In a dispute involving long-term disability benefits under a plan governed by the Employee Retirement Income Security Act of 1974 (ERISA), the US Court of Appeals for the Second Circuit concluded that a benefit determination on administrative review under the Department of Labor's (DOL) claims regulations must decide with finality whether a claimant is entitled to benefits. The court rejected the insurer's argument that the DOL's regulations afforded the insurer flexibility and additional time to remand the matter for further internal consideration.

The Internal Revenue Service (IRS) has issued proposed regulations that would amend existing regulations to provide that affordability of employer-sponsored minimum essential coverage (MEC) for an employee's family members would be determined based on the employee's share of the cost of covering the employee and those family members. Under existing regulations, that determination is based on the cost of covering only the employee. The proposed regulations would provide a similar minimum value rule for related family members—to be based on the level of coverage provided to related individuals under an employer's health plan.