Under the Employee Retirement Income Security Act of 1974 (ERISA), employee welfare benefit plans are subject to certain fiduciary rules, claims procedures and plan document requirements (including providing participants with a Summary Plan Description (SPD) and possibly also filing a Form 5500 annual return). The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) generally requires [...]

Over the past several months, there has been a spate of federal legislation and corresponding guidance related to COVID-19 that requires group health plan changes and allows voluntary changes aimed at removing barriers to care and minimizing the impact of the pandemic on employees’ pocketbooks. Mandatory changes include first-dollar coverage for COVID-19 diagnostic testing and [...]

Last week, the U.S. Department of Health and Human Services released the HHS Secretary’s Report on Addressing Surprise Billing which was required under President Trump’s Executive Order 13877. The Report calls for steps, including Congressional action, to combat surprise billing and promote pricing transparency, with the following principles in mind: Patients receiving emergency care should [...]

A constellation of recent developments related to the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) should prompt employers to take action to ensure there are no errors or omissions in their communications and procedures that could invite legal or regulatory penalties. COBRA is the government mandate that allows employees and their “qualified beneficiaries” to [...]