Health & Welfare

Plans Cannot Prevent Participant from Appointing an Authorized Representative

In a letter dated February 27, 2019, the Department of Labor ("DOL") has reiterated that an ERISA-covered plan cannot prevent a plan participant from appointing an authorized representative for initial claims and for claims appeals. DOL regulations expressly give participants and beneficiaries the right to appoint authorized representatives to act on their behalf in connection with an initial ...

Firing After Leave Request Denial May Be FMLA Violation

The United States District Court for the Southern District of Texas, in Byrd v. City of Houston, has determined that a plaintiff-employee's Family and Medical Leave Act ("FMLA") claim should be allowed to proceed where the defendant-employer first approved and then subsequently denied the employee's FMLA leave request and then fired her for excessive absences. Background. The plaintiff requested ...

DOL Guidance on ERISA Preemption

The United States Department of Labor ("DOL") has issued an Information Letter confirming that state laws requiring employers to obtain written consent before withholding amounts from employees' wages for benefit plan contributions are preempted by ERISA. Background. The DOL has previously issued guidance (i.e., Advisory Opinion 2008-02A) that ERISA preempted state laws that attempt to govern ...

IRS Provides Additional Examples Where Employers May Recover HSA Contributions

The IRS has issued Information Letter 2018-0033, which provides details on certain situations that allow an employer to request the return of Health Savings Account ("HSA") contributions it made on behalf of its employees. Information Letter 2018-0033 expands upon the previous guidance regarding the recovery of HSA contributions found in IRS Notice 2008-59. Background. IRS Notice 2008-59 ...

Proposed Regulations Implementing Massachusetts' Paid Family and Medical Leave Law

The Massachusetts Department of Family and Medical Leave (the "Department") has released proposed regulations explaining the rights and responsibilities of employers and employees under Massachusetts Paid Family and Medical Leave Law (the "Law"). The Law requires most private employers in Massachusetts to provide covered individuals with paid family and medical leave funded through a payroll tax ...

Employer Allowed to Deny Employee Pay Differential Due to FMLA-Related Absences

The United States District Court for the Eastern District of Arkansas, in Flowers v. McCartney, has determined that an employer did not violate the Family and Medical Leave Act ("FMLA") when it discontinued an employee's weekend pay differential due to FMLA-related absences. Background. The employer offered a 30 percent pay differential to its employees who worked weekend shifts and did not miss ...

Court Rejects Third-Party Administrator's Cross-Plan Offsetting Practice

The Eighth Circuit Court of Appeals, in Peterson v. UnitedHealth Group Inc., has upheld a district court's decision that a third-party administrator ("TPA") cannot engage in cross-plan offsetting to recover overpayments. Background. Group health plans typically have both in-network and out-of-network providers. In administering group health plans, TPAs sometimes overpay service providers. For ...

FMLA Leave Cannot be Assessed if Employee Not Required to Report to Work

The U.S. District Court for the District of Alaska, in Acosta v. State of Alaska, has held that an employer could not count the time that a rotational employee was not scheduled to work as part of his leave entitlement under the Family and Medical Leave Act ("FMLA").

Guidance on Parking Expenses as Qualified Transportation Fringe Benefits

The IRS has released Notice 2018-99 to provide guidance to taxpayers on determining the amount of parking expenses for qualified transportation fringe benefits that is nondeductible and/or subject to unrelated business Income Tax ("UBIT"). Notice 2018-99 comes in the wake of the Tax Cuts and Jobs Act of 2017 (the "Act") which revised the law concerning deductions for expenses related to qualified ...

Insurer's Acceptance of LTD Insurance Premiums Does Not Guarantee Coverage

A federal district court has ruled, in Ward v. Aetna Life Insurance Company, that a long-term disability ("LTD") insurer's denial of the plaintiff's benefit claim was appropriate even though the plaintiff had paid the required premiums and was told in writing that he had coverage. Background. The plaintiff's employer contracted with the defendant insurer to provide its employees LTD coverage ...