EBIA Weekly Archives - GHPM

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Results (282 articles found)


  1. How does the Newborns' and Mothers' Health Protection Act (NMHPA) affect our company's group health plans?
    From the August 27, 2009 EBIA Weekly
    QUESTION: Our company offers a major medical plan that is required to comply with the Newborns’ and Mothers’ Health Protection Act (NMHPA). One of our employees is soon to give birth and she has heard that the NMHPA ...
  2. MSP Rules Prohibit Terminating Group Health Plan Coverage Based Solely on ESRD Eligibility, Except as Permitted by COBRA
    From the August 20, 2009 EBIA Weekly
    This case addresses the application of the Medicare Secondary Payer (MSP) rules to Medicare entitlement based on end-stage renal disease (ESRD). A kidney dialysis center (Center), as assignee of a deceased participant’s retiree health care benefits, sued ...
    [Bio-Medial Applications of Tenn. v. Cent. States, SE & SW Areas Health & Welfare Fund., 2009 WL 2516968 (E.D. Tenn. 2009)]
  3. When is a HIPAA authorization required in connection with obtaining a medical certification for FMLA purposes?
    From the July 23, 2009 EBIA Weekly
    QUESTION: In administering our company’s FMLA program, we request a medical certification of a serious health condition in order to approve the leave. Does HIPAA require us to obtain an individual’s authorization when requesting a medical ...
  4. EEOC Staff Members Provide Informal Views on Health Risk Assessments, ADA, and Other Benefit-Related Issues
    From the July 16, 2009 EBIA Weekly
    The Joint Committee on Employee Benefits (JCEB) of the American Bar Association has reported on its May 6, 2009 Q&A session with EEOC staff members. The report includes the following informal, nonbinding remarks regarding health risk assessments, the ...
    [ABA Joint Committee on Employee Benefits, Meeting with EEOC Staff (May 6, 2009)]
  5. Can you explain how the Medicare Secondary Payer (MSP) mandatory reporting requirements apply to our health FSA and HRA?
    From the July 07, 2009 EBIA Weekly
    QUESTION: Our company is subject to the Medicare Secondary Payer (MSP) rules, including the MSP mandatory reporting requirements. We offer employees a health FSA and an HRA. Do the MSP reporting requirements apply to those plans? ANSWER: The MSP reporting ...
  6. CMS Updates Medicare Secondary Payer User Guide With Guidance for Responsible Reporting Entities and Group Health Plans
    From the June 04, 2009 EBIA Weekly
    CMS has again updated the User Guide for group health plans on its Medicare Secondary Payer (MSP) mandatory reporting website. Like the earlier versions of the guide (see our article at http://www.ebia.com/WeeklyArchives/GHPM/Statutes/19686 (Premium ...
    [MMSEA Section 111 MSP Mandatory Reporting GHP User Guide, Version 2.3 (May 22, 2009); and Alert: Compliance Guidance Regarding Obtaining Individual HICNs and/or SSNs for Group Health Plan (GHP) Reporting and MMSEA 111 - HICN, SSN Collection - Model Language (May 26, 2009)]
  7. Informal Discussion Letter Indicates That Requiring Health Risk Assessments to Obtain Health Coverage Violates the ADA
    From the May 07, 2009 EBIA Weekly
    In this informal discussion letter, an EEOC official addresses whether an employer’s requirement that employees participate in a health risk assessment in order to obtain coverage under the employer’s self-funded health plan violates the ADA. ...
    [EEOC Informal Discussion Letter (Mar. 6, 2009)]
  8. Requiring Older, Medicare-Eligible Retirees to Pay Larger Portion of Premium Contribution Under Health Plan Did Not Violate ADEA
    From the April 30, 2009 EBIA Weekly
    After years of providing 100% employer-paid coverage under two retiree health plans, the employer in this case amended the plans so that more recent retirees would have to share in future premium increases under a specified formula. Benefits under ...
    [LeFevre v. Niagara Mohawk Power Corp., 2009 WL 1076785 (N.D.N.Y. 2009)]
  9. How do the rules under the Genetic Information Nondiscrimination Act (GINA) affect group health plans and employers?
    From the April 16, 2009 EBIA Weekly
    QUESTION: We’ve heard that group health plans and employers will soon be impacted by rules under the Genetic Information Nondiscrimination Act (GINA). How will group health plans and employers be affected? ANSWER: You’re right that GINA ...
  10. CMS Issues Medicare Part D Benefit Parameters for 2010
    From the April 09, 2009 EBIA Weekly
    Under Medicare Part D regulations, most group health plan sponsors offering prescription drug coverage to Part D eligible individuals (including active or disabled employees, retirees, COBRA participants, and beneficiaries) must disclose to Part D eligible individuals and to CMS whether ...
    [Announcement of Calendar Year (CY) 2010 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies (Apr. 6, 2009)]

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