Employee Benefits

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Yesterday, the Obama administration announced a partial delay in the effective date of one of the key requirements of the Patient Protection and Affordable Care Act (“PPACA”) – the employer “shared responsibility” requirements (a.k.a. “pay or play”).
Continue Reading PPACA Update: Employer Shared Responsibility Mandate Delayed Again…For Some Employers, But Not All

The U.S. Supreme Court issued a rare unanimous decision earlier this week finding that employee benefit plans can set reasonable time limitations on when a plan participant may bring a lawsuit seeking plan benefits – even when the time limitation is shorter than what would otherwise be permitted under the Employee Retirement Income Security Act of 1974 (ERISA) and analogous state statutes.

In Heimeshoff v. Hartford Life & Accident Ins. Co., Case No. 12-729 (Dec. 16, 2013), Petitioner Julie Heimeshoff, a long-term Wal-Mart executive, began to suffer from a multitude of ailments caused by fibromyalgia. As a result, in August 2005, she filed a claim for disability benefits with the plan administrator for Wal-Mart’s disability plan – Hartford Life & Accident Insurance Co. On December 8, 2005, after considering the medical evidence offered by Ms. Heimeshoff, Hartford denied her claim for failure to provide sufficient proof of loss.
Continue Reading U.S. Supreme Court Upholds ERISA Plans’ Modified Statute of Limitations

This post was contributed by Eric N. Athey, Esq., a Member in McNees Wallace & Nurick LLC’s Labor and Employment Practice Group. 

Flexible spending arrangements, or FSAs, have gained popularity among employers over the past fifteen years.  Today, approximately 14 million families participate in these benefit plans.  An FSA enables employees to set …

Employers are required to provide a notice to employees regarding coverage options under the new Health Insurance Marketplaces created by the Affordable Care Act that are scheduled to be up and running on October 1. Much is uncertain about how the rollout of the Health Insurance Marketplaces will go on October 1; however, one thing is for certain: employees are likely to have many questions and misunderstandings regarding their options under the Affordable Care Act.
Continue Reading Healthcare Reform Update: The Top Five Questions Employees Will Be Asking on October 1

In light of the Supreme Court’s recent decision in United States v. Windsor, the U.S. Department of Labor has just issued updated guidance for employers concerning the rights of same-sex spouses under the Family and Medical Leave Act. As you may recall from our earlier blog post on the legal implications of the Windsor case, in a 5-4 ruling, the Supreme Court struck down a key provision of the Defense of Marriage Act, which defined marriage under federal law as “a legal union only between one man and one woman as husband and wife.”…
Continue Reading DOL Issues Clarification of FMLA Rights for Same-Sex Spouses

As readers of this blog are surely aware, the Patient Protection and Affordable Care Act (PPACA) imposes a number of new obligations on employers and private health insurance plans. Effective January 1, 2013, most private employers with 50 or more employees must provide health insurance coverage for women’s preventative services, including reproductive health screenings and contraception, without charging a co-pay, deductible, or co-insurance. Failure to provide such coverage can lead to financial penalties of up to one hundred dollars per day per employee who is not provided with the required coverage. A limited exception is available for religious institutions, giving such employers the option of whether to cover contraception services. Over 60 lawsuits are pending around the country by for-profit companies and non-profits alike, challenging the constitutionality of the contraception requirement on religious grounds and seeking to block its enforcement. Late last week, the Third Circuit Court of Appeals issued a ruling on one such challenge brought by a private family-owned business in Pennsylvania.
Continue Reading Third Circuit Denies Pennsylvania Business’s Challenge to Contraception Mandate

As we discussed with attendees at our most recent health care reform compliance seminar in June, we wanted to make the presentation available to the readers of our blog. You can access the PowerPoint, “Countdown to 2014: PPACA Compliance Priorities for Employers,” by clicking through to this blog post.
Continue Reading PPACA Presentation – Countdown to 2014: PPACA Compliance Opportunities for Employers

Many employers received a welcome, though temporary, reprieve yesterday, when the U.S. Department of the Treasury announced a one-year delay in the effective date of one of the key requirements of the Patient Protection and Affordable Care Act – the employer “shared responsibility” requirements (a.k.a. “pay or play”).
Continue Reading PPACA Update: Employer Shared Responsibility Mandate Delayed Until 2015

Last week, the Supreme Court of the United States struck down as unconstitutional a key provision of the Defense of Marriage Act (DOMA) that defined “marriage” for purposes of over 1,100 federal laws as a legal union between a man and a woman. With the Court’s decision, same-sex couples that are legally married under state law are now entitled to the same treatment under federal law as opposite-sex married couples. Chief among the benefits now available to same-sex married couples are equal treatment under the country’s immigration and tax laws and equal rights to participate in its federal health and welfare programs. The Court’s decision striking down DOMA also will have a significant impact on the rights of same-sex married couples under various federal laws relating to employment.
Continue Reading Pennsylvania Employers Left Wondering How They Are Affected by the Supreme Court’s Decision on DOMA

Although the Patient Protection and Affordable Care Act is now over three years old, the Act’s core requirements will not take effect until 2014. The last half of 2013 should be a “wild ride” as the federal agencies charged with implementing the Act scramble to prepare for 2014 and employers weigh their compliance options. Recently, attorneys in McNees Wallace & Nurick LLC’s Labor and Employment Law Group prepared a white paper entitled: “Health Care Reform Update: Countdown to 2014.” The White Paper is part of our ongoing PPACA series that is intended to keep clients abreast of recent developments and things to watch for as we count down to 2014. This installment addresses:

1. PCORI Fees: July 2013 Filing Deadline
2. Compliance Loopholes, Shortcuts and Silver Bullets
3. Update on Required Notice of Health Care Exchanges
4. Final Wellness Program Regulations…
Continue Reading Health Care Reform Update: Countdown to 2014