by Jay Kirschbaum | April 26, 2020 | ERISA, The Coronavirus
In response to the coronavirus pandemic, state insurance departments have issued directives prohibiting insurers from canceling certain kinds of policies due to the nonpayment of premiums, requiring the insurer to provide a grace period before canceling, or strongly...
by Jay Kirschbaum | December 4, 2019 | Benefits Administration, Compliance Services, ERISA
Cross-plan offsetting is a common practice among insurance carriers and third-party administrators (TPAs) that can put employers at risk. Briefly, cross-plan offsetting occurs where the insurer or TPA overpays a healthcare provider on a claim submitted to Plan A....
by Jay Kirschbaum | October 3, 2019 | ACA Repeal and Replace, Health Reform, Uncategorized
An article caught our eye this week, and underscored the Yogi Berra adage, “It’s tough to make predictions, especially about the future.” Whenever Congress tackles major health care policy initiatives, from Medicare to the Affordable Care Act (ACA), including the...
by Jay Kirschbaum | September 24, 2019 | DOL, Mental health, Mental Health Parity
The Department of Labor (DOL) has issued new guidance to help plan administrators determine whether certain coverage guidelines applied to mental health and substance abuse treatment are permissible. This new FAQ supplements the slew of guidance previously issued in...
by Jay Kirschbaum | August 5, 2019 | Employer Mandate, Health Reform / ACA, Tax Issues
Recently, the ERISA Industry Committee (ERIC), an association advocating on behalf of large employers that sponsor benefits plans, sent a letter to the IRS. The letter, which addressed the penalty assessment process that has developed under the Affordable Care Act’s...
