In Susan Miele v. Foundation Medicine, Inc., the Supreme Judicial Court ruled that a forfeiture clause triggered by a breach of a nonsolicitation agreement does not constitute a “forfeiture for...
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FMLA Leave Rights Not Strictly Bound by Medical Certification
The U.S. Court of Appeals for the Seventh Circuit, in Davis vs. Illinois Department of Human Services, has ruled that, based on facts already known to an employer, an employee may be entitled to...
Letter to Court Indicates Trump Administration Intent to Upend 2022 DOL Final Rule
by Ari Sonneberg and Barry Salkin On the heels of the Department of Labor’s announcement that it is rescinding the Biden Administration DOL guidance cautioning 401(k) plan sponsors from offering...
DOL Rescinds Biden Administration Guidance on 401(k) Cryptocurrency Investment
By Ari Sonneberg and Barry Salkin Today, the Department of Labor’s Employee Benefits Security Administration issued Compliance Assistance Release No. 2025-01, effectively rescinding Compliance...
The EEOC and Executive Orders: What Employers Ought to Know about EEO-1 Reporting (Filing Deadline June 24, 2025)
By Katherine Brustowicz, Denise Chicoine, David Gabor, Johanna Matloff, or Virginia Peabody (Senior Consultant) What is EEO-1 Reporting? An EEO-1 Report is a document submitted to the Equal...
State Insurance Laws Apply to Insurer That is Also Plan Fiduciary
The Sixth Circuit Court of Appeals, in BlueCross BlueShield of Tennessee, Inc. v. Nicolopoulos, determined that an insurer, which also acted as a plan fiduciary, could not evade state insurance law...
IRS Announces 2026 HSA and HRA Limits
The IRS has announced the 2026 calendar year dollar limits for health savings account (“HSA”) contributions; the minimum deductible amounts; the maximum out-of-pocket expenses for high deductible...
Important Update to the Federal Independent Contractor Test
By Katherine Brustowicz, Denise Chicoine, David Gabor, Johanna Matloff, and Virginia Peabody (Senior Consultant) The Department of Labor (DOL), through its Wage and Hour Division (WHD), issued a...
ERISA and Bankruptcy: Conflict or Harmony?
By Israel Goldowitz With the economy and the securities markets roiled by trade wars, many businesses are no doubt considering the possibility of a recession. We might also expect a major increase...
Retaining an Independent Fiduciary to Address Prohibited Transactions or Enable Plan Fiduciaries to Appropriately Allocate Risk
By Stephen Wilkes and Seth Gaudreau The retention of an independent fiduciary plays a critical role not only to resolve a conflict in a prohibited transaction sense, but to provide an appropriate...
Executive Compensation in Volatile Times: Advice for Privately-held Companies and Their Executives
by Mark Poerio From tariffs to cash flows, small business owners may feel that mid-2025 warrants attention to how key employees are compensated and retained. Formula-based bonuses may need...
Popular Benefits-Related Tax Provisions May be Targeted to Raise Revenue for Federal Tax Cuts
By Eric Keller The White House and Republican leaders in the House of Representatives and Senate are in active discussions about how to pay for the expected extension of the Tax Cuts and Jobs Act of...
Highlights of 2024 PBGC Meeting With ABA’s Joint Committee on Employee Benefits
by Harold Ashner and Israel Goldowitz On April 30, 2025, the American Bar Association (“ABA”) posted a summary of the May 1, 2024, meeting between representatives of the Pension Benefit Guaranty...
“Good Faith Effort” Not Enough to Protect Employer from Defective COBRA Notice
The U.S. District Court for the Middle District of Florida has ruled, in Marrow v. Carpenter Company, that a mere “good faith effort” to comply with COBRA’s notice requirements is an insufficient...
Reimbursing an Employer for Paying Plan Expenses
Sometimes, it is more efficient for an employer to pay the expenses of a retirement plan rather than the plan paying for them directly. If the expense paid is otherwise appropriate, the employer...
DOL Updates Medicaid/CHIP Model Notice
The Department of Labor (“DOL”) has released an updated Model Notice for employers to use to inform employees about their potential to receive state-provided premium assistance subsidies to use...
Form I-9: What is It and What’s Changed
by Katherine Brustowicz, Denise Chicoine, David Gabor, Johanna Matloff, or Virginia Peabody (Senior Consultant) The U.S. Citizenship and Immigration Services (“USCIS”) released a revised Form I-9,...
HHS Proposes Reversal on Gender Affirming Care
On March 19, 2025, the Department of Health and Human Services (“HHS”) issued a Proposed Rule that would eliminate the current requirement that certain health insurance issuers must provide coverage...
ERISA Claims Standards Apply to Exceptions in Employee Benefit Plans
The U.S. District Court for the Southern District of New York has ruled, in Doe v. Deloitte, that a group health plan violated ERISA by failing to apply standard ERISA claims requirements to a...
New FinCEN Rule Exempts Domestic Entities from CTA Reporting Requirements
On March 21, the U.S. Treasury Department’s Financial Crimes Enforcement Network (“FinCEN”) issued an Interim Final Rule (“Rule”) that provides a reprieve from the beneficial ownership reporting...
IRS Issues Guidance on Forms 1095 Requirements
The IRS has issued Notice 2025-15 which explains the application of the reduced disclosure requirements under the recently enacted Paperwork Burden Reduction Act (“PBRA”). Background. Applicable...
Attention Employers: EEO-1 Reporting Deadline Approaching
By Katherine Brustowicz, Denise Chicoine, David Gabor, Johanna Matloff and Virginia Peabody (Senior Consultant) The EEO-1 report for covered employers must be filed with the EEOC by June 4, 2025....
DOL Announces Indexed Penalties for Health and Welfare Plans
The Department of Labor (“DOL”) has released a final rule that provides new figures reflecting the adjusted civil penalty amounts for 2025 for certain health and welfare plan violations. DOL is...
Court Must Consider All Employment Factors in Making Disability Determination
The U.S. Court of Appeals for the Seventh Circuit, in Scanlon v. Life Insurance Company of North America, has ruled that a court must fully consider the nature and the duties of a claimant’s job in...
Corporate Transparency Act Beneficial Ownership Interest Reporting: Game Off…for the Moment
The still short, but eventful history of the Corporate Transparency Act (CTA) and its controversial beneficial ownership information (BOI) reporting requirements, should have made it predictable...
An ERISA Journey for ESG Via American Airlines by Way of Utah?
By Andrew Oringer, Barry Salkin, Jon Schultze and Ari Sonneberg Both supporters and opponents of the consideration of environmental, social and governance (“ESG”) goals can point to decisions by...
How an Attorney’s Professional Activities Affect Consideration of the Attorney for Judicial and Political Positions: A Framework for Citizens
How an Attorney's Professional Activities Affect Consideration of the Attorney for Judicial and Political Positions: A Framework for Citizens - Andrew Oringer, co-author, Report by the New York...
Employer Bound By Its Own Plan Provisions
In Hoff vs. Anadarko Petroleum Corp., the U.S. Court of Appeals for the Tenth Circuit has ruled that an employer is bound by the terms of its own plan and cannot add additional conditions after an...
FinCEN Issues New CTA Beneficial Ownership Reporting Deadline After Court Lifts Nationwide Injunction
On the heels of a court decision in its favor, the Treasury Department’s Financial Crimes Enforcement Network (FinCEN), has issued a statement on its website indicating that the beneficial ownership...
Massachusetts Pay Transparency Law: Key Provisions and Compliance Timeline
Katherine Brustowicz, Denise Chicoine, David Gabor, Johanna Matloff, and Virginia Peabody (Senior Consultant) On February 1, 2025, a new law regarding salary posting requirements went into effect...
DOL Explains Interaction Between FMLA and Paid State Leave
The Department of Labor (“DOL”) has issued Opinion Letter FMLA2025-01-A on whether the Family and Medical Leave Act (the “FMLA”) regulations pertaining to substitution of paid leave apply when...
FAMOUS CHOLLIMA: The Hidden Cyber Threat Lurking Among Your Remote Hires
By Josh Cook Ever since the COVID-19 epidemic popularized offshore remote working conditions, many organizations have learned to embrace these positions. There have been incentives for doing so,...
A Sampling of Compensation and Other Strategies for Small Businesses in a World of Big Changes
The value of a business can depend to a large degree on motivating and retaining key employees. Despite the high stakes, it is remarkably common to encounter owners who rely on informal practices to...
President Trump Issues 10-to-1 Deregulation Executive Order
On January 31, 2025, President Trump signed an executive order (the “Order”) designed to drastically reduce the overall amount of federal government regulation on the books. The underlying stated...
Tax Treatment of State Family and Medical Leave Laws
The IRS has issued Revenue Ruling 2025-4 to explain the Federal income and employment tax treatment of contributions and benefits paid under state-paid family and medical leave laws. Revenue Ruling...
