Category Archives: Benefits nondiscrimination

Devil Is in Details of Final Mental Health Parity Rules

Pre-authorization procedures, plan disclosures and geographical restrictions are just a few features  group health plans will need to re-examine by the time the recently finalized mental health parity rules take effect. For calendar-year plans, this means Jan. 1, 2015 —…

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Reform Agencies Clarify Cost Sharing and Essential Services

A series of agency Q&As resolves a few questions relating to complying with federal health care reform, such as correctly counting participants’ out-of-pocket expenditures; wellness program reward administration; and the status of “carved-out” benefits. In latest set of Frequently Asked…

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Agencies Would Broaden Exceptions to Required Benefits

Employee assistance programs and certain “limited wraparound coverage” would be added to the set of “limited excepted benefits” exempt from most of the requirements of the Affordable Care Act, under proposed rules in the Dec. 24 Federal Register (78 Fed….

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TPA May Not Be Sued for MHPAEA Violations, Court Rules

A third-party claims administrator may not be sued for violating the Mental Health Parity and Addiction Equity Act because the law by its terms applies only to group health plans and their insurers, a federal district court ruled. Related ERISA…

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Mental Health Parity Rules Remove ‘Clinically Appropriate’ Exemption

Final mental health parity rules issued Nov. 8 make several changes to the prior, interim version. The exemption for “clinically appropriate standards of care” was eliminated because regulators decided it was confusing and subject to abuse, and the rules’ application…

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Top 10 Do’s and Don’t's from FMLA and ADA Court Rulings

Leave policy administration under the FMLA and the ADA presents numerous challenges to employers. Following is a “Do” and “Do Not” list based on the outcomes of 10 interference and retaliation claims by aggrieved employees that the courts have heard in…

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GOP Emphasizes Job-hindering Aspects of Health Reform Mandates; Feds Clarify Employer Guidance

In spite of its one-year suspension of the employer mandate under health care reform, the government added implementation and compliance materials for employers to government websites. Meanwhile Republican legislators attacked not only reform’s revenue and penalty collection functions, but also its definition…

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Same-gender Marriage Debate Continues in the States

Employers still have to contend with plenty of uncertainty regarding employees’ same-gender spouses, regardless of the U.S. Supreme Court ruling in U.S. v. Windsor (No. 12-307, June 26, 2013). That decision may have declared Section 3 of the federal Defense…

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FMLA Absences Up, Some Industries Hit Harder Than Others

While leave under the Family and Medical Leave Act can be troublesome for any employer, it is particularly disruptive for manufacturers, call centers and health care organizations whose operations depend on fixed schedules, according to a recent ComPsych Corporation white…

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UPS Not Obligated to Provide ‘Light Duty’ to Pregnant Truck Driver, Says Court

A corporate policy that does not include pregnancy among the conditions making an employee eligible for light duty is a “neutral and legitimate business practice,” not evidence of bias against pregnant workers, according to a recent court ruling that dismissed…

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