Legal & Regulatory

  • Time’s up for mini-med plans as skinny plans gain focus

    July 7, 2014

    With the major elements of the Affordable Care Act taking effect this year, mini-med plans have met their demise, but skinny plans are gaining traction in their place.

  • Industry reacts to Hobby Lobby decision

    July 2, 2014

    Earlier this week, the Supreme Court ruled that, as applied to closely held corporations, Obamacare’s contraception mandate requiring employers to provide workers with no-cost access to contraception violates the Religious Freedom Restoration Act. Reaction to the case, Burwell v. Hobby Lobby Stores, Inc., was swift, although most legal experts believe it is not likely to have broad implications for the majority of employer-sponsored health care plans.

  • Most federal HIX inconsistencies went unresolved

    July 1, 2014

    Nearly all inconsistencies for those who enrolled for health care through the Affordable Care Act’s federal exchanges were unable to be resolved due to Centers for Medicare and Medicaid Services systems not being fully operational.

  • IRS finalizes regulations for health insurance tax credits for small employers

    July 1, 2014

    The IRS has issued final regulations clarifying tax credits for small employers offering coverage to their employees through the SHOP exchange.

  • Can employers reimburse employees for coverage purchased on the ACA exchanges?

    June 26, 2014

    Benefit broker and former lawyer David C. Smith breaks down this question that has been somewhat controversial in the past few months, yet he says has a very clear answer.

  • The logic, calculus, and limits of skinny plans

    June 26, 2014

    Over the last year, “skinny plans” have gained some acceptance among employers under the employer shared responsibility provisions of the Affordable Care Act. And while a skinny plan might be limited to preventative services only, the skinny plans appearing in the marketplace generally include a handful of other features.

  • Critical checkpoint approaches for HIX fix in Mass.

    June 25, 2014

    When he ran for president in 1988, Michael Dukakis infused the phrase “Massachusetts Miracle” into stump speeches to describe the state’s economic transformation. That same description could apply if a costly and controversial plan to fix the state’s Connector exchange succeeds.

  • U.S. hires UnitedHealth exec to lead Obamacare effort at CMS

    June 23, 2014

    The UnitedHealth Group Inc. executive whose Optum division helped states and the federal government fix Obamacare health exchanges will become second-in- command at the agency that runs the U.S. program.

  • Warnings on flaws overlooked

    June 19, 2014

    A contractor the Obama administration hired to monitor progress on its health insurance website,, repeatedly warned the project was falling behind before the site failed in October, Senate Republicans said in a report.

  • Mass. repeals state pay-or-play regulations

    June 13, 2014

    The state of Massachusetts officially repealed the employer pay-or-play regulations that were part of its landmark 2006 health care reform law. Similar to the employer mandate in the Affordable Care Act, the state statute required employers of a certain size to either offer health care coverage to their employees or pay a fine.

  • Are we headed for a national ACA exchange?

    June 11, 2014

    With some state-run exchanges struggling, brokers and agents contemplate whether a national is possible and whether that would be a good or a bad thing for the insurance community.

  • 4 million may pay ACA penalty for lacking insurance

    June 6, 2014

    This figure is about one-third less than previously estimated, after the Obama administration created exemptions from the fine.

  • Burwell approved as new HHS chief to lead ACA

    June 5, 2014

    Sylvia Mathews Burwell was confirmed Thursday by the U.S. Senate as the secretary of the Department of Health and Human Services, replacing Kathleen Sebelius and signaling a new stage for Obamacare.

  • IRS regulations clarify employer ACA reporting requirements

    June 2, 2014

    The IRS issued final regulations in March designed to simplify the employer reporting requirements imposed by the Affordable Care Act. Most importantly, the regulations permit combined reporting for the multiple requirements and simplify reporting where a large employer provides affordable group health coverage, which is of minimum value to almost all of its employees. Here's how the new regulations will affect both large and small employers.

  • ERISA penalizes administrators for ‘hiding’ plan documents

    May 29, 2014

    Benefit advisers can advise their clients on a recent court case that confirms ERISA penalties will ensue for plan administrators that fail to provide plan documents when requested by a plan participant or plan sponsor.

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