Welfare Benefit Plan ERISA News
December 2016

Experimental and Investigational Treatments and Procedures under ERISA Group Health Plans

While most group health plans contain an exclusion for medical and investigational procedures, the scope and the pace at which medical procedures and treatments are tested in the 21st century makes this an extremely difficult standard to apply. There is no bright-line test, experts frequently disagree as to when the line has been crossed, and in some instances the stakes are literally life and death. This article discusses some potential pitfalls for plan administrators and offers suggestions on how to address this difficult aspect of group health care administration. (Benefits Law Journal)

Testimony Shows Anthem and Cigna at Odds Over Proposed Merger
"Anthem and Cigna have quarreled for months behind the scenes even as their push to combine has moved forward, with each company accusing the other of violating their $48 billion agreement... The newly unsealed testimony showed that, among other things, Cigna officials have questioned Anthem's plans for their company postmerger, while Anthem executives have tried to move forward unilaterally after Cigna ceased cooperating with them on various deal-related issues." (The Wall Street Journal; subscription may be required)

IRS Extends Deadline for ALEs to Distribute 2016 ACA Reporting Forms to Individuals

The IRS has issued Notice 2016-70, which provides a 30-day extension to the deadline for Applicable Large Employers ("ALEs") to distribute the 2016 Affordable Care Act ("ACA") reporting forms to employees and covered individuals.

NOTE: This extended deadline applies only to distributing the 2016 ACA reporting forms to employees and covered individuals and not to the deadline for filing the forms with the IRS. (The Wagner Law Group)
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© 2017 ERISAPros, LLC, All rights reserved. Information on ERISAPros' website, its newsletter, “News & Views,” and its blog, “ERISA Wonk,” is published as a general informational source. Information and articles are general in nature and are not intended to constitute legal or tax advice in any particular matter. Blog posts and comments reflect the personal views of their respective authors - not those of ERISAPros. Transmission of this information does not create an attorney-client relationship. ERISAPros, LLC is not a law firm and is not giving legal or tax advice. It does not warrant and is not responsible for errors or omissions in the content on its website or in its newsletters. ERISA is a complicated and confusing law. Summary Plan Descriptions (SPDs), Wrap Plan Documents, and Form 5500s require review and updating by qualified ERISA compliance professionals.


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