision that prohibits group health plans and health insurance carriers from entering into certain agreements that, either directly or indirectly, restrict the release of certain information related to provider networks and de-identified encounter data, among other things. Such [Read More]