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The Wagner Law Group Description 

The Wagner Law Group, A Professional Corporation, is a nationally recognized ERISA & employee benefits, estate planning, employment, labor & human resources practice. 

 

Established in 1996, The Wagner Law Group has 23 attorneys engaged exclusively in employee benefits, estate planning and employment law. Seven of our attorneys are AV rated by Martindale-Hubbell as having very high to preeminent legal abilities and ethical standards. The firm is among the largest ERISA boutiques in the country. Our practice is national in scope, with clients in more than 40 states and several foreign countries.

 

 

 

 

 

Contact Info

The Wagner Law Group

 

  Integrity | Excellence

  

Massachusetts Office 

Tel: (617) 357-5200 

Fax: (617) 357-5250 

99 Summer Street 

13th Floor

Boston, MA 02110


Florida Office 

Tel: (561) 293-3590
Fax: (561) 293-3591
7108 Fairway Drive
Suite 125
Palm Beach Gardens, FL 33418

   

San Francisco Office

Tel: (415) 625-0002

Fax: (415) 358-8300

315 Montgomery Street

Suite 904

San Francisco, CA 94104

 

Illinois Office

Tel: (847) 250-1365

Fax: (847) 250-1367

414 West Deerpath Road
Lake Forest, IL  60045  

 

www.wagnerlawgroup.com

 

 

 

 

March 27, 2014

 

 State and Federal Law Alert

 

 

 

 Insurers Offering Opposite-Sex Spousal Coverage Must Offer Coverage for Same-Sex Spouses 

 

 

 

HHS has announced that, beginning in 2015, health insurance issuers that offer coverage to opposite-sex spouses must provide policyholders with the option of offering identical coverage to same-sex spouses. This announcement was made in the form of Frequently Asked Questions ("FAQs") issued by the Centers for Medicare and Medicaid Services. The FAQs clarify final regulations issued in February 2013.

 

This new guidance comes in the wake of the U.S. Supreme Court's landmark decision last June in United States v. Windsor. In Windsor, the Court struck down a key part of the Defense of Marriage Act that denied federal recognition of same-sex marriages. (See the Alert of 6/27/13 for further details.)

 

According to the FAQs, the regulations implementing the Patient Protection and Affordable Care Act ("PPACA") establish nondiscrimination standards. In particular, these regulations provide that health insurance issuers cannot engage in practices that discriminate on the basis of certain characteristics, such as sexual orientation. These regulations apply to health insurance coverage in the group and individual markets that is not grandfathered under PPACA.

 

The FAQs state that the requirement is effective with the first plan or policy year starting on or after January 1, 2015.

 

The FAQs do not require health insurance issuers to provide coverage that is inconsistent with a group health plan's eligibility requirements or interfere with a plan sponsor's right to define "spouse" for purposes of plan eligibility. Rather, the FAQs merely require health insurance issuers to offer plan sponsors the option of covering same-sex spouses.

 

The FAQs specify that a health insurance issuer engages in a practice that discriminates where it offers coverage to an opposite-sex spouse and chooses not to offer coverage to a same-sex spouse under the same terms and conditions. In addition, the FAQs clarify that an insurance issuer cannot discriminate based on the health insurance policy's situs, or on where the policyholder resides."

 

It is important to note, however, that this nondiscrimination policy only applies to same sex couples who married in a jurisdiction where same-sex marriages are permitted. Also, this guidance does not apply to couples who are in domestic partnerships or civil unions.

 

The FAQs are accessible at: http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/frequently-asked-questions-on-coverage-of-same-sex-spouses.pdf

 

 

 

This Newsletter is protected by copyright. Material appearing herein may be reproduced with appropriate credit.

  

Pursuant to Internal Revenue Service Circular 230, we hereby inform you that any advice set forth herein with respect to US federal tax issues is not intended or written by The Wagner Law Group to be used and cannot be used, by you or any taxpayer, for the purpose of avoiding penalties that may be imposed on you or any other person under the Internal Revenue Code.

 

This Newsletter is provided for information purposes by The Wagner Law Group to clients and others who may be interested in the subject matter, and may not be relied upon as specific legal advice.  This material is not to be construed as legal advice or legal opinions on specific facts. Under the Rules of the Supreme Judicial Court of Massachusetts, this material may be considered advertising.