Executive Orders Addressing Diversity, Equity, and Inclusion Initiatives
By Katherine Brustowicz, Denise Chicoine, David Gabor, Johanna Matloff and Virginia Peabody (Senior Consultant) Last week, President Trump signed two executive orders (the “Trump Executive Orders”...
Corporate Transparency Act Litigation Continues to Induce Whiplash
In the most recent installment of the soap-opera-like saga that has unfolded around the Corporate Transparency Act (CTA), the U.S. Supreme Court has issued a stay of the injunction preventing...
Federal Court Awards $359,000 in FLSA/OSHA Retaliation Case: Lessons Learned for Employers
In December 2023, Su v. Milford Sports Bars, LLC, a noteworthy case, concluded with a ruling in favor of the U.S. Department of Labor, resulting in a payment of $359,000. The court awarded damages...
Unambiguous Plan Document Overrides Employer’s Misrepresentations
In Higgins vs. Lincoln Electric Company, Inc., the U.S. Court of Appeals for the Sixth Circuit placed a high burden on a plan participant who claimed that his employer was “estopped” (i.e.,...
DOL Updates Voluntary Fiduciary Correction Program
In 2002, the Department of Labor (DOL) adopted the Voluntary Fiduciary Correction Program (VFCP). VFCP, modified in 2005 and 2006, is designed to encourage employers and plan fiduciaries to...
FMLA Leave Rights May Extend to Siblings
In Chapman v. Brentlinger Enterprise, the U.S. Court of Appeals for the Sixth Circuit ruled that under the Family and Medical Leave Act (“FMLA”) an employee may be entitled to leave to care for a...
HDHP Exception for Telehealth Services Expires
Congress has failed to extend the High Deductible Health Plan (“HDHP”) exception for telehealth services. Background. Under the Internal Revenue Code (“Code”), tax-exempt Health Savings Account...
No Rest for the Weary: Department of Justice asks Supreme Court to Issue a Stay of Nationwide Injunction Against Corporate Transparency Act (CTA)
For some attorneys, the last week and a half of 2024 was an opportunity for a bit of R & R before resuming customary work activities. Alas, that was not the case for attorneys at FinCEN and the...
New Laws Reduce Employer Reporting and Disclosure Requirements
The recently enacted Paperwork Burden Reduction Act (“PBRA”) and the Employer Reporting Improvement Act (“ERIA”) have reduced certain reporting and disclosure requirements for employers and...
Pencils Down: Corporate Transparency Act (CTA) Injunction Back in Effect
Our Law Alerts tend to be measured in tone, avoiding hyperbole. A court decision or IRS or DOL regulation may be unexpected or unanticipated, and we would characterize it as such, and then describe...
Fifth Circuit Court of Appeals Lifts Nationwide Preliminary Injunction Against Enforcement of Corporate Transparency Act Pending Ruling on the Merits
On December 23, 2024, the Fifth Circuit Court of Appeals (the “Court”), in response to an emergency appeal by the Department of the Treasury and its Financial Crimes Enforcement Network (“FinCEN”),...
“Serious Health Condition” Must Be Established at Time of Absence
In Rodriquez vs. Southeastern Pennsylvania Transportation Authority, the U.S. Court of Appeals for the Third Circuit ruled that the proper time for an employee to establish that a particular...
IRS Announces 2025 PCORI Fee
IRS has released Notice 2024-83, which provides the “applicable dollar amount” for the Patient-Centered Outcomes Research Institute (“PCORI”) fee for plan years that end on or after October 1, 2024,...
Employer Cannot Voluntarily Subject Plan to ERISA
In Hansen v. Lab. Corp. of America, the United States District Court for the Eastern District of Wisconsin ruled that an employer’s attempt to combine its short term disability (“STD”) plan with...
Texas District Court Issues Nationwide Preliminary Injunction Against Enforcement of Corporate Transparency Act (CTA)
When page 1 of a District Court decision on a challenge on constitutional grounds to an action by a governmental entity cites Marbury v. Madison, that is not a good sign for the government agency....
CMS Announces Medicare Part A Deductibles and Part B Premiums for 2025
The Centers for Medicare & Medicaid Services (“CMS”) has announced the 2025 premiums, deductibles and coinsurance amounts for the Medicare Part A and Part B programs. Medicare Part A covers...
Election 2024: ERISA and the Proposed New Labor Secretary – Look(ing) for the Union Label?
President-Elect Trump has proposed Rep. Lori Chavez-DeRemer as the next Secretary of Labor. The selection is particularly notable for the clear pro-union leanings of the nominee of a Republican...
Claims Processor Is Not ERISA Plan Fiduciary
The U.S. District Court for the District of Massachusetts, in Shea v. Unum Life Ins. Co, has ruled that a claims processor is not an ERISA fiduciary because it does not have discretionary powers...
Executive Compensation 2025 – On the Watch for Things Past as Prologue
The 2024 Election already portends transformative consequences for federal agencies, some of which may extend to executive compensation. Among the possible impacts, agency staffing levels are in...
Overtime Exemption Update: Judge Vacates DOL Rule Increasing Overtime Salary Threshold
Exempt or not exempt, that is the question. It is not an easy question to answer, and it did not get any easier to answer when U.S. District Judge Sean D. Jordan vacated the Department of Labor...
FinCEN Beneficial Ownership Reporting Requirements Due by Year End for Many Organizations
In 2021, Congress enacted the Corporate Transparency Act (“CTA”), creating a new beneficial ownership reporting requirement. The purpose of the CTA was to make it more difficult for bad actors to...
Employee May Take FMLA Leave to Participate in Clinical Trial
The Department of Labor’s (“DOL’s”) Wage and Hour Division has issued Advisory Opinion FMLA 2024-01-A, which provides that an employee may use leave under the Family and Medical Leave Act (“FMLA”)...
Update – Recent Developments in Forfeiture Cases
The Wagner Law Group continues to monitor the recent flood of retirement plan “forfeiture” litigation. This alert is our eighth update reporting on and analyzing the nature of the claims raised by...
Prepare for Upcoming Changes to Retirement Plans for 2025
The SECURE 2.0 Act of 2022 (the “SECURE 2.0”) made significant changes to retirement plans and how they operate. Many of the changes have already been implemented by service providers, but some...
IRS Releases 2025 Welfare Benefit Plan Limits
The IRS has released Revenue Procedures 2024-25, 2024-40 and Notice 2024-80, which set forth the 2025 inflation-adjusted limits for certain employee welfare benefit plans and the dollar amounts used...
IRS Issues Final Regulations on Non-U.S. Tax Withholding Under Deferred Compensation Plans, IRAs and Commercial Annuities
By Barry Salkin The Internal Revenue Service (“IRS”) and the Treasury Department on October 21, 2024, issued final regulations under Sections 3405(a) and 3405(b) of the Internal Revenue Code of...
IRS Announces 2025 Cost-of-Living Adjustments Affecting Retirement Plans
The Internal Revenue Service announced cost-of-living adjustments affecting certain dollar limitations for pension plans and other retirement-related limitations for 2025 in Notice 2024-80. The...
Cybersecurity Attorney Joins the Boston Office of The Wagner Law Group
Cybersecurity Attorney Joins the Boston Office of The Wagner Law Group - Joshua Cook, The Wagner Law Group Press Release, November 4, 2024 (PDF)
IRS Expands Definition of “Preventive Care” for HDHPs
The IRS has issued Notices 2024-71 and 2024-75 (the “Notices”) to expand the definition of “preventive care” for high deductible health plans (“HDHPs”). Law. In general, individuals are eligible to...
The Wagner Law Group’s Washington, D.C. Office: Experience, Savvy, And Leadership
The Wagner Law Group’s Washington, D.C. Office has continued to grow, adding Michael Schloss, EBSA’s former Director of Enforcement and before that a career ERISA litigator with the Office of the...
2026 ACA Out-of-Pocket Limits
The Centers for Medicare & Medicaid Services (“CMS”) has announced the proposed maximum out-of-pocket (“OOP”) limits that will apply to non-grandfathered plans for plan years beginning in 2026. ...
Forfeiture Accounts Hold More Than Nonvested Employer Contributions
The Wagner Law Group continues to monitor the ongoing flood of “forfeiture” litigation. This alert is our seventh reporting on and analyzing the nature of the claims raised by plaintiffs, the...
IRS Provides Guidance on Application of SECURE 2.0 Act’s Coverage of Long-Term, Part-Time Employees
By Jon Schultze and Barry Salkin In Notice 2024-73, the Internal Revenue Service (“IRS”) issued guidance on the application of certain non-discrimination rules to long-term, part-time employees in...
