By Porter Wright on Back in 2011, I mentioned a missing link in the health care reform Section 4980H shared responsibility employer excise tax scheme. 42 U.S.C. Section 18081 requires the establishment of an appeals and redeterminations process for penalty assessments, and acknowledges a problem with the provision itself. It requires the Secretary of Health and Human Services to … Continue Reading
By Porter Wright on The U.S. Supreme Court has agreed to hear a Sixth Circuit retiree health care case, M&G Polymers USA, LLC v. Tackett. The issue is: Whether, when construing collective bargaining agreements in Labor Management Relations Act (LMRA) cases, courts should presume that silence concerning the duration of retiree health-care benefits means the parties intended those benefits … Continue Reading
By Porter Wright on We have a new Sixth Circuit decision regarding “vested” retiree health care benefits that is likely to be of concern to many employers, United Steel, Paper and Forestry, Rubber, Manufacturing Energy, Allied Industrial And Service Workers International Union, AFL-CIO-CLC v. Kelsey-Hayes Company. You may recall that in the last significant Sixth Circuit decision on this … Continue Reading
By Porter Wright on Employers have always been concerned about the potential for worker reclassification, but health care reform and a recent NLRB decision take this issue to an entirely new level. “Large” employers who offer coverage will be required to offer coverage to “all” of their “full-time workers,” defined as at least 95% of employees working 30 hours … Continue Reading
By Porter Wright on Hot off the press are the final regulations for the employer shared responsibility provisions of the Affordable Care Act (more commonly referred to as the “pay-or-play mandate”). In fact, the regulations are so new that they will not actually be published in the Federal Register until tomorrow, February 12. … Continue Reading
By Porter Wright on As a reminder, under health care reform, all employers to which the Fair Labor Standards Act (“FLSA”) applies, not just “applicable large employers,” are required to distribute health care exchange notices to their employees by October 1, 2013. Given that health care reform is chock full of big penalties, it puzzled me that I couldn’t find a penalty for failure to provide this notice. Last week, the DOL published Frequently Asked Questions that confirmed, “there is no fine or penalty under the law for failing to provide the notice.” Nonetheless, health care reform involves so many inter-related statutes, pages of guidance, government agencies and interested parties that we encourage employers to comply to demonstrate good faith, and to avoid potential alternative theories of liability.… Continue Reading
By Porter Wright on Employee Relations Seminar Halloween Edition: Toil and Trouble...
Please join the labor and employment group of Porter Wright on Tuesday, October 8 in Cleveland as we address issues that will help keep your workforce out of trouble.
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By Porter Wright on In a surprising but generally welcome move, the Obama administration has moved to delay the enforcement of the employer mandate to provide health care coverage under the Affordable Care Act (the “ACA”), which otherwise was scheduled to go into effect in 2014. This delay in enforcement formally was announced in a statement released July 2, … Continue Reading
By Porter Wright on The Affordable Care Act (the “ACA”) makes sweeping changes to the current health insurance landscape. Though some of these changes are already in force, the most significant provisions of the ACA become effective on January 1, 2014. This includes the "pay or play mandate," the individual coverage mandate, and certain significant taxes and fees that are imposed on employers.… Continue Reading
By Porter Wright on As you may have heard, the U.S Supreme Court denied Hobby Lobby an injunction against the PPACA contraceptive coverage mandate. Employers who maintain health care plans are required to pay excise taxes for failure to comply with a particular aspect of the law, regardless of whether coverage is affordable. … Continue Reading
By Porter Wright on Health care reform just got a clean bill of health from the United States Supreme Court. The Court today ruled on the constitutionality of the Patient Protection and Affordable Care Act ("PPACA"), and generally upheld the legislation in a 5-4 decision written by Chief Justice John G. Roberts.… Continue Reading
By Porter Wright on The health care reform legislation finally is having its day (well, actually several days) in court — in the United States Supreme Court no less. Other than for those fixated on the upcoming Final Four (unfortunately, the author’s team already has been eliminated and thus I am free to write this) or on the triumphant … Continue Reading
