ERISA & Employee Benefits

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...

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...

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...

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...

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...

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...

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...

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,...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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”)....

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...

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...

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...

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...

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...

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...

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...

The U.S. District Court for the Southern District of New York, in Fisher v. Aetna Life Ins. Co., has upheld its prior determination that a beneficiary was required to meet the ACA’s family...

The U.S. Court of Appeals for the Eighth Circuit has ruled, in McIntyre v. Reliance Standard Life, that a claims decision will be judged under the arbitrary and capricious standard despite the fact...

The IRS has issued Notice 2020-76, which provides an automatic deadline extension for Applicable Large Employers’ (“ALE”) reporting obligations to employees under the Affordable Care Act’s (“ACA”)...

The Tenth Circuit Court of Appeals has ruled, in Lyn M. v. Premera Blue Cross, that the “arbitrary and capricious” standard cannot be applied to a plan administrator’s denial of a participant’s...

The Second Circuit Court of Appeals, in Sullivan-Mestecky v. Verizon Communications, Inc., has held that a plaintiff properly pled her breach of fiduciary duty claim for equitable relief against an...

By  Dannae Delano, Barry Salkin and Roberta Casper Watson On August 3, 2020, the District Court for the Southern District of New York ruled that four parts of the temporary rules adopted by the DOL...

The Department of Labor (“DOL”) has issued additional Frequently Asked Questions (“FAQs”) on the administration of Emergency Paid Sick Leave under the Families First Coronavirus Response Act...

The Massachusetts Department of Family and Medical Leave has announced that the “annual” payroll tax exemptions received by employers for insured plans under the Paid Family and Medical Leave Law...

The Ninth Circuit Court of Appeals has held, in Castillo v. Metropolitan Life Ins. Co.,  that ERISA does not authorize an award of attorney’s fees incurred during the administrative phase of the...

The U.S. Department of Labor (“DOL”) has released updated Family and Medical Leave Act (“FMLA”) forms. Background. Certain posters and forms are required under the FMLA to inform employees of their...

By Dannae Delano, Barry Salkin and Roberta Casper Watson The federal District Court for the Southern District of New York invalidated parts of  the DOL’s final rules implementing the paid leave...

In Private Letter Ruling 202023001, the IRS has ruled that collectively bargained employees can allocate employer contributions between a profit sharing plan and a health reimbursement arrangement...

The Internal Revenue Service has issued Revenue Procedure 2020-36 to implement the 2021 index adjustments for certain Affordable Care Act (“ACA”) contribution percentages used to determine...

The Department of Labor (“DOL”) has issued additional Frequently Asked Questions (“FAQs”) on the administration of Emergency Paid Sick Leave (“EPSL”) and Emergency Family and Medical Leave (“EFMLA”)...

The Department of Labor, Department of Health and Human Services (“HHS”), and the IRS (collectively, the “Agencies”) have issued proposed regulations that would provide greater flexibility for plan...

The Department of Labor (“DOL”) has issued Field Assistance Bulletin No. 2020-4 ("FAB 2020-4") to provide guidance on when an employee may take paid leave under the Families First Coronavirus...

The Department of Labor, Department of Health and Human Services, and the IRS (the “Agencies”) have issued Frequently Asked Questions #43 (“FAQs”) regarding implementation of the Families First...

The Department of Health and Human Services (“HHS”) announced on June 12, 2020, as part of a new final regulation (the “Final Rule”), that it had eliminated Obama-era nondiscrimination rules under...

Although the penalties under the Affordable Care Act’s individual mandate were eliminated in 2017, Massachusetts has continued its own individual health insurance mandate as well as associated...

The IRS has issued Notice 2020-46 to explain the tax consequences of employer-based COVID-19 leave donation programs. Background. The IRS recognized that, in response to the need to provide relief...

HHS and IRS have announced inflation-adjusted out-of-pocket (“OOP”) limits that will apply to non-grandfathered health plans for plan years beginning in 2021, and the indexed PCORI fee. The OOP...

The DOL and IRS have issued COVID-19 related guidance that temporarily extends certain deadlines applicable to welfare plans and their participants and beneficiaries. COVID-19 Related Guidance. In...

The IRS has announced the 2021 calendar year dollar limits for health savings account (“HSA”) contributions, and the minimum deductible amounts and maximum out-of-pocket expenses for high deductible...

The IRS, in Notice 2020-29, has relaxed the mid-year election change rules for cafeteria plans due to the nature of the public health emergency imposed by COVID-19, extended grace and carryover...

The Department of Labor (“DOL”) has issued updated versions of its model general notice and model election notice to ensure that qualified beneficiaries better understand the...

In coordination, the Department of Labor, the Department of Health and Human Services, and the Internal Revenue Service (collectively, the “Agencies”) have extended deadlines for multiple events...

The IRS has issued Notice 2020-23 to provide employers, employees and retirement plan service providers with relief from business disruptions from the COVID-19 pandemic. Notice 2020-23 automatically...

The Department of Labor (“DOL”) has issued additional FAQs that provide further guidance for employers and employees on the administration of the Emergency Paid Sick Leave (“EPSL”) Act and the...

HHS, DOL and IRS (the "Agencies") have jointly issued FAQ 42 to provide guidance on the implementation of the COVID-19 coverage requirements of the Families First Coronavirus Response Act ("FFCRA")...

The IRS has issued guidance for employers with under 500 employees explaining how to claim a tax credit for emergency paid sick leave ("EPSL") and expanded FMLA ("EFMLA") under the Families First...

The DOL has issued a series of FAQs that provide guidance for employers administering the Emergency Paid Sick Leave ("ESPL") and the Emergency Family and Medical Leave Act ("EFMLA") under the...

The IRS has issued Notice 2020-15 permitting High Deductible Health Plans ("HDHPs") to cover testing and treatment for COVID-19, without affecting the status of a person as an "eligible individual"...

By Roberta Casper Watson and Barry Salkin Last June, in Executive Order 13877, President Trump directed HHS, Treasury, and Labor (collectively, the “Agencies”) to solicit comments on how providers,...