CMS Issues Medicare Reporting Penalty Rules
The Centers for Medicare & Medicaid Services (“CMS”) has issued final rules on the penalties imposed when Responsible Reporting Entities (“RREs”) fail to meet their Medicare as Secondary Payer...
Update – Recent Developments in Forfeiture Cases
The Wagner Law Group continues to monitor the recent flood of “forfeiture” litigation. This alert is our sixth update reporting on and analyzing the nature of the claims raised by plaintiffs, the...
CMS Issues Medicare Reporting Penalty Rules
The Centers for Medicare & Medicaid Services (“CMS”) has issued final rules on the penalties imposed when Responsible Reporting Entities (“RREs”) fail to meet their Medicare as Secondary Payer...
The Importance of Promptly Paying All Final Wages in Massachusetts
The Massachusetts Wage and Hour statute mandates that employers pay departing employees their final wages, inclusive of accrued but unused vacation time, in their final paycheck on the day of...
IRS Releases ACA Affordability Rates for 2025
The Internal Revenue Service has issued Revenue Procedure 2024-35 to implement the 2025 index adjustments for certain Affordable Care Act (“ACA”) applicable contribution percentages used to...
Massachusetts Court Rules that Paid Family Medical Leave Act Does Not Require Employer to Guarantee Accrual of Vacation and Sick Time During Leave
By Denise Chicoine In Bodge et al. v. Commonwealth et al. the Massachusetts Supreme Judicial Court ruled that the Massachusetts Paid Family Medical Leave Act does not require an employer to...
Forfeiture Cases Update – BAE Prevails on a Motion to Dismiss
Over the past year, we have kept you apprised of evolving trends involving putative class action lawsuits alleging that plan fiduciaries violated their duties of prudence and loyalty under Title I...
Seemingly “Minor” Mistake in Claims Procedure Administration Costs Employer
In Witt v. Intel Corp. Long-Term Disability Plan, the United States District Court for the District of Oregon refused to dismiss a long term disability (”LTD”) benefits lawsuit when the plan...
Code Section 1042 Transaction Gone Awry
It is often the case under the Internal Revenue Code (“Code”) that adherence to procedural rules is crucial to secure tax benefits. Failure to meet these procedural conditions can result in...
Court Applies “But For” Standard to LTD Mental Health Benefit Limitation
In Weyer v. Reliance Standard Life Insurance Company, the U.S. Court of Appeals for the Eighth Circuit has determined that the “but-for” causation standard is appropriate for determining whether...
Change-in-Control Severance and Elon Musk: Why You Need a Springing Rabbi … Trust
On August 10th, Elon Musk made national headlines due to a lawsuit that Business Today heralded as “Former Twitter executive sues Elon Musk's X for $20 million in unpaid shares.” The article reports...
IRS Issues Interim Guidance on Matching Contributions Made on Account of Qualified Student Loan Repayments
Starting in 2024, Section 110 of the SECURE 2.0 Act allows employers to make matching contributions to Section 401(k), 403(b) and governmental 457(b) plans, and SIMPLE IRAs (which have analogous but...
Employer Need Not Seek Second Medical Decision for FMLA Request
In Perez v. Barrick Goldstrike Mines, the U.S. Court of Appeals for the Ninth Circuit has ruled that the Family and Medical Leave Act (“FMLA”) does not require an employer to present contrary...
Forfeiture Cases – Update
Last year, we alerted you to the filing of several class action lawsuits alleging that plan fiduciaries violated their duties of prudence and loyalty under Title I of ERISA by applying forfeitures...
Group Health Insurer Need Not Cover Certain Autism Treatments
The U. S. Court of Appeals for the Seventh Circuit, in Hensen v. Group Health Plan Cooperative of South Central Wisconsin, has ruled that the Mental Health Parity and Addiction Equity Act (“MHPAEA”)...
HHS Issues Model HIPAA Attestation Form
The Department of Health and Human Services (“HHS”) has issued a model attestation form for any “Requested Use or Disclosure of Protected Health Information Potentially Related to Reproductive...
A New “One Percent” Tax Issue – Proposed IRS Regulations on the Excise Tax on Stock Repurchases
The Department of the Treasury (“Treasury”) and the Internal Revenue Service (“IRS”), in an April 2024 follow-up to IRS Notice 2023-2, issued proposed regulations dealing with the one-percent excise...
Failure to Follow FMLA Regulations Could Cost Employer
n Mook v. City of Martinsville, the U.S. District Court for the Western District of Virginia has ruled that an employer’s failure to follow the procedure set forth in the Family and Medical Leave...
Retirement Security Rule Stayed
Last week was not a good week for the Department of Labor (“DOL”) in Texas. On July 25, the District Court for the Eastern District of Texas, in a civil action filed by the Federation of Americans...
Father Not Entitled to Prenatal FMLA Leave
In Tanner v. Stryker, the U.S. Court of Appeals for the Eleventh Circuit has ruled that an employee’s parental Family and Medical Leave Act (“FMLA”) rights do not begin until the actual birth of his...
Jury Must Make Factual Determinations in FMLA Lawsuit
In Crispell v. FCA, the U.S. Court of Appeals for the Sixth Circuit determined that a jury must decide whether an employee’s failure to follow her employer’s leave procedures was due to “unusual...
District Court Grants Motion to Dismiss Forfeiture Complaint
Prior to joining the firm,...
Appeals Court Issues Split Ruling on ACA’s Preventive Services Requirements
In Braidwood Management, Inc. v. Becerra, the U.S. Court of Appeals for the Fifth Circuit has issued a “mixed bag” of rulings with regards to the preventive services requirements of the Affordable...
IRS Issues FAQs on Educational Assistance Programs
The IRS has issued a fact sheet (FS-2024-22) to provide Frequently Asked Questions (“FAQs”) regarding educational assistance programs. Background. An educational assistance program is a written...
Employer May Rely on Address Provided by Employee
In Anaya v. Birck, the United States District Court for the Northern District of Illinois ruled that an employer met its COBRA notification requirements even though it did not send a terminated...
Reg S-P Amended Around Cybersecurity
Seth F. Gaudreau concentrates his practice in ERISA...
Transportation Fringe Benefit Contributions May Not Be Reimbursed to Employee
In Information Letter 2024-004, the IRS has reiterated that contributions to a qualified transportation fringe benefits plan may not be reimbursed, even if the employee could not commute because of...
District Court Denies Motion to Dismiss Forfeiture Complaint
Michael Schloss is a highly...
The Rise of Fiduciary Health Plan Litigation
By Stephen Wilkes and Michael Schloss According to CMS, annual health care spending in the United States reached about $4.5 trillion in 2022, 9% of which (about $405 billion) was spent on...
DOL Issues Warnings About the Use of AI in FMLA Administration
The Department of Labor (“DOL”) has issued Field Assistance Bulletin (“FAB”) 2024-1 which contains guidance and warnings on the use of artificial intelligence (“AI”) when administrating various...
DOL Releases Final Rule Revising FLSA Overtime Regulations
By Virginia Peabody (Senior Consultant) and Cassandra White (Paralegal) On April 23, 2024, the Biden administration announced a final rule that impacts overtime protections by increasing...
Important Takeaways For Employers Following The EEOC’s Final Rule Implementing the Pregnant Workers Fairness Act (PWFA)
By Katherine Brustowicz, David Gabor, and Johanna Matloff Introduction This is a follow-up to our May 9, 2023, alert regarding the Pregnant Workers Fairness Act (PWFA) which went into effect on June...
DOL Revokes Association Health Plan Regulations
The Department of Labor (“DOL”) has revoked its Association Health Plan (“AHP”) regulations and expects to replace them with stricter standards that provide additional employee protections....
Department of Labor’s New Investment Advice Fiduciary Rule and Related Exemption Amendments
By Michael Schloss and Stephen Wilkes On April 25, 2024, the Department of Labor’s (DOL) new fiduciary investment advice rule, restyled as the “Retirement Security Rule”, was published in the...
Group Health Plans Must Take Action to Comply with Changes to HIPAA Privacy Rules Designed to Protect Reproductive Healthcare Privacy
By Dannae Delano In further response[i] to the Supreme Court ruling in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade, the U.S. Department of Health and Human Services...
Attention Investment Managers: QPAM Matters for Immediate Review
Seth F. Gaudreau concentrates his practice in ERISA...
Ban on Non-Competition Agreements – What Employers Need to Know and Do Now
Introduction: On April 23, 2024 the U.S. Federal Trade Commission (FTC) approved a proposed final rule which bans new non-competition clauses in employment contracts for most workers across the...
Insurer May Rely on In-House Advisors’ Disability Determination
In Harmon v Unum Life, the U.S. Court of Appeals for the Sixth Circuit has ruled that an insurer may rely on its own medical advisors in denying long term disability (“LTD”) benefits, as long as the...
