New Series! The Blog Days of Summer: Dobbs and GHPs

Don’t get me wrong, I’ll take the warmth of summer over the cold of winter any day, but sometimes we simply need a break from the heat, humidity, and baking sun!

Enter: the Blog Days of Summer 

For the next six week’s we’ll be posting blog “blurbs,” easily consumable bits of benefit content, digestible in a shaded hammock or the cool of AC – whether in office or working remotely.

First up? The Dobbs decision.

Question: What should employers be considering respecting their welfare benefits plans as States begin implementing regulations since the Dobbs decision?

Background: Dobbs was decided just five days ago, and States are scrambling to address laws either in the books, or create new ones now that the Supreme Court reversed Roe v. Wade, holding that the Constitution does not confer a right to abortion. Authority now lies with the people of each State. What does this mean for employers who sponsor group health plans?

Consider: Review all benefit welfare plan(s) details, including scope of coverage, and consult with counsel as necessary. Note:¬† have no federal agency guidance since the Dobbs decision, and health insurers in each state must follow state law. However, this doesn’t prevent speculation, nor does it prevent persons from staying informed, researching applicable laws, and preparing for changes.

  1. Understand your plan(s) structure (fully insured v self-insured; grandfathered or not; applicability to state law, etc.) and how it affects required and voluntary coverage of services. Employers may choose to modify their plans, and modifications trigger ERISA-required plan document updates (e.g., SBC, SMM, and SPD, to name a few).
  2. Know your state’s laws: these vary widely, are in a change process, and may or may not intersect with other federal regulations and state insurance laws.
  3. Communicate with your employees. How will an employer address questions from plan participants about benefits? Communication and review of employer policies may ease tension and curb inevitable conflicts.
  4. Alternatives? Employers may be considering options to support plan participants. Suggestions within the industry include, for example, that self-insured plans could cover out-of-state abortion and travel benefits via an integrated or excepted benefits HRA; with use of a health FSA; through an EAP; or via taxable reimbursements.

Remember: whatever actions employers choose to take respecting their plans are fact-specific, and must be thoroughly vetted with counsel in accordance with applicable state law.

The information and content contained in this blog post are for general informational purposes only, and does not, and is not intended to, constitute legal advice. As always, for specific questions concerning your group health plan(s), or for help in operating your plan during the current COVID-19 crisis, please consult your own ERISA attorney or professional advisor.

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