Managing healthcare costs often feels like an endless struggle for benefits professionals, employers, and employees. Nevertheless, benefits professionals persist in their efforts to control escalating healthcare expenses.
In this article, Alden Bianchi and industry members share their predictions about the healthcare landscape, zeroing in on primary care, weight loss drug coverage, the Affordable Care Act, and artificial intelligence.
The US Supreme Court is currently reviewing a case (US v. Skrmetti) concerning Tennessee’s ban on gender-affirming care for youth. If the Court upholds the ban, some employers might consider offering travel benefits to help employees access healthcare services that are prohibited by state law. This could also apply to other plan-covered services that are not available within a certain geographic distance.
Beginning in the first quarter of 2025, California healthcare service plans, health insurers, and certain other organizations must ensure that staff who have direct enrollee contact receive evidence-based cultural competency training focused on transgender-inclusive healthcare. This requirement arises from Senate Bill No. 923, a law passed by the California legislature in 2022. Provider directories must also be updated by March 1, 2025, to identify which in-network providers have previously offered gender-affirming services.
Two recently passed laws have modified the provisions of the Affordable Care Act (ACA) that require employers and insurers to prepare tax forms showing offers of health coverage, streamlining the compliance and reporting process.
Under the ACA’s employer shared responsibility provisions, applicable large employers must either offer qualifying health coverage to full-time employees (and their dependents), or they may face significant excise taxes. Employers may also face penalties if they fail to report, or make mistakes in reporting, the offered coverage. These new rules will ease the reporting burdens on employers seeking to prove that they follow these complex and demanding requirements.
Over the past two weeks, wildfires have caused substantial loss and damage to homes and communities in Los Angeles, California, and the surrounding areas. In the wake of such devastation, employers may seek opportunities to provide financial assistance to impacted employees. Fortunately, the Internal Revenue Service (IRS) has outlined various ways for employers to provide much-needed assistance to employees impacted by natural disasters like the wildfires, including tax-free qualified disaster relief payments, leave donation programs, and other tax-efficient options.
Gender-affirming care has become a central topic in US political discussions, significantly affecting employer-sponsored group health plans. Depending on whether they purchase insurance or self-fund their health benefits, group health plan sponsors face different challenges in covering gender-affirming care. In this PlanSponsor article, Alden Bianchi, Sarah Raaii, and Scott Kenkel explore these challenges and share best practices for group health plans to navigate this complex issue.
Many countries finalized new regulations and released new guidance in 2024 that will impact global equity plans. This client alert highlights key updates from Canada, the European Union, the United Kingdom, Brazil, and other jurisdictions, and recommends steps companies should take to address them.
Following a dynamic year, coupled with a continually evolving legal landscape, employers face increasing regulatory compliance, organized labor advances, technological changes, challenges in protecting company information and retaining talent, and new litigation trends.
In a recent webinar, McDermott’s industry-leading employment team unpacked the most pertinent legal updates and provided tips and action items to get ahead in 2025. They discussed new laws taking effect in the new year, explored key developments impacting management and the workforce, and provided guidance on what employers can anticipate this year.
The No Surprises Act, a law that ended the practice of “balance billing” by certain out-of-network providers, was enacted as part of the Consolidated Appropriations Act of 2021 on December 27, 2020. While the law was passed during President Trump’s first term in office, the Biden administration has been fully responsible for its implementation to date.
In this insight, McDermott+’s Jeffrey Davis and Kristen O’Brien highlight four major areas of No Surprises Act implementation that the Trump administration could decide to focus on in the months following the inauguration.
Payor contracting can seem daunting, particularly for new companies and innovative organizations that are unfamiliar with the nuances of providing a product to health insurers and health maintenance organizations. Navigating regulatory considerations and payor contract complexities requires a solid understanding of the basics. During this webinar, McDermott Partners Gregory Mitchell, Mimi Alexandre, and Erin Kelly discussed some key principles of payor contracting.
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