Notice for Fixed Indemnity Insurance Revised
The Internal Revenue Service, Department of Labor, and Department of Health and Human Services (the “Agencies”) have issued a revised, mandatory notice for fixed indemnity insurance coverage....
Employee Must Provide Adequate Notice of Need for FMLA Leave
The U.S. Court of Appeals for the Fifth Circuit has ruled, in Cerda v. Blue Cube Operations, that an employee was not protected by the Family and Medical Leave Act (“FMLA”) when she never gave the...
Agencies Revise Short-Term Health Insurance Regulations
HHS, DOL and IRS (the “Agencies”) have jointly issued revised final regulations reducing the maximum duration of short-term, limited-duration health insurance (“STLDHI”) coverage. Background. ...
Insurer May Be Liable Under ERISA for Unauthorized Premium Increases
The U.S. Court of Appeals for the First Circuit, in Parameter v. Prudential Insurance and Tufts University, has ruled that an insurer may have breached its fiduciary duty through unauthorized...
Pension Risk Transfers and the Continuing Concern About Buying a Pig in a Poke
By Michael Schloss Pension risk transfers (“PRTs”) continue to make the news. And well they should. Last year alone, over $100 billion in liabilities were transferred from defined benefit pension...
Employer May Be Liable for Misrepresenting Life Insurance Conversion Information
In Watson vs. EMC Corp., the U.S. Court of Appeals for the Tenth Circuit has ruled that an employer may be liable for the amount of life insurance proceeds if the participant failed to convert his...
IRS Warns Companies are Making False Statements About Health Plan Reimbursements
In IR-2024-65 (the “IR”), the IRS warns taxpayers that some companies are misrepresenting the circumstances under which food and wellness expenses can be paid or reimbursed under health flexible...
LTD Plan Must Consider Future Harm from Stress
In Aisenberg v. Reliance Standard Life Ins. Co., the United States District Court for the Eastern District of Virginia has ruled that a long term disability (“LTD”) plan must take into account...
Court Finds Health Plan Not Required to Furnish Administrative Service Agreements in Response to ERISA Document Request
In Zavislak v. Netflix, Inc., the U.S. District Court for the Northern District of California has largely rejected a plaintiff’s assertion that an employer/plan administrator for an ERISA...
Merger and Acquisition Considerations for Employee Benefit Plans
By Seth Gaudreau and Stephen Wilkes In the context of mergers and acquisitions, an acquisition target’s qualified retirement plans, health plans, executive compensation arrangements, and benefit...
IRS Announces Decreased 2025 Employer Shared Responsibility Penalties
In Revenue Procedure 2024-14, the IRS has announced the 2025 penalty rates for violations of the employer shared responsibility provisions of the Affordable Care Act (“ACA”). Background. Under the...
DOL Updates FMLA Fact Sheets
To assist in employer and employee compliance, the Department of Labor (“DOL”) has issued several revised Family and Medical Leave Act (“FMLA”) Fact Sheets, including Fact Sheet 28D: Employer...
Agencies Update Non-English Language Requirements
The Departments of Labor and Health and Human Services, and the IRS (“the Agencies”) have issued Frequently Asked Questions About Affordable Care Act (“ACA”) and Consolidated Appropriations Act,...
California Restricts Non-Compete Agreements
By David Gabor Over the years, California has taken steps to prevent employers from forcing employees to enter into non-compete agreements that limit an employee’s ability to obtain subsequent...
New Fire for Enforcing Forfeiture-for-Competition Provisions
By Mark Poerio and Jordan Mamorsky The enforceability of non-compete provisions continues to be in the national spotlight. In a very recent Delaware Supreme Court decision, Cantor Fitzgerald, L.P....
DOL Announces Indexed Penalties for Health and Welfare Plans
The Department of Labor released a final rule that provides new figures reflecting the adjusted civil penalty amounts for 2024, for certain health and welfare plan violations. The DOL is required...
SEC Matters to Consider in the New Year: 2024 Exam Priorities and Off-Channel Enforcement Actions
Seth F. Gaudreau concentrates his practice in ERISA...
Plan Insurer Held Liable for Failure to Follow Claims Procedures
The U.S. District Court for the District of Utah, in R.E. v. Blue Cross Blue Shield, has ruled that the failure to properly follow ERISA’s claims procedures may result in a reversal of a claims...
State Law Claims Preempted By ERISA
In Steigleman v. Symetra Life, the U.S. District Court for the District of Arizona has ruled that a small business owner could not sue an insurance company under state law for long term disability...
LTD Insurer May Subsequently Reverse Disability Determination
The U.S. District Court for the Southern District of Florida has ruled, in Delucca v. The Guardian Life Insurance Company of America, that a long term disability (“LTD”) plan was not bound by prior...
DOL Proposes Rescission of Association Health Plan Rules
The Department of Labor (“DOL”) has proposed that the Association Health Plan (“AHP”) regulations be revoked and replaced with stricter standards that provide additional employee protections....
Eleventh Circuit Adopts Strict Standard for FMLA Claims
The Eleventh Circuit Court of Appeals, in Lapham v. Walgreen Co., has ruled that the “but for” legal standard applies to Family and Medical Leave Act (“FMLA”) retaliation claims. Law. The FMLA...
Bugielski v. At&T Case Continues With Appellate Reversal
By Michael Schloss and Stephen Wilkes On August 4, 2023, a Ninth Circuit panel reversed a District Court decision in favor of AT&T - holding that AT&T breached its fiduciary duties by,...
Plan Must Consider All “Independent Grounds” for Claims Coverage
The U.S. Court of Appeals for the Tenth Circuit, in Ian C. v. UnitedHealthcare Ins. Co., has ruled that a group health plan violated ERISA’s claims procedures by failing to separately evaluate each...
Longstanding Internal Revenue Service Position Called into Question
By Barry Salkin, Michael Schloss and Mark Greenstein Recently, several class action lawsuits have been filed challenging the permissibility of plan language providing discretion as to how...
2025 ACA Out-of-Pocket Limits
The U.S. Department of Health and Human Services (“HHS”) has announced the proposed maximum out-of-pocket (“OOP”) limits that will apply to non-grandfathered plans for plan years beginning in...
Participant May Sue Plan for Facial Feminization Surgery Coverage
The United States District Court for the Eastern District of Pennsylvania, in Doe v. Independence Blue Cross, declined to dismiss a participant’s lawsuit claiming that a group health plan covered...
SEC Speaks to Importance of Naming Convention
By Seth Gaudreau and Stephen Wilkes SEC Commissioner Crenshaw reminded us last year that, despite the poetic beauty of Shakespeare’s observation that, “A rose by any other name would smell as...
Court Upholds PBGC Denial of Special Financial Assistance to a Terminated Multiemployer Plan
By Israel Goldowitz In March 2021, Congress enacted the American Rescue Plan Act (ARPA), which authorized the Pension Benefit Guaranty Corporation (PBGC) to provide taxpayer-funded special financial...
The SEC Fires All Guns Against a Crypto Platform Plan Fiduciaries Should Take Note
By Kim Shaw Elliott The SEC announced November 20 that it has charged Payward Inc. and Payward Ventures, Inc. (together “Kraken”, an online crypto platform) with a litany of securities registration...
Developments on the ESOP Front
By Jon Schultze, Andrew Oringer and Barry Salkin Employee stock ownership plans (“ESOPs”) are retirement plans that provide employees with the opportunity to own stock of their employer. Congress...
The Retirement Security (Nee Fiduciary) Rule Rides Again
By Michael Schloss, Andrew Oringer, Barry Salkin, John Sohn and Stephen Wilkes Earlier this week, on October 31, 2023, the Department of Labor (the “Department”) rolled out its long anticipated new...
IRS Announces 2024 Cost-of-Living Adjustments Affecting Retirement Plans
By Ari Sonneberg The Internal Revenue Service announced cost-of-living adjustments affecting certain dollar limitations for pension plans and other retirement-related limitations for 2024 in Notice...
Prepare for Upcoming Changes to Defined Contribution Plans Long-Term, Part-Time Employees
The SECURE Act of 2019 (the “2019 Act”) and the SECURE 2.0 Act of 2022 (the “2022 Act”) made many significant changes to retirement plans and how they operate. Several provisions became effective...
IRS Announces PCORI Fee
IRS has released Notice 2023-70, which provides the “applicable dollar amount” for the Patient-Centered Outcomes Research Institute (“ PCORI” ) fee for plan years ending before October 1, 2024....
Massachusetts has Increased its Estate Tax Exemption to $2,000,000
By Regina Snow Mandl Massachusetts has raised the estate tax exemption from $1,000,000 to $2,000,000, retroactively to January 1, 2023. As a result, for decedents dying after 2022 who have a...
