The Department of Health and Human Services (“HHS”), in a series of Qs & As, has stated that the HIPAA Privacy Rules do not prohibit covered entities and business associates from asking whether...
Firm News
Court Finds “No Harm No Foul” Where Employee Fails to Show She Suffered Harm from FMLA Violation
The U.S. District Court of Montana, in Jergens v. Marias Medical Center, has dismissed an employee’s claim for FMLA violations by her former employer because the employee failed to show that she...
The DOL’s New Cybersecurity Audits and Informal Guidance
Recently, the Department of Labor (“DOL”) has become highly focused on the cybersecurity practices of plan sponsors and their service providers. Perhaps in response to the growing number of ERISA...
Court Decision Highlights Importance of Complying with ERISA’s “Other Instruments Rule” for Document Disclosures
The U.S. District Court of Utah has confirmed, in M.S. v. Premera Blue Cross, that a plan administrator for a self-insured group health plan violated ERISA’s disclosure requirements in its response...
IRS Guidance for Plan Sponsors on ARPA’s Effect on Funding for Plan Years 2020 and 2019
As we advised in Important Benefit Plan Provisions of the American Rescue Plan Act of 2021, in the American Rescue Plan Act of 2021 (ARPA), Congress provided funding relief for single-employer...
IRS Releases ACA Affordability Rates for 2022
The Internal Revenue Service has issued Revenue Procedure 2021-36 to implement the 2022 index adjustments for certain Affordable Care Act (“ACA”) contribution percentages used to determine...
AD&D Plan Not Subject to State Health Insurance Law
The U.S. Court of Appeals for the Eighth Circuit has ruled, in Williams v. Unum Life, that a state law regulating health insurance policies does not apply to an accidental death and dismemberment...
Mental Health Parity is Finally Being Enforced
On August 12, 2021, the U.S. Department of Labor (“DOL”) issued a press release regarding a groundbreaking settlement reached with United Healthcare Insurance Co., United Behavioral Health and...
Employer’s Leave Policies Required It to Provide Paid Military Leave
The Third Circuit Court of Appeals has ruled, in Travers v. Federal Express, that the Uniformed Services Employment and Reemployment Rights Act (“USERRA”) requires employers to provide paid leave to...
FSA Debit Card Substantiation Rules
The IRS has released Information Letter 2021-0013 to reconfirm the substantiation rules for debit card use in health care flexible spending account plans (“FSAs”). Law. Health care FSAs may issue...
IRS Sheds Some Clarity on COBRA Premium Assistance
The American Rescue Plan Act of 2021 (ARPA) provides for a six-month period between April 1, 2021 and September 30, 2021, during which certain participants eligible for COBRA continuation coverage...
Court Settles Dispute When Employer Switches LTD Insurer
The Fifth Circuit Court of Appeals has determined, in Talamantes v Metropolitan Life Insurance Company, that a long-term disability (“LTD”) insurer was responsible for benefit payments even though a...
Agencies Issue Regulations Restricting Surprise Billing
The Biden administration, through HHS, DOL, IRS and the Office of Personnel Management (collectively, the “Agencies”), issued an interim final rule that aims to restrict excessive out-of-pocket...
Court Rejects Health TPA’s Cross-Plan Offsetting Practice
The U.S. District Court for the District of New Jersey, in Lutz Surgical Partners PLLC v. Aetna, Inc., has ruled that a group health plan administrator (“TPA”) cannot offset overpayments made to a...
DOL Says Claimant May Request Phone Call Recordings Relevant to Benefits Claim
The DOL has stated in a June 14, 2021 Information Letter, that under ERISA claims procedures, a participant must be given audio recordings of telephone conversations that are relevant to his claim...
Court Says No Specific Wording Required in Plan Document to Give Plan Discretionary Claims Authority
The Second Circuit Court of Appeals, in Tyll vs. Black and Decker Life Insurance Program, has ruled that a plan document is not required to use any specific language in order to give the plan...
IRS Announces 2022 HSA and HRA Limits
The IRS has announced the 2022 calendar year dollar limits for health savings account (“HSA”) contributions, the minimum deductible amounts and maximum out-of-pocket expenses for high deductible...
Court Confirms Participant Must Exhaust Administrative Remedies Before Filing a Suit
The U.S. District Court for the Southern District of New York, in Benson vs. Tiffany and Company SPD, has ruled that a participant in an ERISA-governed group health plan may not proceed with her...
