Health & Welfare

The Wagner Law Group

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 (“AD&D”) plan.

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 employees who take military leave when the employer provides paid leave for various other forms of leave.

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”).

IRS Sheds Some Clarity on COBRA Premium Assistance

By Dannae Delano, Barry Salkin and Roberta Watson

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 participant’s disability began before its insurance policy was effective. 

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 discretionary authority when reviewing claims against 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 health plans (“HDHPs”) and the HRA excepted benefit limit. By law, these limits are indexed annually to adjust for inflation. 

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 retain their group health plans’ “grandfathered” status under the Affordable Care Act (“ACA”).  The final regulations are substantially unchanged from the earlier proposed regulations.

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 (“FFCRA”).