CMS Announces Medicare Part A Deductibles and Part B Premiums for 2024
The Centers for Medicare & Medicaid Services (“CMS”) has announced the 2024 premiums, deductibles and coinsurance amounts for the Medicare Part A and Part B programs. Medicare Part A covers...
IRS Issues Notice Providing Relief to Taxpayers Affected by Recent Terroristic Actions Against Israel
By Michael Schloss On October 13, 2023, responding to the terroristic action in the State of Israel that began on October 7, 2023, the Department of the Treasury and the Internal Revenue Service...
IRS Notice on Treatment of Leave-Based Donation Programs
In response to an extreme need for charitable relief by victims of the Hawaiian wildfires that began on August 8, 2023, the IRS has issued Notice 2023-69 (the “Notice”) to provide guidance under the...
Participant May Receive Monetary Damages for Plan’s Failure to Approve Procedure
In Rose v. PSA Airlines, Inc., the Fourth Circuit Court of Appeals ruled that a self-funded group health plan may be sued for monetary damages for failure to approve a medical procedure for a plan...
Court Rules ERISA Preempts Oklahoma Law Regulating PBMs
The U.S. Court of Appeals for the Tenth Circuit, in Pharmaceutical Care Management v. Mulready, has ruled that a state law regulating pharmacy benefit managers (“PBMs”) is preempted by the Employee...
Guidelines for Mental Health and Medical/Surgical Claims Need Not Be Identical
The U S District Court for the District of Utah has ruled, in L.D. v. United HealthCare, that a group health plan does not violate the Mental Health Parity and Addiction Equity Act (“MHPAEA”) if it...
COBRA Notice Need Not Be Single Notification
In deciding Bryant v. Walgreen Co., the U.S. District Court for the Northern District of Illinois addressed several important aspects of the COBRA notification requirements. Law. Employers must...
Highlights of 2023 PBGC Meeting With ABA’s Joint Committee on Employee Benefits
By Harold Ashner and Israel Goldowitz On September 11, 2023, the American Bar Association (“ABA”) posted a summary of the May 3, 2023, meeting between representatives of the Pension Benefit Guaranty...
Claims Denial Overturned for Failure to Follow Claims Procedures
The U.S. Court of Appeals for the Tenth Circuit, in David P. v. United Healthcare Ins. Co., has reversed a group health plan’s benefits claim denial because the plan’s claims administrator failed to...
IRS Delays Roth Catch-up Contribution Change to Defined Contribution Plans
By John Schultze and Barry Salkin One of the changes made by the SECURE 2.0 Act requires that catch-up contributions made by employees with FICA compensation from an employer sponsoring a 401(k),...
HHS Issues Warning About Online Tracking
The Office of Civil Rights (“OCR”) at the U.S. Department of Health and Human Services (“HHS”) and the Federal Trade Commission (“FTC”) have issued a letter, dated July 20, 2023 (the “Letter”),...
IRS Releases ACA Affordability Rates for 2024
The Internal Revenue Service has issued Revenue Procedure 2023-29 to implement the 2024 index adjustments for certain Affordable Care Act (“ACA”) contribution percentages used to determine...
IRS Issues Guidance on Taxation of Restricted Stock Units to Employees Working in United States and Abroad
By Barry Salkin In a global economy, it will frequently be the case that employees of multinational organizations will be employed in both the United States and abroad. In Chief Counsel Advice...
DOL Revises Medicaid/CHIP Model Notice
The Department of Labor (“DOL”) has released a revised Model Notice for employers to use to inform employees about the potential for them to receive state-provided premium assistance subsidies to...
Failure to Follow Claims Regulations Results in De Novo Review
The U.S. District Court for the Southern District of New York, in Rhodes v. First Reliance, has ruled that an insurer’s denial of a long-term disability (“LTD”) claim must be reviewed under the de...
Departments Consider Potential Safe Harbor for Nonquantitative Treatment Limitations under the Mental Health Parity and Addiction Equity Act Regarding Network Adequacy
By Dannae Delano, Roberta Casper Watson and Barry Salkin On July 25, the Departments of Treasury, Labor, and Health and Human Services (the “Departments”) issued proposed regulations and other...
Agencies Issue Proposed Regulations on Mental Health Parity Implementation
HHS, DOL and IRS (collectively, the “Agencies”) have jointly issued proposed regulations to provide guidance on the implementation of the requirements of the Mental Health Parity and Addiction...
CMS Recommends Extension of Special Enrollment for Individuals Losing Medicaid and CHIP
By Roberta Watson, Dannae Delano and Barry Salkin Employers frequently provide group health plan coverage for their employees through pre-tax contributions to a cafeteria plan. Elections under a...
Departments Issue Guidance on No Surprises Act and Limitations on Cost Sharing Under the Affordable Care Act
By Dannae Delano, Roberta Watson and Barry Salkin In FAQ Part 60, the Departments of Health and Human Service, Treasury, and Labor (the “Departments”) addressed limitations on cost sharing under the...
Danger Will Robinson, Esq. – A Cautionary Note to Lawyers Regarding Engagement Letters
Buried in the recent decision in Supercooler Technologies, Inc. v. The Coca Cola Company, No. 6:23-cv-187-CEM-RMN (M.D. Fl. July 17, 2023), is a set of circumstances that amount to a cautionary tale...
Plan Penalized for Failure to Follow Its Own Provisions
In Laake v. Benefits Committee, Western & Southern Financial Group Co., the U.S. Court of Appeals for the Sixth Circuit determined that the de novo standard of review applies where an employer’s...
IRS Issues Transitional Guidance for Required Minimum Distributions
By Jon Schultze and Barry Salkin In response to changes made by the SECURE 2.0 Act of 2022 (SECURE 2.0) to the required minimum distribution (“RMD”) rules of the Internal Revenue Code (the “Code”),...
Departments Propose Regulations on Short-Term Limited Duration Insurance and Indemnity Insurance Excepted Benefits
By Dannae Delano, Roberta Casper Watson and Barry Salkin On July 7, the Departments of Health and Human Services, Labor, and Treasury (the “Departments”) issued proposed regulations modifying the...
Significant Changes Made to IRS Employee Plans Compliance Resolution System
By Dannae Delano, Seth Gaudreau and Barry Salkin The SECURE 2.0 Act of 2022, Division T of Public Law No. 117-328 (“the Act”) includes dozens of provisions that affect retirement plans and...
Reservists Must Receive Paid Administrative Leave Benefits
In Myrick v City of Hoover, the U.S. Court of Appeals for the 11th Circuit has ruled that military reservists must be treated as if they were on paid leave for purposes of the Uniformed Services...
Plan May Exclude Certain Specified Emergency Services
The U.S. Court of Appeals for the Eighth Circuit has ruled, in Shafer v. Zimmerman Transfer, that a group health plan does not have to pay for emergency services specifically excluded by the plan...
IRS Issues HDHP Guidance for End of COVID Emergency Period
In response to the ending of the COVID-19 public health emergency and national emergency, the IRS has issued Notice 2023-37, which modifies its prior guidance on benefits relating to the testing and...
SEC’s Recent Marketing Rule Risk Alert Identifies Additional Areas of Focus During Compliance Examinations
By Seth Gaudreau and Stephen Wilkes On June 8, 2023, the Securities and Exchange Commission’s (“SEC”) Division of Examinations (the “Division”) published a risk alert (the “Risk Alert” - found here)...
IRS Releases Guidance Denying Favorable Tax Treatment to Certain Wellness Program Incentive Payments
IRS has released guidance, in the form of Chief Counsel Memorandum Number: 202323006 (the “Memorandum”), denying favorable tax treatment to wellness incentive program payments provided through...
DOL Provides Guidance About Holidays During FMLA Leave
The Department of Labor (“DOL”) has issued Opinion Letter FMLA 2023-2-A (the “Letter”) to clarify how the amount of leave used is calculated when an employee takes Family and Medical Leave Act...
Massachusetts Division of Insurance Provides Special Enrollment Period for Loss of COBRA Coverage
By Dannae Delano, Barry Salkin and Roberta Casper Watson As we have previously described in client alerts, the end of the National Emergency and the cessation of the outbreak period on July 10,...
Coverage Requirements for COVID-related Services Post-Public Health Emergency
The COVID-19 national emergency (“NE”) and public health emergency (“PHE”) officially ended on April 10 and May 11, 2023, respectively. The end of the emergencies provides group health plan sponsors...
IRS Announces 2024 HSA and HRA Limits
The IRS has announced the 2024 calendar year dollar limits for health savings account (“HSA”) contributions, the minimum deductible amounts and maximum out-of-pocket expenses for high deductible...
Employer Can Select Individuals Who Receive Severance Benefits
The U.S. Court of Appeals for the Seventh Circuit has ruled, in Carlson v. Northrop Grumman Severance Plan, that an employer can use its discretion to individually select which terminated employees...
