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Guidance Provided on Summary of Benefits and Coverage

By Marla G. Roshkoff and Brian M. Pinheiro Continuing with the recent proliferation of guidance on health care reform, the U.S. Departments of the Treasury, Labor, and Health and Human Services have released proposed regulations and requested comments regarding the implementation of a new, simplified...

U.S. Airways v. McCutchen: Is It “Fair” for Your Health Plan to Enforce Its Reimbursement Rights?

by Sara E. Hauptfuehrer Group health plans typically provide that when the plan pays benefits for treatment of injuries incurred as the result of a third party's negligence, the plan is entitled to reimbursement for those payments from the proceeds of injured participant's recovery (if...

Ballard Spahr LLP Alert: Final Regulations Address Summary of Benefits and Coverage

By Edward I. Leeds The Affordable Care Act (ACA) requires group health plans and health insurers to prepare and distribute a brief, uniform summary of benefits and coverage (SBC) that aims to provide individuals with a better understanding of the health coverage offered under an arrangement and a...

Ballard Spahr Legal Alert: HHS Releases FAQs on Essential Health Benefits

By Edward I. Leeds and Clifford J. Schoner On February 17, 2012, the U.S. Department of Health and Human Services (HHS) released a set of FAQs concerning the Essential Health Benefits Bulletin it issued on December 16, 2011. The FAQs offer new guidance and raise new questions about the scope of what...