IRS Finally Releases Guidance Implementing COBRA Subsidies but Leaves Important Questions Unanswered
On May 18, 2021, the IRS issued Notice 2021-31 providing highly anticipated guidance for employers who must implement the COBRA rules under ARPA (as we described in our publication on March 17,...
Must Death Distributions Under 10-Year Rule Be Taken Annually?
By Kimberly Shaw Elliott and Barry Salkin New Pub 590B Prompts Surprise Just in the nick of time for filing 2020 federal income tax returns, the IRS issued a revised Publication 590-B (2020),...
Employer Has Separate Obligations Under Workers’ Compensation and FMLA
The U.S. Court of Appeals for the Eleventh Circuit has ruled, in Ramji vs. Hospital Housekeeping Systems, that complying with the state’s workers’ compensation laws does not absolve an employer from...
Court Finds Project Completion Incentive Plan Not an ERISA-Covered Severance Plan
The U.S. Court of Appeals for the Fifth Circuit has ruled in Atkins vs. CB&I, LLC, that a Project Completion Incentive (“PCI”) plan which offered a bonus to employees upon termination of...
IRS Says Personal Protective Equipment Expenses are Qualified Medical Expenses
The IRS has issued Announcement 2021-7, which confirms that personal protective equipment (“PPE”) such as masks, hand sanitizer, and sanitizing wipes purchased “for the primary purpose of preventing...
Court Says Group Health Plan May Not Exclude Specified Autism Treatments
The District Court for the Northern District of California has ruled, in Doe v. United Behavioral Health, that the exclusion of certain specified procedures related to the treatment of autism...
American Rescue Plan Act Extends Tax Credits for COVID-19 Leave
On March 11, 2021, President Biden signed into law the American Rescue Plan Act of 2021 (“ARPA”). Among other provisions aimed at economic recovery, ARPA extends employer tax credit opportunities...
Important Benefit Plan Provisions of the American Rescue Plan Act of 2021
By Dannae Delano, Israel Goldowitz, Barry Salkin and Roberta Casper Watson Although not the primary focus of the American Rescue Plan Act of 2021 (“ARPA”) and, at least with respect to the...
Court Says Welfare Plan Fiduciary Breached Duties by Misusing Participant Contributions
A federal district court in the Western District of Virginia has held, in Hammer v. Johnson Senior Ctr., that the fiduciary for a welfare plan violated its duties of loyalty, care and prudence by...
Surprise DOL Guidance on Conclusion of One-Year ERISA Compliance Relief Period
By Dannae Delano and Barry Salkin Even with widespread bipartisan support, it can be difficult to draft legislation to address all possible contingencies. In the wake of the events of September 11,...
IRS Guidance on Flexible Spending Account Relief Under CAA
The IRS has issued Notice 2021-15 (“Notice”) to provide clarification on the flexible spending account (“FSA”) relief contained in the Consolidated Appropriations Act, 2021 (“CAA”). The Notice also...
Employer Failed to Adequately Notify Participant of Group Life Insurance Conversion Rights
The Ninth Circuit Court of Appeals, in Estate of Foster v. American Marine Servs. Group Benefits Plan, has held that an employer failed to provide a former employee with adequate notice of the...
CMS Creates Additional Marketplace Special Enrollment Period
The Centers for Medicare & Medicaid Services (“CMS”) has determined that the COVID-19 emergency presents exceptional circumstances for consumers in accessing health insurance, and will be...
EEOC Explains Application of ADEA to ICHRAs
On January 7, 2021 the Equal Employment Opportunity Commission (“EEOC”) issued an opinion letter explaining the application of the Age Discrimination in Employment Act (“ADEA”) to individual...
FAQs Discuss Expiration of Paid Sick and Family Leave Requirements
The Department of Labor has issued additional FAQs regarding the expiration of the requirement that employers provide paid sick and family leave under the Families First Coronavirus Response Act...
Do You Have Questions About How to Comply with the New DOL fiduciary “Investment Advice” Prohibited Transaction Exemption?
By Stephen Wilkes and Susan Rees On December 15, 2020, the Department of Labor (DOL) issued class exemption 2020-02 (the PTE or Exemption) which provides conditional relief to fiduciaries who render...