The DOL Accepts a FAQ-Out and Rolls Over . . . for Now – Appeal of ASA v. DOL Is Abandoned
By Andrew Oringer It was reported yesterday, on May 15, 2023, that the U.S. Department of Labor (the “DOL”) has abandoned its appeal in American Securities Association [“ASA”] v. U.S. Department of...
Claims Appeals Procedures Must be in Formal Plan Documents
In Yates v. Symetra Life Insurance, the U.S. Court of Appeals for the Eighth Circuit has ruled that a life insurance beneficiary need not exhaust a plan’s claims appeals procedures when the plan...
The Pregnant Workers Fairness Act (PWFA): What Employers Need to Know Before Summer 2023
By Katherine Brustowicz and David Gabor Introduction: It has long been the law that Title VII, the Age Discrimination in Employment Act (ADEA), and the Family Medical Leave Act (FMLA) protect...
IRS Chief Counsel Discusses Cafeteria Plan Substantiation Rules
The IRS Office of Chief Counsel has issued Memorandum Number 202317020 (the “Memorandum”) to explain the substantiation rules for claims made under health and dependent care FSAs by means of six...
Government Plan Not Covered by ERISA
In Pue v. New Jersey Transit Authority, the U.S. Court of Appeals for the Third Circuit has dismissed an ERISA-based lawsuit because government plans are not covered by ERISA. Law. ERISA section...
TPA Subject to Nondiscrimination Rules
The Federal District Court for the Western District of Washington has ruled, in C.P. vs. Blue Cross Blue Shield of Illinois, that an insurer acting as a third party administrator (“TPA”) is covered...
Board Resolution Insufficient to Terminate Severance Pay Plan
The U.S. Court of Appeals for the Fourth Circuit has ruled, in Messer v. Bristol Compressors, that a Board of Directors resolution intended to terminate a severance pay plan was insufficient because...
Agencies Issue Guidance Regarding Effect of the End of the COVID-19 Public Health Emergency (PHE) and National Emergency (NE) on Benefits
By Barry Salkin, Dannae Delano and Roberta Casper Watson On January 31, 2020, the Department of Health and Human Services (HHS) declared that a nationwide public health emergency (PHE) had existed...
IRS Issues Guidance on Nonfungible Tokens (“NFTs”) in IRAs and Tax-Qualified Individual Account Plans
By Barry Salkin and Jon Schultze Unlike ERISA, the Internal Revenue Code (“Code”) places almost no restrictions on the manner in which plan assets of individual retirement plans or tax-qualified...
IRS Requires Most Employee Benefit Plans to File Forms Electronically
The IRS has issued final regulations that will require almost all employee benefit plan filings to be made electronically. Background. Generally, Applicable Large Employers are required to file...
IRS Provides Guidance on the Definition of “Medical Expenses”
The IRS has issued a series of Frequently Asked Questions (“FAQs”) to provide guidance as to whether certain costs related to nutrition, wellness, and general health are medical expenses that may be...
IRS Issues Proposed Regulations Regarding Use of Forfeitures in Tax-Qualified Plans
By Jon Schultze and Barry Salkin Some of the IRS regulations dealing with tax-qualified plans predate ERISA and subsequent federal tax legislation, and have become outdated. However, sometimes it...
SECURE Act 2.0 Modification to Controlled Group and Affiliated Service Group Requirements
By Jon Schultze and Barry Salkin One of the less-discussed provisions of the recently enacted SECURE Act 2.0 makes two changes to the “family attribution” rules under Section 414 of the Internal...
Departments Issue Guidance Requiring First Annual “Gag” Attestation by December 31, 2023
By Dannae Delano, Roberta Casper Watson and Barry Salkin The Consolidated Appropriations Act of 2021 (“CAA”) is the most significant compliance challenge for employer health plan sponsors since the...
DOL Distinguishes Between FMLA and ADA Rights With Regards to Required Overtime
The Department of Labor (“DOL”) has issued Opinion Letter FMLA 2023-1-A with regards to employees who have health conditions that prevent them from working more than 40-hours per week. DOL was asked...
FMLA Rights For Employees Who Telework
The Department of Labor (“DOL”), in Field Assistance Bulletin No. 2023-1 (“FAB”), has explained how to apply the eligibility rules under the Family and Medical Leave Act (FMLA) when employees...
Jury Must Determine “Comparability” Under USERRA
The U.S. Court of Appeals for the Ninth Circuit, in Clarkson v. Alaska Airlines, has determined that a jury must decide whether an employer offered “comparable,” non-military, paid leave, and was...
Was the DOL FAQed Out and Rolled Over? Second Court Rejects DOL’s Interpretation of ERISA’s Fiduciary Rule
By Andrew Oringer Two recent federal courts, in Carfora v. TIAA, No. 1:21-cv-08384 (S.D.N.Y. Sept. 27, 2022) and American Securities Association [“ASA”] v. U.S. Department of Labor, No....
DOL Announces Indexed Penalties for Health and Welfare Plans
The Department of Labor (“DOL”) has announced the inflation-adjusted penalties for certain health and welfare plan violations. The new amounts are effective for penalties assessed after January 15,...
Who’s Liable When a Plan Participant is a Victim of Identity Theft
By Jordan Mamorsky and Barry Salkin Because of the scarcity of case law and regulatory guidance on the issues, any case that analyzes the liability of ERISA plan sponsors and service providers...
Only One Notice Required for Intermittent FMLA Leave
The U.S. Court of Appeals for the Sixth Circuit, in Render, v. FCA US, LLC, has ruled that only one FMLA-qualified notice is required from an employee for intermittent FMLA leave. Law. The FMLA...
Proposed IRS Regulations Would Make Permanent the Availability of Remote Spousal Consent Elections
By Barry Salkin Longstanding Internal Revenue Service (“IRS”) regulations with respect to spousal consent to a waiver of benefits require an election to be witnessed in the physical presence of a...
2024 ACA Out-of-Pocket Limits
The U.S. Department of Health and Human Services (HHS) has announced the inflation-adjusted maximum out-of-pocket (OOP) limits that will apply to non-grandfathered plans for plan years beginning in...
Congress Enacts Respect for Marriage Act
By, Barry Salkin, Roberta Watson and Jon Schultze n the ordinary course, we would not be advising clients that a statute that a Supreme Court held unconstitutional nine years ago was being removed...
ERISA Group Health Plan’s Self-Help Provision is Enforceable
The Ninth Circuit Court of Appeals, in Mull v. Motion Picture Industry Health Plan; Board of Directors of Motion Picture Industry Health Plan, has determined that an ERISA-covered group health plan...
DOL Rule Permits Consideration of Climate and ESG Factors and Codifies Proxy Voting Responsibilities
By Stephen Wilkes, Izzy Goldowitz and John Sohn On November 22, 2022, the Department of Labor (“DOL”) issued a final rule modernizing and revising the long-standing Investment Duties Regulation....
Secure Act 2.0 Brings a Litany of Retirement Changes
By Roberta Watson, Barry Salkin and Alex Olsen The SECURE Act 2.0 of 2022 (“SECURE 2.0”, or the “Act”) became law as part of the Consolidated Appropriations Act of 2023. SECURE 2.0 builds on the...
IRS Publishes Registered Apprenticeship Guidance
By Stephen Wilkes and Seth Gaudreau On November 30, 2022, the Internal Revenue Service (“IRS”) and the Department of the Treasury (“Treasury”) published Notice 2022-61 (the “Notice”) in the Federal...
Federal Agencies Issue Group Health Plan Guidance
By Roberta Watson, Barry Salkin and Dannae Delano On December 23, 2022, new guidance applicable to group health plans was issued by federal agencies, as described more fully below. The Center for...
IRS Finalizes Delayed Effective Dates for ACA Filing Requirements
In past years, the IRS has extended the deadlines for employer and group health plan Affordable Care Act (“ACA”) reporting. In lieu of the deadline extensions, the IRS has now issued final...
Trade Association’s Insurance Program Not Covered by ERISA
Ninth Circuit Court of Appeals has ruled, in Steigleman vs. Symetra Life, that neither an employer nor its trade association created an ERISA-covered plan merely because the employer paid for long...
Pre-existing Condition Exclusion Enforceable Despite Employer Misrepresentation
The Fifth Circuit Court of Appeals, in Bunner v. Dearborn Nat’l Life Ins. Co., has held that a disability insurer properly denied a claim for long-term disability (“LTD”) benefits based on the...
Plan Administrators May Not Adopt Rationales for Benefit Denials Not Raised During the Claims Review Process
The Ninth Circuit Court of Appeals, in Collier v. Lincoln Life Assurance Co. of Boston, has held that when a district court engages in a de novo review of an ERISA plan administrator’s denial of...
