Recently, HHS released a set of FAQs concerning an individual’s right to access health information. HIPAA requires covered entities, which include insurers and self-insured group health plans, to provide individuals with access to their protected health information (PHI), such as medical records, information related to enrollment, payment, or claims adjudication, and other records used by the covered entity to make decisions about those individuals. This right of access includes the right to obtain copies (paper or electronic) of the PHI and the right to direct the covered entity to transmit...

The IRS recently published the 2024 IRS Publication 15-B, the Employer's Tax Guide to Fringe Benefits. This publication provides an overview of the taxation of fringe benefits and applicable exclusion, valuation, withholding, and reporting rules. The IRS updates Publication 15-B each year to reflect any recent legislative and regulatory developments. Additionally, the publication provides the applicable dollar limits for various benefits for 2024.

On January 9, 2023, the DOL announced its final rule on worker classification for purposes of the Fair Labor Standards Act (FLSA).

On December 13, 2023, the US Court of Appeals for the Eleventh Circuit (Eleventh Circuit) held in Lapham v. Walgreen Co., that to prove Family and Medical Leave Act (FMLA) retaliation or interference claims, an employee must establish that an adverse employment decision was because of an FMLA leave request, not just motivated by the request. Plaintiff Doris Lapham worked for Walgreens in various roles and at multiple store locations for over a decade. Between 2011 and 2016, Ms. Lapham took intermittent FMLA leave to care for her disabled son. During that same period, Ms. Lapham...

On December 20, 2023, the DOL proposed rescinding a 2018 rule that created alternative criteria that could be used to determine whether a group or association of employers could establish an association health plan (AHP). The rule allows employers without a commonality of interest to form AHPs if they are in the same state or metropolitan area. Further, AHPs can form for the primary purpose of providing benefits (something that was prohibited before 2018) if they can show a “substantial business purpose,” which includes minimal proof — anything from setting business standards and...

On December 21, 2023, the IRS, DOL, and HHS (collectively, the agencies) issued a final rule related to fees established by the No Surprises Act for the federal independent dispute resolution (IDR) process under the Consolidated Appropriations Act, 2021 (CAA). The IDR process comes into play when health plans and issuers and providers, facilities and providers of air ambulance services cannot agree on an appropriate payment for out-of-network items and services. Two types of fees apply to the process: an administrative fee paid to the applicable federal agency and a fee paid to the certified...

On September 29, 2023, the IRS released the 2023 instructions for Form 8889. Employees use this form to report HSA contributions and distributions.

On November 9, 2023, the IRS issued Revenue Procedure 2023-34, providing certain cost-of-living adjustments for a wide variety of tax-related items, including health FSA contribution limits, transportation and parking benefits, qualified small employer health reimbursement arrangements (QSEHRAs), the small business tax credit, and other adjustments for tax year 2024. Those changes are outlined below.

On November 28, 2023, the DOL, HHS, and Treasury (the departments) issued guidance in the form of FAQs entitled ACA and CAA, 2021 Implementation Part 63 . One FAQ announced an update to the ACA requirement to provide certain notices in a culturally and linguistically appropriate manner. Two FAQs address if and when multiple claims for qualified federal independent dispute resolution (IDR) items and services may...

On September 29, 2023, the DOL entered into a settlement agreement with EmblemHealth Inc. (“Emblem”), a New York-based insurer and third-party administrator (TPA) of ERISA group health plans, resolving claims that Emblem breached its fiduciary duties under federal law by engaging in a practice known as “cross-plan offsetting.”