EBIA Weekly Newsletter

May a Health Plan Impose Cost-Sharing on Any FDA-Approved Methods of Contraception for Women? 


   January 25, 2018

QUESTION: Our company sponsors a non-grandfathered self-insured group health plan, and we are subject to the preventive services mandate. Can our plan impose cost-sharing on some methods of contraception for women so long as we provide first-dollar coverage for other methods? ANSWER: Your plan must provide women access to the full range of contraceptive methods … Read More


An EBIA Webinar Based on Your Key Challenges!


   January 18, 2018

Don’t miss this opportunity! Our January 25 webinar will be devoted to attendee questions (submitted in advance and live via WebEx) on group health plan challenges, plus a “Washington Update” segment on recent and anticipated developments. And registration is now open for 2018 EBIA Seminars! For more information or to register, please click on the … Read More


HHS Reports Mental Health Parity Enforcement Efforts, Including Cases Involving Opioid and Autism Treatment


   January 18, 2018

Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) Enforcement Report (December 2017) Available at https://www.cms.gov/CCIIO/Resources/Forms-Reports-and-Other-Resources/Downloads/HHS-2008-MHPAEA-Enforcement-Period.pdf HHS has issued a mental health parity enforcement report describing six cases it closed in 2016 and 2017. As the report explains, HHS’s enforcement authority with respect to the federal mental health parity requirements … Read More


Court Upholds Plan’s Denial of “Medically Unnecessary” Residential Mental Health Treatment


   January 18, 2018

Peter B. v. Premera Blue Cross, 2017 WL 4843550 (W.D. Wash. 2017) An employer-sponsored group health plan refused to pay for continued residential mental health treatment for an employee’s minor son, stating that the residential treatment did not meet the plan’s medical necessity requirement. The employee exhausted all internal and external review procedures and sued, … Read More