DOL “Clarifies” Guidance on the Bonding Requirements to PEPS and Their Pooled Plan Providers
By Stephen Wilkes, Seth Gaudreau and Susan Rees A recent Information Letter from Eric Berger, Chief, Division of Coverage, Reporting and Disclosure, in the Office of Regulations and Interpretations...
IRS Announces Increase in PCORI Fee
The IRS has released Notice 2022-59 to announce the “applicable dollar amount” for the Patient-Centered Outcomes Research Institute (“PCORI”) fee for plan years ending before October 1, 2023....
Department of Labor Proposes Updates to the Voluntary Fiduciary Correction Program
In 2002, the Employee Benefits Security Administration (“EBSA”) of the Department of Labor (“DOL”) established the Voluntary Fiduciary Correction Program (“VFCP”), a free program designed to...
IRS Announces Expansion of Change in Status Rules for Cafeteria Plans
One of the basic rules under which cafeteria plans operate is that elections are irrevocable except in certain limited circumstances. Further, even when those limited circumstances apply, the change...
The Wagner Law Group Signs Letter to Congress on Crucial HSA Issue
During the pandemic, Congress allowed telehealth services to be provided to HSA-eligible individuals without cost-sharing and without regard to whether they had met their deductibles under their...
IRS to Permit Determination Letters in Limited Circumstances for Individually Designed Code Section 403(b) Plans
Historically, an important element of compliance for tax-qualified plans under Code Section 401(a) or 403(a) was the submission of a request for a favorable determination letter on the form of the...
New IRS Regulations Resolve “Family Glitch” Issue
The IRS has issued final regulations amending the Affordable Care Act (“ACA”) rules regarding eligibility for the law’s premium tax credit (“PTC”). The new rules provide that the “affordability” of...
Despite TPA’s Contractual Obligation, Employer May Still Be Liable for COBRA Notice Violation
An Alabama district court, in Howard v. Ivy Creek of Tallapoosa, LLC, has held that an employer could not avoid liability for failing to provide a COBRA election notice to a plan participant at the...
Independent Review Prevents “Cat’s Paw” Liability in FMLA Retaliation Claim
The Tenth Circuit Court of Appeals, in Parker v. United Airlines, Inc., has held that the “cat’s paw” theory of liability for FMLA retaliation or interference claims does not apply if the employer...
IRS Releases 2023 Welfare Benefit Plan Limits
The IRS has released Revenue Procedure 2022-38, which sets forth the 2023 inflation-adjusted limits for certain employee welfare benefit plans and the dollar amounts used for certain discrimination...
IRS Issues Important Guidance with respect to Required Minimum Distribution Regulations
By Jon Schultze and Barry Salkin The SECURE Act made significant revisions to the required minimum distribution rules under Internal Revenue Code (“Code”) Section 401(a)(9) that apply to defined...
Agencies Request for Comments on Issues Related to New Disclosures Under the No Surprises Act Indicate the Importance of Informing Marginalized Populations and Maintaining Privacy of Advance Health Care Information
By Roberta Casper Watson, Dannae Delano and Barry Salkin It should come as no surprise that most Americans do not have the information available to them that is necessary to make informed decisions...
IRS Announces 2023 Cost-of-Living Adjustments Affecting Retirement Plans
By Ari Sonneberg The Internal Revenue Service announced cost-of-living adjustments affecting certain dollar limitations for pension plans and other retirement-related limitations for 2023 in Notice...
Court Finds Employer’s Evidence of COBRA Notice Mailing Procedures Insufficient
An Illinois federal district court, in Earl v. Jewel Food Stores, Inc., has concluded that an employer failed to show it made a good faith effort to provide a COBRA election notice to a terminated...
Insurer Must Make “Reasonably Proximate” Coverage Determinations
The U.S. Court of Appeals for the First Circuit has ruled, in Shields v. United of Omaha, that an insurer must make a coverage determination for a plan participant within a reasonable period of time...
Court Defers to Insurer’s Discretionary Authority
The Eleventh Circuit Court of Appeals, in Stewart v. Hartford Life & Accident Insurance Company, has upheld a lower court’s decision to deny a plaintiff’s appeal for long-term disability (“LTD”)...
Ninth Circuit Requires Lower Court to Consider New Evidence in LTD Suit
The Ninth Circuit Court of Appeals, in Kay v. Hartford Life and Accident Insurance Company, has reversed a lower court’s decision upholding an insurer’s termination of long-term disability (“LTD”)...
Federal Court Finds Key Part of ACA’s Preventive Service Mandate Unconstitutional
A Texas federal district court, in Braidwood Management, Inc. v. Becerra, has held that the Affordable Care Act’s (“ACA’s”) requirement that most group health plans and health insurers cover certain...
Department of Labor Updates Guidance on Independence of Qualified Plan Accountants
Plan sponsors of large employee benefit pension plans are familiar with the requirement of audited financial statements for annual reporting purposes. That requirement is discussed in the DOL’s...
“Probate Exception” Precludes Federal Jurisdiction over ERISA Lawsuit
The Sixth Circuit Court of Appeals, in American Electric Power Service Corporation v. John K. Fitch et al., has affirmed a district court’s dismissal of a group health plan’s ERISA action seeking...
Pay for Performance 2022: From Disclosure to Execution … to Retention
By Mark Poerio Tight labor markets tend to sharpen loyalty issues, as employers compete for an edge by which to retain — and motivate — their key employees. It does not take rocket science to defuse...
ERISA Lawsuit Time-Barred Due to Plan’s Limitations Period
The Eleventh Circuit Court of Appeals, in Bakos v. Unum Life Insurance Company of America, has upheld the dismissal of a lawsuit for wrongful denial of long-term disability (“LTD”) benefits because...
No Surprises in Agencies’ Reproposal of Independent Dispute Resolution Regulations on No Surprise Act Billing Arbitration
By Danae Delano, Roberta Watson and Barry Salkin Last November, we published a law alert regarding the first two rounds of regulatory guidance on the No Surprise Billing portion of the Consolidated...
SEC Provides Further Guidance in its Staff Bulletin: Standards of Conduct for Broker-Dealers and Investment Advisers Conflict of Interest
By Stephen Wilkes and Seth Gaudreau The U.S. Securities and Exchange Commission (“SEC”) recently published a Staff Bulletin (the “Bulletin”) providing further fiduciary standards guidance for...
Court Finds Employee-Paid LTD Policy Was Part of Employer’s ERISA Plan
A federal district court in the Middle District of Tennessee has held, in Insurance Company of America, that a long-term disability (“LTD”) policy offered under an employer’s group health plan was...
Inflation Reduction Act’s Impact on Group Health Plans
On August 16, 2022, President Biden signed into law the Inflation Reduction Act (“IRA”). The new legislation contains several provisions impacting group health plans. Below is a description of...
IRS Releases ACA Affordability Rates for 2023
The Internal Revenue Service has issued Revenue Procedure 2022-34 to implement the 2023 index adjustments for certain Affordable Care Act (“ACA”) contribution percentages used to determine...
Department of Labor (“DOL”) Proposes to “Update” QPAM Exemption
One of the most frequently used of the prohibited transaction class exemptions is Prohibited Transaction Class Exemption 84-14, which provides an exemption for Qualified Plan Asset Managers (the...
Agencies Issue Guidance on Contraception Coverage Requirements
The Department of Labor, Department of Health and Human Services, and the IRS (the “Agencies” ) have issued Frequently Asked Questions 54 (“FAQs”) regarding the contraception coverage requirements...
Employer Cannot Terminate Employee’s Vested Retiree Life Insurance Benefits
The U.S. Court of Appeals for the Fourth Circuit, in Bellon v. The PPG Employee Life, has ruled that an employer cannot terminate retiree life insurance coverage of employees for whom it had...
Wage and Hour Updates for Maine, New York, and New York City
By Katherine Brustowicz, David Gabor, Virginia Peabody I. Maine – Mandatory Vacation Payout Upon Separation from Employment Maine will follow Massachusetts’ lead in implementing mandatory vacation...
Multiemployer Plan Developments: PBGC Final Rule on Special Financial Assistance and Withdrawal Liability Actuarial Assumptions Litigation
By Dannae Delano and Israel Goldowitz On July 8, 2022, the Pension Benefit Guaranty Corporation (“PBGC”) issued its Final Rule (the “Final Rule”) implementing the American Rescue Plan Act of 2021...
ERISA World Awaits Next EBSA Move on Proposed Restrictions on the Prohibited Transaction Exemptions Process
It has been almost four months since the Employee Benefit Security Administration (EBSA) of the Department of Labor (“DOL”) published its proposed amendments to regulations for the procedures by...
HHS Issues Guidance on HIPAA Protections
In response to the Supreme Court ruling in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade, the U.S. Department of Health and Human Services (“HHS”) has issued new HIPAA...
