Legal Alert – Departments Adopt Non­Enforcement Policy on Drug Manufacturer Coupons 

Below you will find a link to our alert on DOL FAQ #40, which describes the Departments’ non­enforcement policy with respect to group health plans and health insurance issues that do not count a prescription drug manufacturer’s coupons as participant cost sharing toward the ACA’s out­of­pocket limit.  The DOL issued this FAQ after questions were raised as a result of a recent HHS rule.

Click here to read more about this important Legal Alert.

Legal Alert – IRS Issues Affordability Percentage Adjustment for 2020

Below please find a link to our legal alert on Rev. Proc. 2019=­29, which contains the inflation adjusted amounts for 2020 used to determine whether employer­sponsored coverage is “affordable” for purposes of the ACA’s employer mandate and premium tax credit program. As shown in the table below, for plan years beginning in 2020, the affordability percentage for employer mandate purposes is indexed to 9.78%, a slight decrease from 9.86% in 2019.

Click here to read more about this important Legal Alert.

Legal Alert – CL 3 Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First 2019628

On June 24, 2019, President Trump issued an Executive Order intending to develop price and quality transparency initiatives to ensure that healthcare patients can make well-informed decisions about their care. This is part of the consumer-driven healthcare initiative, which has been a focus of government and patient groups alike to have more transparency regarding the cost of services from hospitals and other healthcare providers, as well as expanding the ability to use certain pre-tax health spending arrangements. The goal is to help consumers to make better informed decisions regarding their healthcare. It is also intended to address so-called “surprise billing,” which can expose patients to unexpected medical bills. The Executive Order directs federal agencies to promulgate regulations and issue guidance to meet these objectives.

Click here to read more about this important Legal Alert.