Healthcare Reform for Employer Group Health Plans

The Affordable Care Act (ACA) continues to bring about sweeping changes for employer group health plans, and it presents numerous questions for all employers.

Since the passage of the ACA in March 2010, Venable has been counseling employers on all aspects of the Act and its impact on their health plans, including:

  • Creating strategies for addressing an employer's risk for shared responsibility penalties, and implementing administrative and systemic changes to support those strategies (the first penalties will be based on 2015 activity and will be due in 2016)
  • Creating the infrastructure to support the new coverage reporting requirements (the first reports will be based on 2015 activity and will be due in 2016)
  • Preparing for the "Cadillac Tax"
  • Complying with substantive market reforms, such as limiting waiting periods to no more than 90 days, providing coverage to adult children, and removing dollar limits on "essential health benefits"
  • Restructuring retiree, dental, and vision plans so that most of the ACA is inapplicable to them
  • Helping employers move away from traditional retiree health coverage in favor of account-based plans that support the retirees’ purchase of individual coverage on the public healthcare marketplaces
  • Advising as to whether various changes will result in the loss of "grandfathered" status and evaluating the advantages and disadvantages of retaining that status
  • Explaining the small business healthcare tax credit

Venable attorneys collaborate with large employers to identify their "full-time" employees. Many clients have employees who are currently identified as "leased," "on call," "temporary," "seasonal," or "as needed," or otherwise classified as non-benefits eligible. If any of these employees work an average of at least 30 hours per week, the employer must report them as full-time employees and may be required to pay a shared responsibility penalty. We have considerable experience in working with traditional staffing firms and professional employer organizations. And, when our clients reduce or outsource their workforce, we help them avoid legal traps for the unwary, including whistleblower and anti-discrimination provisions.

Venable attorneys assist clients in developing employee communication campaigns regarding their employer-provided coverage and contrasting that coverage to the coverage now available on the public healthcare marketplaces. These communication campaigns include explaining how the employer's coverage affects whether an employee is eligible for subsidized coverage on the marketplaces and the enrollment opportunities on the marketplaces.

We also examine alternative health arrangements, including onsite clinics, wellness programming, voluntary coverage, private exchanges, and association health plans.

In addition to handling healthcare reform issues, we regularly help with the day-to-day compliance needs of health and welfare plans. We regularly draft plan documents, summary plan descriptions, and summaries of benefits and coverage. We review Forms 5500, prepare HIPAA policies, analyze medical child support orders, provide advice concerning COBRA compliance, and provide guidance during mergers and acquisitions.

Venable's Employee Benefits and Executive Compensation Group provides legal services to all sizes and types of employers and all manner of employee benefit arrangements. Attorneys in the groups work with single-employer plans, multi-employer plans, church plans, and governmental plans. We have attorneys who specialize in qualified retirement plans, ESOPs, nonqualified deferred compensation, and equity-based compensation arrangements.


  • Chambers USA, Healthcare, Maryland, 2016 – 2021
  • U.S. News – Best Lawyers, Best Law Firms, Health Care Law (Tier 1), Baltimore, 2011 – 2018
  • The Best Lawyers in America, 2012 – 2021 (Venable attorneys selected for inclusion)
  • Nightingale’s, Outstanding Healthcare Antitrust Lawyers, 2010