Happy 2015 from the Bose Insurance Blog!

To all our friends and readers, we wish you a happy, healthy, and prosperous 2015!

2015 New Year celebration

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Transitional Reinsurance Reporting Deadline Extended

Another useful health insurance post from our friends at the Bose Employee Benefits Blog.

Bose Employee Benefits Blog

The Center for Medicare & Medicaid Services (“CMS”) granted a last minute extension for filing the Annual Enrollment and Contributions Submission Form as part of the Affordable Care Act’s Transitional Reinsurance Program. On Friday, November 14th, CMS announced that the reporting deadline of November 15th is extended until 11:59 pm on December 5, 2014. This extension gives health insurance issuers and certain self-funded group health plans a little more time to complete the Submission Form which can be found on the Pay.gov website. The payment deadlines are unchanged. The deadlines for payment of the transitional reinsurance fee remain as January 15, 2015 and November 15, 2015.

The CMS announcement as well as the revised reinsurance contribution deadlines for the 2014 benefit year can be viewed here.

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EEOC Files Lawsuit Against Employee Wellness Program

Another great health insurance update from our colleagues at the Bose Employee Benefits Blog. Enjoy!

Bose Employee Benefits Blog

On August 20, 2014, the U.S. Equal Employment Opportunity Commission (“EEOC”) filed suit in Wisconsin federal court challenging an employee wellness program’s legality under the Americans with Disability Act (“ADA”). As noted in a press release, this lawsuit is the EEOC’s first to directly challenge a wellness program under the ADA.

Orion Energy Systems (“Orion”) implemented a wellness program that included health screenings and disability related inquiries. The ADA prohibits medical examinations and inquires unrelated to employment, unless they are voluntary. The EEOC alleges that Orion’s wellness program did not qualify as voluntary under the ADA because one employee who refused to participate was forced to bear the entire cost of her health coverage premium and was ultimately terminated. “Employers certainly may have voluntary wellness programs,” stated John Hendrickson, regional attorney for the EEOC Chicago district. “But they have to actually be voluntary. They can’t compel participation by imposing…

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Auto Body Shop Antitrust Cases Consolidated in Florida

On Friday, the Judicial Panel on Multidistrict Litigation ordered five antitrust cases brought by numerous auto body shops in five separate federal districts—including the Southern District of Indiana—consolidated in the Orlando Division of the United States District Court for the Middle District of Florida. (Full disclosure: The Bose McKinney & Evans team of Brian Jones, Curtis Jones, and Joel Nagle represents one of the defendants in the Indiana antitrust case.) The order is attached below.

As the Panel noted, the plaintiffs in the cases are “principally individual collision repair shops in five states. They allege a conspiracy in the automobile insurance industry to suppress the reimbursement rates for automobile collision repairs, in violation of Section 1 of the Sherman Antitrust Act and various state laws.” Further,

This litigation involves allegations of a complex anticompetitive conspiracy among the nation’s leading insurance carriers and dozens of regional companies, as well as allegations that the databases of three third-party information services companies—ADP, CCC, and Mitchell—played a substantial role in facilitating the alleged scheme.

Collectively, the plaintiffs sued over 80 insurers. In response to the plaintiffs’ motion to consolidate all pending cases in the Southern District of Mississippi, the insurers’ universally opposed consolidation in Mississippi, but varied as to where the cases should be consolidated, if at all.

Ultimately, the Panel found that consolidation “will offer the benefit of placing all related actions before a single judge who can structure pretrial proceedings to accommodate all parties’ legitimate discovery needs while ensuring that common witnesses are not subjected to duplicative discovery demands.” Because the five cases involved common questions of fact, “centralization of the actions on the motion in the Middle District of Florida will serve the convenience of the parties and witnesses and promote the just and efficient conduct of the litigation.”

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IRS Adjusts Affordability Percentage Under Employer Mandate

Another excellent health insurance post from our colleagues at the Bose Employee Benefits Blog.

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Conflicting Federal Rulings Issued Today on ACA

As I mentioned in my earlier post, I’m out of the office, so of course there were not one, but two significant rulings today. Fortunately, our sister blog, the Bose Employee Benefits Blog, has as excellent post on these two cases, which I thought was worth sharing here.

Bose Employee Benefits Blog

Earlier today, two circuits of the U.S. Court of Appeals handed down conflicting rulings regarding the legality of insurance subsidies offered in connection with federally facilitated exchanges. The controversy surrounding these subsidies involves language found in the Affordable Care Act (“ACA”) which provides that subsidies are available to individuals purchasing insurance through exchanges “established by the State.” The IRS interpreted this language broadly to allow for subsidies to be offered with both state and federally facilitated exchanges.  The plaintiffs in both cases believe that the IRS exceeded its authority in expanding subsidies to states with federally facilitated exchanges, thereby unfairly exposing applicable large employers in those states to shared responsibility penalties.

In Halbig v. Burwell, the U.S. Court of Appeals for the District of Columbia held that the language of the ACA allowing for insurance subsidies in state operated exchanges did not apply to federally facilitated exchanges. However, only…

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Breaking: D.C. Circuit Nixes ACA Premium Subsidies

(Of course there would be breaking news while I’m out of the office…)

In any event, the D.C. Circuit this morning nixed the premium subsidies at the heart of the Affordable Care Act, effectively taking the “affordable” out of the Act. Click here for the opinion.

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