Today the Supreme Court released its decision in Obergefell v. Hodges, a 5-4 decision. The Court ruled in favor of same-sex marriage, holding that the Fourteenth Amendment requires states to issue marriage licenses for same-sex couples. The Court also held that states must recognize same-sex marriages that were lawfully licensed and performed out of state.

The Supreme Court released their ruling on King v. Burwell today. The vote was 6-3 in favor of upholding health premium subsidies in all States, including States that have a Health Plan Exchange run by the Federal Government.

Now that the decision is made, we will most likely see action in Congress to clean up parts of the Affordable Care Act.

Here is a link to the Supreme Court’s Opinion: http://www.supremecourt.gov/opinions/14pdf/14-114_qol1.pdf

The proposed rules on use of financial incentives within workplace wellness programs were published by the Equal Employment Opportunity Commission (EEOC) on April 16, 2015.   These rules align the wellness provisions of the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA) with the nondiscrimination rules in the Americans with Disabilities Act (ADA).

As employer groups with 51-100 employees renew or purchase health insurance coverage in 2016, they must abide by the rules and regulations governing the small group market, including those related to benefit coverage and essential health benefits; actuarial value, and premium rating restrictions, such as adjusted community rating and no medical underwriting.

The small group rules apply to fully insured plans, including those purchased in the Small Business Health Options Program (SHOP) marketplace.

In some markets, the state and insurance carriers may give employers the option to keep their plan for a while longer by:

• Changing their plan year to maximize the time the employer can keep their plan in 2016.
• Taking advantage of transitional relief, which allows employers in some states to keep their current plans through Sept. 30, 2017.

Employers that self-insure (self-funded) are not subject to these requirements.

Options and requirements vary by state, issuer and segment. For more information, please contact us for a consultation at 832-482-2494 or via email through the “contact us” page on our website.