By Porter Wright on We now have Q&A’s on the health care Summary of Benefits and Coverage. This guidance is incredibly late and is not binding, but it may be of assistance to everyone rushing to get this documentation put together and distributed. … Continue Reading
By Porter Wright on The Patient Protection and Affordable Care Act (“PPACA”) contained a provision that established the Early Retiree Reinsurance Program (“ERRP”), the goal of which was to encourage plan sponsors to retain health care coverage for retirees through at least 2013. The ERRP was designed to provide reimbursement to eligible sponsors of employment-based plans for a portion … Continue Reading
By Greg Daugherty on Employers who maintain health plans may recall from our prior blogs (see "Health Care Plan Annual Enrollment Triage: The Summary of Benefits and Coverage Standards Have Not Been Issued Yet and May Just Have to Wait" and "Health Care Plan Summary of Benefits and Coverage: Still No Final Model, But Substantial Excise Taxes are Looming Anyway") that they would soon need to address the new Summary of Benefits and Coverage ("SBC"), although urgent action would need to wait until the issuance of final guidance. Well, the wait is over.… Continue Reading
By Porter Wright on While conducting a health care reform webinar recently, we received questions that suggested the need to remind employers sponsoring group health care plans about their self-reporting obligations, and significant potential exposure to excise taxes. … Continue Reading
By Porter Wright on The table now is set for the last chapter in our long (and, to many, excruciating) debate over the constitutionality of the health care reform legislation enacted in 2010. At a conference last Thursday, November 10, the members of the United States Supreme Court voted to consider an appeal of one of the lower court decisions dealing with the constitutionality of the landmark legislation.… Continue Reading
By Porter Wright on The Patient Protection and Affordable Care Act (PPACA) shared responsibility provisions require speculation about whether health care coverage will be affordable for an individual. Whether affordable coverage was available, whether an individual was eligible for a premium credit, and whether an employer was subject to penalties, cannot be determined until after the individual files a personal tax return. … Continue Reading
By Greg Daugherty on In our prior blog, we explained that under principles of triage, employers may need to focus on the current annual enrollment and wait to take care of the Summary of Benefits and Coverage ("SBC"). Although the SBC does not need immediate attention, we caution employers not to wait too long or take the SBC responsibilities too lightly.… Continue Reading
By Porter Wright on The Obama administration was faced with a deadline to ask for an en banc review by the 11th Circuit Court of Appeals of a decision that declared the health care reform legislation's individual mandate unconstitutional. Under applicable court rules, such a request had to be filed by Monday, September 26. A decision to seek such a review would have caused further delay, and very likely would have delayed the timing of a decision on the legislation by the Supreme Court until after the 2012 national elections.… Continue Reading
By Porter Wright on M*A*S*H* taught us how to do triage, and MacGyver taught us to creatively think our way out of an impossible situation. Both are skills that may come in handy for the many employers who maintain calendar year health plans and who were in the process of preparing for annual enrollment when the Summary of Benefit … Continue Reading
By Porter Wright on The U.S. Court of Appeals for the Eleventh Circuit in Atlanta on Friday ruled, in the 26-state challenge to the Patient Protection and Affordable Care Act (PPACA) in Florida v, U.S. Dept. of Health and Human Services, that the health care reform law’s requirement that nearly all Americans have health insurance is unconstitutional. This ruling comes two months after the U.S. Court of Appeals for the Sixth Circuit upheld the constitutionality of PPACA.… Continue Reading
By Porter Wright on Most Americans (other than those focused solely on the resolution of the NFL lockout) have taken notice of the partisan scramble going on here in Washington these days over the debt ceiling limit and our seemingly out-of-control federal deficit. As I write this, partisan bickering and veto threats are the order of the day—even as … Continue Reading
By Jim Prior on Most everyone wants to be culturally appropriate. But just what does that mean? The answer to that question became a little clearer for non-grandfathered group health plans in the context of notices to be provided for internal health claims and appeals. Plan sponsors will need to pay attention, as compliance with new guidance is required … Continue Reading