Does the Recently Amended Investment Duties Regulation Change How Fiduciaries Are Expected to Make Investment Decisions for Employee Benefit Plans?
Introduction The more things change the more they stay the same. Or do they? This question should be on every employee benefit plan fiduciary’s mind after January 12, 2021, when an amended U.S....
DOL’s Proxy Voting Regs Confirm Fiduciaries Need Not Vote on Every Proxy Proposal but Must Limit Voting Decisions to Economic Interests
By Kim Shaw Elliott The Department of Labor (“DOL”) issued final regulations on December 11, 2020 about fiduciary duties for proxy voting, in its attempt to clarify many prior misunderstandings. Key...
EEOC Issues Proposed Regulations on Employer Wellness Programs
The Equal Employment Opportunity Commission (“EEOC”) has issued two sets of proposed regulations that would change certain rules on how employer-sponsored wellness programs that require employees to...
DOL Clarifies Use of Telemedicine for Purposes of FMLA Leave
The Department of Labor (“DOL”) has issued Field Assistance Bulletin (“FAB”) 2020-8 to provide guidance regarding the use of telemedicine in establishing a “serious health condition” under the...
Stimulus Package Makes Major Changes with Respect to Employer Sponsored Benefit Plans
By Dannae Delano, Barry Salkin and Roberta Casper Watson In a year-end piece of legislation intended to fund the federal government, especially one that is 5,593 pages in length, there is always the...
DOL Field Assistance Bulletin for FMLA Electronic Notices
The Department of Labor (“DOL”) has issued Field Assistance Bulletin (“FAB”) 2020-7 to provide guidance on when, as a matter of enforcement policy, it will consider the electronic posting of the...
IRS Issues Final Regulations Under Code Section 162(m)
By Barry Salkin and Mark Poerio Section 162(m) of the Internal Revenue Code (“Code”) denies a deduction to a publicly held corporation for remuneration paid to a covered employee in any taxable year...
Arkansas Pharmacy Law Not Preempted by ERISA
In Pharmaceutical Care Management Association v. Rutledge, the U.S. Supreme Court has held that ERISA does not preempt an Arkansas statute that imposes rules on pharmacy benefits managers (“PBMs”)....
Agencies Issue Final Grandfathered Group Health Plan Regulations
The Department of Labor, Department of Health and Human Services, and the IRS (collectively, the “Agencies”) have issued final regulations providing greater flexibility to plan sponsors that wish to...
IRS New Guidance on State Unclaimed Property Laws and IRS Helpful Reminders on Missing Participants
View Printable PDF By Susan Rees and Seth Gaudreau After years of public commentary, the Internal Revenue Service (IRS) addresses, for the first time, whether a plan should withhold income tax when...
IRS Explains “Qualified Health Plan Expenses” for Purposes of FFCRA Tax Credit
The IRS has issued FAQs to help employers determine the amount of “qualified health plan expenses” for purposes of determining their tax credit under the Families First Coronavirus Response Act...
IRS Confirms Options for Unused Qualified Transportation Benefits Due to COVID-19
Facts. The IRS released Information Letter 2020-0024 in response to an inquiry it received from a qualified transportation plan participant with unused transit benefits due to COIVD-19. In...
2021 Medicare Parts A & B Premiums and Deductibles
The Centers for Medicare & Medicaid Services (“CMS”) has announced the deductibles, premiums and coinsurance amounts for Medicare Part A and Part B for 2021. Medicare Part A covers inpatient...
Agencies Issue Final Regulations Regarding Health Care Transparency
By Barry L. Salkin, Roberta Casper Watson, and Dannae Delano Last June, in Executive Order 13877, President Trump directed HHS, Treasury, and Labor (collectively, the “Agencies”) to solicit comments...
Agencies Issue Guidance on Coronavirus Diagnostic Testing and Immunizations
Section 6001 of the Families First Coronavirus Response Act (FFCRA) required group health plans and health insurance issuers to provide coverage for certain items and services including in vitro...
IRS Releases 2021 Welfare Benefit Plan Limits: Health FSA and HSA Limits Increase
The IRS has released Revenue Procedures 2020-45 and 2020-32, which set forth the 2021 inflation-adjusted limits for certain employee welfare benefit plans and the dollar amounts used for certain...