IRS Announces Decreases in ACA Affordability Threshold and Increases in ACA Employer Shared Responsibility Penalties for 2022 Plan Years
The IRS has recently updated its Questions and Answers on Employer Shared Responsibility Provisions under the Affordable Care Act to reflect 2022 indexing adjustments for the ACA’s affordability...
Employer Responses to Overturning of Roe v. Wade
Many employers are considering how to respond to the recent ruling overturning Roe v. Wade, which has given states the leeway to outlaw abortion. Employers may have employees who are on either side...
Delay in Final Claims Appeal Determination Excuses Claimant from ERISA’s Exhaustion of Administrative Remedies Requirement
The Second Circuit Court of Appeals, in McQuillin v. Hartford Life & Accident Ins. Co., has ruled that a claimant exhausted his plan’s administrative remedies and was, therefore, entitled to sue...
Plan’s Lawsuit Deadline Not Enforceable Unless Communicated in Final Claims Denial
In two recent cases, a judge in the United States District Court for the District of Utah has ruled that, if an ERISA welfare benefit plan sets a time limit on when a claimant may file a civil...
Required Minimum Distribution Modifications Applicable to Defined Benefit Plans as Well
While most of the attention was on how the IRS’s proposed regulation would address tax-qualified defined contribution plans and IRAs, the IRS also took the opportunity to update the existing...
Employer Can Interfere with FMLA Rights Without Denying FMLA Leave
The United States Court of Appeals for the Seventh Circuit, in Ziccarelli vs. Dart, has ruled that an employer need not deny FMLA leave to an employee in order to interfere with his FMLA rights....
IRS Announces New Pre-Audit Compliance Pilot Program
Last week, the IRS announced via newsletter a new pre-audit compliance opportunity for employer-sponsored retirement plans selected for audit beginning immediately (the “Pilot Program”). Under the...
Interaction Between FMLA and Mental Health Conditions
The Department of Labor (“DOL”) has released Fact Sheet 280 (“Fact Sheet”) and a series of FAQs with regards to the interplay between the FMLA and mental health conditions. Law. Under the FMLA,...
IRS Provides Guidance on Leave-Based Donation Programs for Ukraine
The IRS has issued Notice 2022-28 (the “Notice”) to explain the tax treatment of employer leave-based donation programs to aid the people of Ukraine. The Notice begins by stating that the “invasion...
Small Employer Did Not Commit Itself to FMLA Leave Requirements
In Jones v. Wireless Time of Alabama, the U.S. District Court, Southern District of Alabama ruled that an employee was not entitled to FMLA leave despite the fact that her employer referred to the...
Insurer Breached Fiduciary Duty to Maintain Effective Benefit Enrollment System
The Eighth Circuit Court of Appeals, in Skelton v. Radisson Hotel Bloomington, has upheld a district court’s decision that an insurer acted as a fiduciary in determining eligibility and conducting...
Are Brokerage Windows an Effective Way of Limiting Fiduciary Risk After Hughes v. Northwestern?
In Hughes v. Northwestern University, 142 S.Ct. 737 (January 24, 2022), the Supreme Court held that fiduciaries to self-directed defined contribution retirement savings plans are responsible for...
IRS Announces 2023 Limits for HSAs, HDHPs and Excepted Benefit HRAs
The IRS has announced the cost-of living adjustments to the applicable dollar limits for health savings accounts (“HSAs”), high deductible health plans (“HDHPs”) and excepted benefit health...
Employers Act as Fiduciaries When Managing Premium Payments for Benefit Plan
The Sixth Circuit Court of Appeals, in Chelf v. Prudential Insurance Company of America, has determined that a district court erred in dismissing a claim for breach of fiduciary duty based on...
Longstanding IRS Administrative Practice Invalidated
When agencies take controversial regulatory actions, it can be anticipated that those actions will be challenged in federal district courts as soon as they become operative, if not before. In other...
IRS Proposes Change in Eligibility Provisions for ACA Premium Tax Credit
The IRS has issued a proposal that would amend the existing Affordable Care Act (“ACA”) regulations regarding eligibility for the law’s premium tax credit (“PTC”) to provide that the affordability...
IRS Issues Proposed Regulations for Required Minimum Distributions Under the SECURE Act
The SECURE Act (the “Act”) made two major changes to the required minimum distribution rules under Internal Revenue Code (“Code”) Section 401(a)(9): it extended the required beginning date for...
IRS Issues Proposed Regulation to Give SECURE Act MEPS “Bad Apple” Relief
On March 28, 2022, the IRS issued a notice of proposed rulemaking to add a new section - 26 CFR section 1.413-3 Special Rules for Section 413(e) Plans - to the Code of Federal Regulations (CFR). 87...
HHS Increases Civil Monetary Penalties for Certain HIPAA and ACA Violations
The Department of Health and Human Services (“HHS”) has published updated civil penalties. The new penalty amounts, which became effective March 17, 2022, apply to violations occurring on or after...
Massachusetts, Pennsylvania and New Jersey Taxpayers Beware
Massachusetts, Pennsylvania and New Jersey Taxpayers Beware: Don’t Let a Mismatch between Your State’s Tax Laws and the Federal Rules for Deducting Contributions Result in Overpaying Your State Tax...
Firing After FMLA Leave Did Not Violate FMLA
The Seventh Circuit Court of Appeals, in Anderson v. Nations Lending Corporation, has ruled that an employer’s decision to terminate an employee after returning from FMLA leave did not violate the...
Ninth Circuit Finds Welfare Plan Did Not Abuse Its Discretion In Denying Benefits
The Ninth Circuit Court of Appeals, in Alves v. Hewlett-Packard Comprehensive Benefits Plan, has found that a welfare benefit plan’s claims administrator did not abuse its discretion in denying a...
President Continues COVID Extensions
Reasoning that “the COVID-19 pandemic continues to cause significant risk to the public health and safety of the Nation,” President Biden has extended the COVID-19 National Emergency, which was...
Employer’s Recertification Requirement Doesn’t Interfere with Employee’s FMLA Rights
The U.S. Court of Appeals for the Eighth Circuit, in Whittington v. Tyson Foods, Inc., has concluded that an employer may require recertification of an employee’s need for leave under the Family and...
Mandatory Arbitration Prohibited for Sexual Harassment Claims
On February 7, 2022, the House passed H.R. 4445, three days later the Senate also passed the measure, and President Biden has just signed the bill into law. H.R. 4445, titled Ending Forced...
IRS Releases Revised Guidance on Medical and Dependent Care Expenses
The IRS has released the 2021 editions of Publication 502, “Medical and Dental Expenses” and Publication 503, “Child and Dependent Care Expenses.” Publication 502 (“Pub. 502”). Pub. 502 defines...
409A Checklist for Employment Agreements
It has been over 15 years since Congress enacted Internal Revenue Code §409A, and compliance has become generally routine for traditional deferred compensation and other non-qualified plans. Most...
Employer Must Provide Retroactive Coverage and Pay Penalties for COBRA Election Notice Violations
The U.S. District Court of Michigan, in Buford v. General Motors, L.L.C., has concluded that an employer’s conduct violated COBRA election notice requirements and warranted the imposition of...
FMLA-Eligible Employee May Be Terminated for Violating Employer’s Leave Policy
In Koch v. Thames Healthcare Group, the United States Court of Appeals for the Sixth Circuit has ruled that an employee may be terminated for violating her employer’s leave policy despite the fact...
DOL “Clarifies” Guidance on Private Equity Investments In Defined Contribution Plans
It has been a frequently stated observation that the policy position of the Department of Labor (“DOL”) on pension issues may vary a bit with the party occupying the White House. A recently issued...
Tax Court Rejects Aggressive IRA Strategy
View Printable PDF In recent years, the IRS has paid increased attention to what it regards as impermissible uses or operation of individual retirement accounts (“IRAs”). The recent Tax Court case...
Insurer Cannot Terminate LTD Benefits Without Additional Information
The United States Court of Appeals for the Eighth Circuit has determined, in Roehr v. Sun Life Assurance Co. of Canada, that long term disability (“LTD”) benefits cannot be terminated by an insurer...
SEC Expects to Focus on Cybersecurity in 2022
The U.S. Securities and Exchange Commission (“SEC”) has focused on cybersecurity under the Biden administration and it is expected to be one of its top priorities for the coming year. The SEC’s...
SEC Extracts $96M Settlement from TIAA Subsidiary for Rollover Practices – This is Only the Beginning
The Securities and Exchange Commission (“SEC”) beat the Department of Labor (“DOL”) to the punch and announced a major settlement with a broker dealer arising from its rollover practices. In what is...
Rabbi Trusts – When to ask. What to get.
By Mark Poerio A recent Law360 headline brought rabbi trusts immediately to mind. It reads "Ex-Manufacturing Co. CEO Says He's Owed $4.4M in Benefits" (4/10/2019).* Litigation sprung because the...